Providing Community-Based Care by the State Depends on the Resources Available As Well As the Ability to Mete Out These Services Equitably

In Olmstead v. L. C. ex rel. Zimring (527 U.S. 581, 119 S. Ct. 2176, 144 L. Ed. 2d 540 [1999]), the United States Supreme Court addressed the issue of what constitutes a fundamental alteration of a service or program. The Court rejected the Circuit Court of Appeals' construction of the reasonable-modification regulation. The Court of Appeals would have required the District Court to assess the reasonableness of each mental health care recipient's request when measured against the entire mental health budget of the State. The Supreme Court concluded that this standard is too restrictive of a state's ability to maintain a range of services and to administer services with an even hand. Instead, the Supreme Court stated the standard as follows: In evaluating a State's fundamental-alteration defense, the District Court must consider, in view of the resources available to the State, not only the cost of providing community-based care to the litigants, but also the range of services the State provides others with mental disabilities, and the State's obligation to mete out those services equitably. Olmstead v. L. C. ex rel. Zimring, 119 S. Ct. at 2185. The focus is, therefore, not only on the impact on the State's budget of providing the services, but also on the competing demands of others requiring services and the State's available resources. Id.; Rolland v. Cellucci, 191 F.R.D. 3, 15, 2000 WL 60927, (D Mass 2000).