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Trump Administration Continues to Water Down ADA Title II Protections for Disabled Americans to Receive Health Care in the Most Integrated Community Setting

By PWDF Staff

On June 18, 2026, the U.S. Department of Justice (DOJ) released a memo, which concluded that states may disregard decades of legal precedence and regulatory guidance that ensure integration of people with disabilities into their homes and communities.

In short, the DOJ questions the legitimacy of Title II of the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. § 12131 et seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; and the U.S. Supreme Court’s decision in Olmstead v. L.C., 527 U.S.  581 (1999), which affirmed the Eleventh Circuit and articulated defenses under Title II, which mandates that states are required to treat mentally disabled patients in the most integrated community setting.

Specifically, DOJ  states:

“In prohibiting discrimination on the basis of disability, neither section 504 of the Rehabilitation Act nor Title II of the Americans with Disabilities Act (“ADA”) imposed an integration mandate on states in their treatment of mentally disabled individuals. Nor does either statute authorize the responsible Executive Branch agencies to impose such a mandate.

“A statutory mandate that states treat mentally disabled patients in maximally integrated settings would raise serious questions regarding the scope of Congress’s power under the Fourteenth Amendment, the Interstate Commerce Clause, and the Spending Clause.

“In Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581 (1999), the Supreme Court did not hold that section 504 of the Rehabilitation Act or Title II of the ADA require states to treat mentally disabled patients in the most integrated setting appropriate to their needs.”

PWDF finds it regrettable that our nation’s chief law enforcement agency would position these protections in such a false light. We believe our colleagues at the American Bar Association, in a July 1, 2026, article[1], provided a clear, logical and convincing response to the DOJ. We are reprinting it here in its entirety:

July 1, 2026

“Narrowing Olmstead: A Response to the OLC’s June 2026 Memorandum

On June 18, 2026, the U.S. Department of Justice’s (DOJ) Office of Legal Counsel (OLC) issued a memorandum reinterpreting the scope of the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, and the U.S. Supreme Court’s 1999 decision in Olmstead v. L.C. The memo concludes that neither the ADA nor Section 504 requires states to provide services in the “most integrated setting appropriate” or creates a broad legal obligation to offer home- and community-based services. Instead, it argues that Olmstead held only that states may not unnecessarily institutionalize individuals with disabilities without adequate justification, and that the decision did not establish a general “integration mandate.”

Although not binding on courts and without the force of law, the memo is likely to guide Executive Branch agencies, shaping federal enforcement priorities and substantially narrowing the government’s approach to investigations, compliance, and litigation under the ADA and Section 504.

This piece will discuss—and counter—some of the key arguments made in the memo.

First, the memo suggests that Congress prohibited disability discrimination generally, not segregation specifically. However, the factual findings that Congress relied on in enacting the ADA show otherwise. Pursuant to 42 U.S.C. § 12101(a), Congress found that “[h]istorically, society has tended to isolate and segregate individuals with disabilities and, despite some improvements, such forms of discrimination against individuals with disabilities continue to be a serious and pervasive social problem.” § 12101(a)(2). Congress also found that “[d]iscrimination against individuals with disabilities persists in such critical areas as… institutionalization…” Id. 12101(a)(3), and that [i]ndividuals with disabilities “continually encounter various forms of discrimination, including… segregation….” § 12101(a)(5). These statutory findings—not legislative history—demonstrate that Congress expressly identified segregation and unnecessary institutionalization as forms of disability discrimination that the ADA was enacted to eliminate.

Second, the memo characterizes Olmstead as merely recognizing that unjustified institutionalization “can” constitute discrimination and suggests that the DOJ’s integration mandate lacks firm statutory grounding. That framing underreads both the Court’s reasoning and the regulatory framework on which it relied. In Olmstead, the Supreme Court explained that “unjustified isolation… is properly regarded as discrimination based on disability,” and emphasized that institutional placement perpetuates unwarranted assumptions that individuals with disabilities are incapable or unworthy of participation in community life, while also severely restricting everyday life activities, including family relations, social contacts, work opportunities, economic independence, educational advancement, and cultural enrichment. 527 U.S. 597, 600–01 (1999). These rationales reflect the Court’s understanding that discrimination arises from the effects of enforced isolation and segregation, not merely from formal placement in a particular type of facility.

Third, the memo further suggests that the DOJ lacked authority to adopt an “integration mandate” in its Title II regulations and that such a requirement is not compelled by the statute. Olmstead does not support that characterization. In construing Title II, the Court expressly relied on longstanding implementing regulations under both Section 504 and the ADA, as well as Congress’s directive that the Attorney General issue regulations consistent with the Section 504 coordination regulations. See 42 U.S.C. § 12134 (a) & (b). Those regulations require that public entities administer services, programs, and activities in the “most integrated setting appropriate,” 28 C.F.R. § 35.130(d), reflecting a regulatory approach that long predates the ADA. The Court treated this framework as consistent with the statute’s nondiscrimination mandate and as part of the established interpretive backdrop against which Congress enacted Title II. Read against this backdrop, the memo would effectively displace more than two decades of consistent Title II interpretation and enforcement built around this regulatory mandate.

Fourth, the memo’s framing can also suggest that the “integration mandate” emerged as a post-Olmstead development. In fact, the requirement that services be provided in the “most integrated setting appropriate” predates the ADA by more than a decade. The Section 504 coordination regulation issued in 1978 directed recipients of federal funds to administer programs and activities in the most integrated setting appropriate, 28 C.F.R. § 41.51(d), establishing an early federal regulatory commitment to integration in disability services. DOJ later carried forward this same formulation in its Title II regulations implementing the ADA. This regulatory continuity demonstrates that the integration principle was not created in response to Olmstead but was already embedded in federal disability rights enforcement prior to the ADA’s enactment and judicial interpretation.

These regulations emerged during a period of increasing public awareness of the harmful effects of institutionalization, following widely publicized exposés and litigation involving facilities such as Willowbrook and Pennhurst. Against that historical backdrop, Olmstead and the regulatory framework on which it relied reflect a consistent understanding that disability discrimination includes the unjustified institutional isolation of individuals with disabilities, as implemented through longstanding federal regulations requiring services in the most integrated setting appropriate.”

[1] Narrowing Olmstead: A Response to the OLC’s June 2026 Memorandum, Am. Bar Ass’n (July 1, 2026), https://www.americanbar.org/groups/diversity/disabilityrights/news/narrowing-olmstead/ (last visited Jul. 30, 2026).

PWDF Profile

Who We Are

People With Disabilities Foundation is an operating 501(c)(3) nonprofit organization based in San Francisco, California, which focuses on the rights of the mentally and developmentally disabled.

Services

Advocacy: PWDF advocates for Social Security claimant’s disability benefits in eight Bay Area counties. We also provide services in disability rights, on issues regarding returning to work, and in ADA consultations, including areas of employment, health care, and education, among others. There is representation before all levels of federal court and Administrative Law Judges. No one is declined due to their inability to pay, and we offer a sliding scale for attorney’s fees.

Education/Public Awareness: To help eliminate the stigma against people with mental disabilities in society, PWDF’s educational program organizes workshops and public seminars, provides guest speakers with backgrounds in mental health, and produces educational materials such as videos.

Continuing Education Provider: State Bar of California MCLE and Commission of Rehabilitation Counselor Certification.