National Alliance on Mental Illness
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The court of appeals correctly concluded that the ADA is reasonably interpreted and applied, as it has been by the Attorney General pursuant to a broad grant of implementing authority, to mean that an individual with a disability who is being provided government services is [page 10] entitled to be provided those services in a community setting if such a setting is an appropriate one for the individual, subject to a defense that the result would be a "fundamental alteration" of the government services. That principle finds its easiest application in the present case. The State’s own professionals determined that community settings were appropriate ones for L.C. and E.W., and existing community-based programs were available to serve them.

Contrary to petitioners’ core statutory contention, the fundamental discrimination bar of Title II (§ 12132) is not restricted to intra-"program" or intra-"service" discrimination, but is reasonably read to bar the State as a whole from demanding that persons with disabilities unjustifiably make an important sacrifice, as a condition of receiving government services, when that sacrifice is not required of other, non-disabled recipients of government services (even different services). The statutory bar applies by its terms to "any public entity," including (under the express definition, §12131(2)) the State itself; it forbids disparate access to (collectively) "the services, programs, or activities" of the State, not any particular service, program, or activity; and it also broadly bars the State itself (a public entity) from any "discrimination." § 12132. The statutory language thus is not limited to discrimination within the confines a particular "program" or "service." Moreover, rejection of such an approach not only advances the basic statutory policy, given that the interests at stake here are so vital, but also serves a strong interest in avoiding artificial and dispute-breeding line-drawing about where one "program" stops and another starts. Nothing in the pre-ADA background against which Congress enacted the ADA precludes this reasonable reading of the statute.

Once the focus is reasonably placed on the State as a whole, the substantive discrimination principle is straightforward: [page 11] depriving an individual with a disability of the benefits of community integration, unless such a community setting is inappropriate for the individual, is a form of discrimination (where other recipients of government services need not sacrifice their interests in community integration). The ADA, reflecting a decades-long trend toward reducing institutional populations, makes overwhelmingly clear the congressional determination of the importance of the interests that are damaged, for many individuals with disabilities, by separation from their communities. To be sure, and of great importance, institutional settings are in the best interests of other individuals, and denial of such settings in those situations would work opposite damage. But unless a community setting is inappropriate for a particular individual, as determined according to professional judgment, denial of such setting is discriminatory. In this case, the State’s own professionals found community settings appropriate, so there is no occasion to set a standard for review of contrary determinations by a government’s professionals.

There is also no occasion, and it would be premature, to explore the exact contours of the "fundamental alteration" defense to an otherwise-valid claim of unlawful discrimination. That defense is consistent with the ADA, and its availability, along with the "qualified individual with a disability" precondition to a claim, necessarily moderates the impact of, and confirms the reasonableness of, the presumptive integration rule at issue here. But the defense was not applied in the ruling before this Court, and its application properly awaits exploration in the lower courts of what real-world effects–possibly cost savings–will be produced by the rule. The court of appeals’ adoption of the Attorney General’s presumptive integration rule should therefore be affirmed.