Disability advocates say DOJ memo threatens community-based care : NPR

The Justice Department has recently issued a memo that raises concerns about longstanding civil rights protections for Americans with disabilities, causing alarm among advocates and families. The memo, provided by the Office of Legal Counsel, states that states are not obligated to offer in-home or community-based care to disabled individuals requiring assistance. These services are critical for allowing many disabled Americans to live and work within their communities.

“The U.S. government’s current stance effectively marginalizes people with disabilities from their communities,” states Alison Barkoff, a health law and policy professor at George Washington University, who has played a key role in shaping disability law and policy under both the Obama and Biden administrations. “The significance of this shift cannot be overstated.”

Without federal mandates for these services to facilitate community integration for disabled individuals, advocates and legal experts warn that financially strapped states might eliminate them, reverting to a past where disabled Americans were often segregated in nursing homes and large institutions.

There was a swift backlash from the disability community.

“As the U.S. approaches its 250th anniversary, this memo threatens to return us to a period marked by ignorance and cruelty,” says the American Association of People with Disabilities. “It could lead states back to confining people with disabilities in institutions, out of sight and out of mind.”

“This opinion endangers decades of progress towards community living for people with disabilities,” says Shira Wakschlag of The Arc of the United States, a nonprofit disability advocacy organization. “People with disabilities should not be forced into institutions just because a state opts not to provide community services.”

The Justice Department has not responded to NPR’s request for clarification on its stance and the reasons behind this policy shift after years of supporting community services.

What the law says

The new memo challenges what legal experts have long considered established law. Both Section 504 of the Rehabilitation Act and Title II of the Americans with Disabilities Act have historically been interpreted to require that states provide services to disabled Americans in the most integrated setting possible, with institutionalization as a last resort.

In 1999, the Supreme Court heard a case, Olmstead v. L.C., involving two women with mental disabilities who sued Georgia, claiming the state failed to provide services enabling them to live in their communities, thus violating their civil rights. The court ruled that states have a legal obligation to support the integration of disabled Americans into their communities, an interpretation that has been upheld by courts nationwide for nearly three decades.

By 2023, 8.4 million Americans were receiving home- and community-based services through Medicaid.

The memo, authored by Lanora Pettit, principal deputy assistant attorney general in the Office of Legal Counsel, argues that while federal law prohibits discrimination based on disability, it does not mandate that states provide these community services. It further claims that the Supreme Court’s Olmstead decision only requires states not to institutionalize patients without justification. However, what constitutes adequate justification remains unresolved, according to the memo.

Pettit acknowledges the unconventional nature of this interpretation: “We recognize that this view is not aligned with the common understanding of the Olmstead decision within federal courts.”

Why it matters

Since 1977, the U.S. government has held that federal law includes an integration mandate requiring services to be provided in the most integrated setting appropriate,” explains Professor Barkoff, who led Olmstead enforcement efforts in the Obama Justice Department. For decades, both Republican and Democratic administrations, including the first Trump administration, have actively enforced federal disability law, taking action against states overly reliant on segregated institutional care.

Institutionalization as a last resort was determined by courts and Congress to protect personal liberty, says Jennifer Mathis of the Bazelon Center for Mental Health Law: “It controls who you see, when you go out, what you eat, and who you talk to. For many institutionalized people, life is confined to a hallway. I’ve witnessed these conditions; it’s deadening.”

This memo marks a significant shift in the U.S. government’s official position.

“We are deeply concerned that the federal government’s message in this memo implies that returning to institutional placements is acceptable, even if community services are possible, desired, and more cost-effective,” Barkoff comments.

The timing is crucial. The memo coincides with a new case, Texas v. Kennedy, currently in the courts. Brought by Texas and several other states, this case challenges the integration mandate on states. With this memo, the federal government seems to side with the plaintiffs. Mathis warns: “It’s important to remember that this memo isn’t law; the Justice Department cannot change the law. Only Congress can.”

The immediate effects of the memo are uncertain, though it appears the Justice Department will halt its Olmstead enforcement efforts.

Why now?

The Justice Department’s memo seems to be part of a broader initiative that began on July 24, 2025, when President Trump issued an executive order aimed at facilitating state and local government efforts to address homelessness. The order claims that widespread vagrancy and disorder have made cities unsafe, asserting that most of these individuals are addicted to drugs, have mental health issues, or both.

The administration’s proposed solution is involuntary institutionalization: “Relocating homeless individuals into long-term institutional settings for humane treatment through civil commitment will restore public order,” states the order.

In a 2023 campaign video, President Trump promised: “We will return those who are severely mentally ill and deeply disturbed to mental institutions, where they belong.”

The Cicero Institute, a conservative Texas think tank, has been influential in recent efforts to aggressively tackle homelessness, including through institutionalization.

A significant barrier to large-scale institutionalization of the homeless is federal disability law, which has long required home- or community-based services, when appropriate. A footnote in the Justice Department’s memo suggests these laws have contributed to chronic homelessness. However, Barkoff argues that the Olmstead decision has been instrumental in providing services and stable housing for the homeless.

NPR previously reported that the Trump administration’s push for institutionalization faces another major hurdle: a severe shortage of beds in these specialized facilities.

The memo comes as Republicans have passed significant cuts to Medicaid, the primary funding source for community-based services relied on by many disabled Americans. Legal experts tell NPR that states must make deep cuts to a range of services previously funded by Medicaid in response to last year’s One Big Beautiful Bill Act. The Trump administration’s memo effectively allows states to reduce these local supports and rely on institutionalization, even though research shows the latter is significantly more expensive to provide.

This development occurs as disability advocates have already been opposing the Trump administration’s announcement on Tuesday to transfer federal administration of special education programs from the Department of Education to the Department of Health and Human Services. This change, like the new Justice Department memo, has sparked concerns about the potential rollback of longstanding civil rights protections.