40 Big Ideas

4. Unfinished Business
Realizing the Revolutionary Promise of the ADA and Olmstead

Author

Kara B. Ayers is the associate director of the University of Cincinnati Center for Excellence in Developmental Disabilities and an associate professor of pediatrics at Cincinnati Children’s Hospital Medical Center in Cincinnati, Ohio. kara.ayers@cchmc.org

The Americans with Disabilities Act (ADA) became law in 1990. It made it illegal to discriminate against people with disabilities in the workplace, public services, transportation, and spaces like shopping malls that are open to the public. Attitudes about people with disabilities started to change because of this law, and in 1999, the Olmstead Supreme Court decision said that keeping them in institutions unnecessarily violated the ADA. Many moved from big state facilities to live in the community. Community-based services, employment, and self-advocacy efforts also grew, but there are still a lot of barriers and long waitlists for services.

When President George H.W. Bush signed the Americans with Disabilities Act into law on July 26, 1990, he declared it would break down barriers and open doors for all Americans to participate fully in society. Thirty-five years later, we must ask ourselves: have we fulfilled that revolutionary promise, or have we allowed the ADA to become merely a checklist of regulations rather than the transformative vision it was meant to be?

The ADA emerged from decades of grassroots disability rights activism, building on the momentum of earlier civil rights movements while recognizing disability as a natural part of human diversity worthy of protection and inclusion. The law required accessibility in public buildings, transportation, and communications, and made it illegal to discriminate against people with disabilities in education, employment, and public accommodations.

Two seated men flank President Bush, also seated, as he signs an important document. Another woman and man stand behind them.

Photo courtesy Tom Olin

For people with intellectual and other developmental disabilities (IDD), the ADA represented more than legal protection. It embodied a fundamental shift toward viewing disabled people as full citizens deserving of community participation, not patients to be treated, managed, or contained.

Nine years after the passage of the ADA, the Supreme Court's 1999 Olmstead v. L.C. decision amplified this vision by ruling that unnecessary segregation of people with disabilities violates the ADA's integration mandate. The Court recognized that institutional placement often reflects prejudice and assumptions about disabled people's capabilities rather than a genuine or absolute need for specialized care. Olmstead established that states must provide community-based services so more people with disabilities could live, work, and play in their own communities.

Together, the ADA and Olmstead created a powerful framework for community inclusion. They challenged the medical model that pathologized disability and the institutional model that segregated disabled people from society. Instead, they emphasize what disability scholars call the social model—recognizing that barriers exist not within individuals but within environments and systems that fail to accommodate human diversity.

For people with IDD, this legal foundation has yielded significant progress. Supported employment programs have enabled thousands to work in integrated settings rather than sheltered workshops. Supported living arrangements have replaced large state institutions. Community-based services have expanded, and self-advocacy movements have flourished as disabled people claim their rightful place as decision-makers in their own lives.

Yet implementation remains frustratingly uneven. Too many states still operate extensive institutional systems, sheltered workshops, and segregated day programs. Too many communities lack accessible housing, transportation, or support services. Too often, individuals and families face impossible choices between inadequate community supports and institutional placement.

The challenge lies not in the laws themselves but in how we interpret and implement them. When we treat the ADA as a burden—a list of minimum compliance requirements—we miss its transformative potential. When we view Olmstead narrowly as a cost-cutting measure rather than a civil rights mandate, we perpetuate the very segregation these policies were designed to eliminate.

True community inclusion requires more than physical accessibility or the mere presence of disabled people in community settings. It demands genuine participation, meaningful relationships, and recognition of disabled people's contributions to the fabric of society. It requires addressing the intersection of disability with other identities and experiences, including race, class, gender, and sexuality.

Moving forward, we must hold fast to the ADA's original vision while refusing to accept incremental progress as sufficient. We must view Olmstead not as permission to abandon institutional models only when convenient, but as an imperative to build robust community supports that enable all people with disabilities to live, work, and participate where they choose.

The ADA and Olmstead represent more than legal victories—they articulate a vision of an inclusive society that values all its members. Our task is to make that vision a reality, not through begrudging compliance but through bold imagination and unwavering commitment to justice. Only then will we honor the revolutionary promise these landmark policies represent and create the truly inclusive communities they envision.