Rehabilitation Reform

State Resources by Federal Circuit

State Resources by Federal Circuit

State-by-state guide to Olmstead enforcement, community integration resources, and disability rights remedies. Updated September 2026.

Olmstead v. L.C. (1999) established your federal right to live in the community with supports, rather than in an institution. This resource organizes state-specific information—litigation status, Medicaid HCBS programs, vocational rehabilitation services, and Protection & Advocacy contacts—by federal circuit to help you understand what enforcement looks like in your region and find the services and legal tools available in your state.

How to Use This Resource

🧑 If You’re Seeking Services

Find your state below and click to access Medicaid HCBS services, vocational rehabilitation, peer support, and guidance on filing complaints if your rights are violated.

⚖️ If You’re an Advocate or Lawyer

Click your state card to access litigation history, settlement terms, circuit court enforcement patterns, and legal tools for Olmstead enforcement and pro se representation.

📊 If You’re a Researcher or Practitioner

Click your state to find SCII metrics, employment outcomes, state policy data, provider networks, and vocational rehabilitation success indicators.

Federal Circuits: Enforcement Patterns

Most Protective (Seventh Circuit): Illinois, Indiana, Wisconsin – Courts willing to find systemic violations and order institutional closures. Illinois operates under three active consent decrees.

Broad Enforcement: First, Second, Third, Eighth, Ninth, Eleventh Circuits – Courts recognize institutional segregation and enforce Olmstead across multiple service domains.

Moderate Enforcement: Fourth, Sixth Circuits – Limited federal settlements; state-level advocacy critical.

Limited Federal Enforcement: Tenth Circuit – No major settlements; Section 504 and ADA Title II primary tools.

Most Restrictive (Fifth Circuit): Texas, Louisiana, Mississippi – U.S. v. Mississippi (2023) severely limited federal enforcement. State-level advocacy essential.

Find Your State

First Circuit

  • New Hampshire – Settlement Concluded | Model Olmstead compliance

Second Circuit

  • Connecticut – Ongoing Consent Decree | Nursing facility reliance litigation
  • New York – Settlement Implementation | Adult home segregation enforcement (U.S. v. New York)

Third Circuit

  • Delaware – Settlement Completed | Model settlement framework
  • New Jersey – Ongoing Litigation | Disability rights settlement pending

Fourth Circuit

  • North Carolina – Settlement Concluded | State-level advocacy critical

⚠️ Fifth Circuit (Most Restrictive)

  • Texas – Limited Federal Enforcement | Tier 4 (Critical) | Post-Mississippi constraints
  • Louisiana – Limited Federal Enforcement | Tier 4 (Critical) | Nursing facility reliance
  • Mississippi – Limited Federal Enforcement | Tier 4 (Critical) | Lowest SCII Score (27/100)

Seventh Circuit ✅ (Most Protective)

  • Illinois – Three Active Decrees | Colbert, Williams, Ligas consent decrees | Tier 3 (Lagging)
  • Indiana – Maertz Litigation Active | Supported employment enforcement

Eighth Circuit

  • Arkansas – Lapsed Olmstead Plan | Tier 4 (Critical) | Community integration challenges
  • Missouri – Nursing Facility Litigation | State litigation ongoing

Ninth Circuit

  • California – Multiple Litigation Tracks | Katie A. settlement (sheltered workshop reform) | Tier 2 (Progressing)

Eleventh Circuit

  • Florida – Medically Fragile Children Case | Emerging litigation on complex care
  • Georgia – Psychiatric Hospital Enforcement | School segregation (GNETS) litigation
  • Alabama – Settings Rule Audit Ongoing | Tier 4 (Critical) | Institutional reliance high

What You’ll Find on Each State’s Resource Page

  • Litigation & Olmstead Status – Current cases, DOJ findings, settlement status
  • State Olmstead Plan – Integration planning documents, closure timelines, compliance targets
  • Vocational Rehabilitation – Designated state unit contacts, eligibility, CAP services
  • Medicaid & HCBS – Waiver names, enrollment processes, service coordinators
  • Protection & Advocacy – P&A agency contact, investigative authority, mandated programs
  • SCII Standing – State Community Integration Index score and tier classification

Related Resources