Fifth Circuit Cases: Texas, Louisiana & Mississippi
Circuit Status: MOST RESTRICTIVE – The Fifth Circuit’s decision in United States v. Mississippi (2023) severely limits Olmstead enforcement across all three states.
The Fifth Circuit Restriction: United States v. Mississippi (2023)
Case Name: United States v. Mississippi, No. 21-60772 (5th Cir.)
Case Resources:
- Google Scholar Case Law
- Fifth Circuit Decision (PDF)
- PACER Federal Court Records (21-60772)
- AHLA Analysis: Fifth Circuit Creates Circuit Split
What Happened: The district court found Mississippi violated Olmstead by unnecessarily institutionalizing people with developmental disabilities and mental illness, despite the ability to serve them in the community. Mississippi appealed.
The Fifth Circuit’s Reversal (September 20, 2023): The Fifth Circuit reversed the district court and held that Olmstead protects only individuals already institutionalized — not those at risk of institutionalization or experiencing unnecessary segregation in the community. This severely narrows enforcement.
Implication: Federal Olmstead enforcement is significantly constrained across Texas, Louisiana, and Mississippi. State-level advocacy, litigation, and legislative action are critical.
Mississippi: U.S. v. Mississippi (District Court)
Case Name: United States v. Mississippi (S.D. Miss.)
Case Resources:
- Google Scholar Case Search
- PACER Federal Court Records
- Disability Rights Mississippi (P&A)
- Mississippi Division of Medicaid
District court found Mississippi violated Olmstead; Fifth Circuit reversed September 2023.
Mississippi: Troupe v. Barbour
Case Name: Troupe v. Barbour, 10-cv-00153 (S.D. Miss.)
Case Resources:
EPSDT services for Medicaid-eligible children with disabilities
Louisiana: U.S. v. Louisiana (Eastern District)
Case Name: United States v. Louisiana, 3:18-cv-608 (E.D. La.)
Case Resources:
- Google Scholar Case Search
- PACER Federal Court Records (3:18-cv-608)
- Disability Rights Louisiana (P&A)
- Louisiana Department of Health
DOJ findings letter December 21, 2016 regarding people with serious mental illness in nursing facilities. Implementation ongoing; Fifth Circuit restrictions may limit enforcement leverage.
Louisiana: Pitts v. Greenstein
Case Name: Pitts v. Greenstein, 10-cv-635 (M.D. La.)
Case Resources:
Serious mental illness in nursing facilities (related to DOJ findings)
Texas
Status: No major active federal Olmstead consent decrees. Fifth Circuit restrictive doctrine limits federal enforcement avenue. State-level advocacy critical.
Resources:
Fifth Circuit Enforcement Pattern
The Fifth Circuit’s narrow interpretation of Olmstead means advocates in this region must rely more heavily on:
- State administrative complaints under Medicaid regulations
- State-level litigation and statutory rights
- ADA Title II and Section 504 claims (broader than Olmstead)
- Protection & Advocacy enforcement and investigation