On May 18, 2016, the State of Georgia and the United States Department of Justice filed in federal district court an agreement to expand the capacity and improve the quality of community-based services the State provides to individuals with developmental disabilities and mental illnesses. This “Extension Agreement” built on the commitments the State made in an historic, comprehensive 2010 settlement agreement resolving Georgia’s unlawful institutionalization of individuals with mental illnesses and developmental disabilities in its state hospitals, in violation of the Americans with Disabilities Act (ADA) and the Supreme Court’s landmark 1999 decision in Olmstead v. L.C. The case was originally brought by the U.S. Department of Justice. Earlier, a coalition of stakeholders convinced the court to withhold approval of a settlement that would have ended the litigation without adequate ADA relief.

Stakeholders known as “the Amici,” or friends of the court, participated in crafting the terms of the Extension Agreement. The Bazelon Center represented nearly a dozen Georgia mental health groups and advocates, including the Carter Center Mental Health Program, Mental Health America of Georgia, Georgia Mental Health Consumer Network, Georgia Parent Support Network, Georgia Council on Substance Abuse, Atlanta Legal Aid Society’s Disability Integration Project, the National Alliance on Mental Illness-Georgia, and individuals Cynthia Wainscott and John Gates. The Georgia Advocacy Office, the independent Protection and Advocacy System for people with disabilities in Georgia, also was an amicus in the case.

The case began after a series of 2007 articles in the Atlanta Journal Constitution described the disastrous and deteriorating situation of the state’s public mental health system since the Olmstead decision. The Civil Rights Division of the Department of Justice (DOJ) opened an investigation under the Civil Rights of Institutionalized Persons Act (CRIPA).  In 2008, the DOJ issued scathing findings of serious constitutional and statutory violations in the psychiatric hospitals, including failure to protect patients from harm, failure to provide adequate mental health care, abusive seclusion and restrain practices, substandard medical and nursing care and inadequate discharge planning.

The Department entered into settlement negotiations with the State. Although mental health advocates and stakeholders had assisted DOJ investigators, they were excluded from the settlement process. Then, in January 2009–literally in the final hours of the Bush administration—the Department and the State filed a settlement agreement in federal court.  It was little more than a promise by Georgia to improve the hospitals.  Mental health advocates and stakeholders were shocked and asked the Bazelon Center to help organize, and ultimately represent them, in attempts to improve the agreement. The court ordered the DOJ and the State to meet with the attorneys for the coalition, which includes the Carter Center.

The Extension Agreement will continue to be monitored by the independent reviewer for the 2010 agreement. The parties have requested that the court approve the Extension Agreement and retain jurisdiction to enforce it.


U.S. District Court for the Nothern District of Georgia


March 2, 2009




United States of America


State of Georgia