The North Carolina Department of Health and Human Services, including the Division of Health Services regulation that monitors adult care homes, is housed on the campus of the former Dorthea Dix state mental hospital in Raleigh. Frank Taylor / Carolina Public Press

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North Carolina discriminates against people with intellectual and developmental disabilities by forcing them to accept institutionalization instead of receiving community-based services and supports, a Wake County judge ruled Thursday.

The ruling in the case Samantha R., et al v. North Carolina, et al found that current state policies violate the N.C. Persons with Disabilities Act by essentially forcing the segregation of people in order to receive services.

The case was filed by the nonprofit organization Disability Rights NC in 2017.

“We are pleased that the judge ruled in favor of people with disabilities having the choice to living in the community,” said Disability Rights NC CEO Virginia Knowlton Marcus in a statement.

“This order is the first step, and we will be actively working toward a remedy that helps more people with I/DD get the support they need in the home they choose. We hope that the state and DHHS will commit to do the same.”

The court will later reveal how this decision will be enforced and what steps the Department of Health and Human Services and other state agencies may need to take to come into compliance.

“The Department of Health and Human Services is committed to a system that provides services and supports to individuals with disabilities in the most integrated setting possible, as appropriate to their needs,” said a DHHS statement released Friday morning in response to Thursday’s ruling.

“Over the past several years, key initiatives at the department pushed toward this future, but we recognize much work remains. A key strategy and national model in driving this difficult systems-change work as quickly and effectively as possible is the development of an Olmstead Plan — a roadmap for increasing community levels of care, changing the way care is delivered and, most importantly, carefully working with stakeholders to ensure their well-informed choices guide the system of the future.

“Late last year, the department began the process of creating such a plan, starting by consulting national models and seeking out national expertise. The Court recognized this effort and is in discussions with DRNC and the department on how best to bring the state into compliance with the integration mandates of the North Carolina Persons with Disabilities Protection Act by the development of an Olmstead Plan.”  

The state case parallels and partially overlaps the federal Olmstead ruling, which found that such practices violate the Americans with Disabilities Act for North Carolina residents with serious mental illness, who are often forced into adult care homes due to the unavailability of services based in the community.

A CPP investigative report in 2017, “Questionable Care,” found serious concerns about the conditions at these facilities for people with mental health issues and cognitive disabilities, including dementia, as well as with the consistency and effectiveness of the state’s oversight of them through a mix of county and state inspections.

CPP recently reported that the independent observer assigned to oversee the state’s progress in complying with a settlement in the Olmsted case raised serious doubts about whether the state has a shot at meeting a July 2021 deadline for full compliance, despite significant recent improvements in some areas.

Corye Dunn, director of public policy for Disability Rights NC, talked with CPP about Thursday’s ruling and agreed that the state court ruling in this case paralleled the federal issues in the Olmsted case. In a few cases, exactly the same conditions for the same people are involved.

“There is a small amount of overlap of folks with both,” she said.

Dunn expressed satisfaction that the state court in Thursday’s ruling “recognized our clients’ right to live in their communities without the threat of institutionalization.”

Editor’s note: This article was updated at 10:15 a.m. Feb. 7, 2020, to include a response from the NC Department of Health and Human Services.

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Frank Taylor

Frank Taylor is the managing editor of Carolina Public Press. Contact him at

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