IN THE PROFESSION
Director Susan W . Goico ( DIP ), says that type of long-term dedication is typical of Pastore ’ s work , noting , “ what she really excels in is getting to know clients and figuring out what they need as people – what is going to make their life better .”
“ Once I have a face to go with the problem , it kind of just latches on and I cannot let go ,” Pastore says . Helping individuals with disabilities get the services they need to live a meaningful life in the community is what Pastore and the rest of the team at DIP strive for every day .
DIP was founded in the 1980s with just one dedicated attorney who went into psychiatric hospitals and nursing homes to advocate for individuals with disabilities confined in these institutions . The project now employs two paralegals and three attorneys . DIP is well known for winning the 1999 landmark U . S . Supreme Court case Olmstead v . L . C . and E . W . 527 U . S . 581 ( 1999 ), which held that under the Americans with Disabilities Act ( ADA ) people with disabilities have a right to services provided in the community and not institutions , if their conditions allowed it .
Brought by Attorney Sue Jamieson ( Atlanta Legal Aid Society , Inc .), on behalf of two women with intellectual and psychiatric disabilities who had each been institutionalized dozens of times , the Olmstead complaint argued that the women would be better served through community -based living . Although the State argued that it could not afford to provide community-based care , Atlanta Legal Aid submitted evidence proving that the cost of housing a person in an institution is almost always more expensive than communitybased services . The Supreme Court agreed .
In the majority opinion , Justice Ruth Bader Ginsburg wrote :
"[ I ] nstitutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life . Confinement in an institution severely diminishes the everyday life activities of individuals , including family relations , social contacts , work options , economic independence , educational advancement , and cultural enrichment ."
Many disability liken Olmstead to be the Brown v . Board of Education of the disability world . However , the reality of Olmstead has not quite lived up to its promise .
" Since Olmstead , states have invested more money in the community service system , but unfortunately people with disabilities continue to cycle in and out of institutions or are stuck unnecessarily in nursing homes ,” said Goico . “ People ' s rights under Olmstead and the ADA are violated every day . We have a very long way to go until the decision is fully implemented ."
Georgia is no exception . Following Olmstead , the State of Georgia did very little to implement community-based care solutions . Atlanta Legal Aid , through DIP , filed civil rights complaints as well as federal lawsuits on behalf of individuals confined in institutions to obtain Olmstead relief . While each of these clients transitioned into the community , Georgia was slow to make any real changes to its hospital-based system .
Little by little , though , progress has been made . In 2010 , after more than a decade of advocacy , Atlanta Legal Aid helped craft and negotiate a settlement between the U . S . Department of Justice and the State of Georgia to implement Olmstead . The agreement included a promise to provide State subsidized housing for 2,000 individuals with severe and persistent mental illness who would otherwise be in institutions , at risk of institutionalization , or homeless , also the assurance that 9,000 people would receive some type of supported housing , short-term crisis stabilization units , peer support , bridge money to support transitions from State hospitals , supported employment , multiple levels of case management , as well as Medicaid waivers and family supports for individuals with developmental disabilities .
The programs that grew out of this agreement provided the housing voucher and other community-based supports that have helped L and many DIP clients stay out of institutions .
However , although there are various community-based support programs available through State agencies , the process of ensuring people with disabilities are receiving the appropriate services still involves an-often herculean effort from the entire DIP staff . The program attorneys work to meet the legal needs of clients through case-work , impact litigation , education and advocacy . Paralegals Toni Pastore and Kristin Robinson ( DIP ) handle intake , assess client needs , advocate for clients to receive appropriate services and guide them through getting and keeping those services .
“ It is really hard at times ,” says Robinson , who has worked at DIP for five years . “ You get to know clients over a period of years . You know their family . You know how much they are struggling and know that if your client could just get this one service , everything would work .”
When Robinson ’ s client R * contacted DIP , he was caught in a revolving door of institutionalization . R is a person with both a mental illness and an intellectual disability , and is also a ward of the State . R would be placed in a personal care home , get kicked out and sent to jail or a psychiatric hospital where he would then be triaged and sent back to another personal care home , which would eventually kick him out again .
In the months after R became a client , Robinson watched this cycle repeat itself . She realized this cycle was happening because when R was in personal care homes , he was not getting the community-based services he needed and was afforded under Olmstead . Due to R ’ s multiple diagnoses , DIP staff knew it would be hard to get approved for a Medicaid waiver for people with developmental disabilities . Instead , Robinson advocated for R to get an Assertive Community Treatment ( ACT ) team . ACT teams
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