Olmstead & Other Legal Issues Facing State Behavioral Health Agencies

Over the past six years, the Department of Justice has increased their scrutiny of states’ compliance with the 1999 Olmstead mandate.


The populations targeted under these investigations continues to expand to include those that have never had prior interaction with the state behavioral health system. In addition to Olmstead litigation, state behavioral health authorities are also at risk of investigation or legal action under CRIPA and other legal statutes. When a state behavioral health authority is notified that it is under investigation for a violation of one of these statutes, the potential costs to the state in terms of staff time, legal fees, and damaged reputations can be enormous.


NRI’s breadth and depth of knowledge and available data around state Olmstead, CRIPA, and other legal issues can help inform states about service gaps and potential violations before an investigation is launched, and can help states highlight strengths in their systems to defend against any pending or current litigation. NRI is available to work with state behavioral health leadership to develop customized reports and testimony to address these and other legal issues, and provide technical assistance in data collection and analysis. To assist with these efforts, NRI can utilize the following:


  • Thirty years of trend data in mental health agency revenues and expenditures.

  • Information about the organizations, policies, and services of state behavioral health authorities

  • Behavioral health service utilization and demographic information about the number of consumers served by behavioral health authorities

  • Client-Level Data from most states with detailed diagnostic and other client characteristics

  • Other State Government Agency Study design to identify and document mental health resources from other state government agencies

  • Community Integration State Self-Assessment Tool


You can also download this information as a PDF (169KB)



Please contact NRI@nri-inc.org for more information about how we can help you with your Olmstead and related issues.