This June marks 27 years since the United States Supreme Court handed down its decision in Olmstead v. L.C. — one of the most consequential disability rights rulings in American history. If you're a family member of someone with an intellectual or developmental disability, or a person with I/DD yourself, you may not have heard the name Olmstead. But you have very likely lived inside the world it created. Every time someone with I/DD lives in their own apartment instead of an institution, attends a community-based day program instead of a sheltered workshop, joins a public school class instead of being segregated, or gets to choose where, how, and with whom they live — Olmstead is part of the reason that's possible. As we approach the anniversary of this landmark ruling, we want to take a moment to share what Olmstead is, what it has changed, what it has not yet changed, and why it remains the legal and moral foundation of community-based services like the ones we provide at North Star Oregon. A Brief History: Two Women in Georgia The story of Olmstead begins not with policy but with two women — Lois Curtis and Elaine Wilson — who were living at Georgia Regional Hospital, a state-run psychiatric institution, in the mid-1990s. Both women had intellectual disabilities and mental health diagnoses. Both had been institutionalized for years. And both had been told by their treatment teams that they no longer needed to be in the hospital — that they could live successfully in the community with appropriate supports. But the community supports they needed weren't available, or weren't being offered. So they remained in the hospital, year after year, even though everyone agreed they didn't need to be there. With the help of the Atlanta Legal Aid Society, they sued the state of Georgia, arguing that the unjustified institutionalization of people who could live in the community violated Title II of the Americans with Disabilities Act (ADA). Their case made its way to the U.S. Supreme Court. In June 1999, the Court ruled in their favor. What the Court Actually Said The Olmstead decision is technically narrow but philosophically vast. In a 6-3 ruling, the Court held that under the ADA, states are required to provide community-based services to people with disabilities when: Such services are appropriate. The individuals affected do not oppose community-based treatment. The placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others receiving disability services. In plain language: if a person with a disability can live and receive services in the community rather than in an institution, and they want to, the state must make that possible — except in narrow circumstances. Unjustified segregation, the Court ruled, is itself a form of discrimination prohibited by the ADA. That last sentence is the heart of it. Unjustified segregation is a form of discrimination. For decades before Olmstead, the default response to disability — particularly intellectual and developmental disability — was to separate people from the rest of society. Large state institutions warehoused tens of thousands of people with I/DD across the country. Children were taken from their families and placed in these settings, sometimes for life, often based on doctors' recommendations to parents that they should "let go" and "move on." Olmstead didn't end that history overnight. But it did establish, in the highest court in the country, that the practice was wrong — and that doing the opposite (supporting people in their communities) wasn't just kind or progressive but legally required. What Olmstead Has Changed In the 27 years since the decision, the landscape of disability services has shifted dramatically. Institutional populations have continued to decline. In 1967, there were nearly 200,000 people with I/DD living in state institutions in the United States. Today, that number is under 16,000 nationally and continues to drop. Oregon closed its last state institution for people with I/DD, Fairview Training Center, in 2000 — the year after Olmstead. The state has not built another one. People who previously would have lived in institutions now live in their own homes, with family, in foster care, or in small group homes — supported by community-based services. Community-based service systems have grown. Medicaid Home and Community-Based Services (HCBS) waivers — like the ones Oregon uses to fund North Star's services — were expanded and strengthened in the years following Olmstead. The 1915(c) waivers and Oregon's K Plan are direct descendants of the Olmstead mandate. Without them, the kind of in-home attendant care and community-based DSA programs we provide simply wouldn't exist at this scale. Person-centered planning has become the standard. The Individual Support Plan (ISP) process — where a person's preferences, goals, and choices drive the services they receive — owes its prominence to Olmstead's emphasis on integration and individual choice. Sub-minimum wage and sheltered workshops have come under scrutiny. Oregon, in particular, has been a national leader in transitioning away from segregated employment settings toward integrated, community-based work. The state's Employment First initiative, formalized through executive orders and legal settlements in the 2010s, was driven in significant part by Olmstead obligations. Day services have moved into the community. The North Star Oregon DSA model — community outings, volunteering, real workplaces, public libraries, museums, parks, neighborhoods — is itself an Olmstead-era model. Day services that take place primarily in segregated buildings, with the same group of people every day, doing activities that wouldn't be available to non-disabled adults in the same age range, are increasingly being phased out as inconsistent with the integration mandate. What Olmstead Has Not Yet Changed It would be inaccurate to say Olmstead has fully delivered on its promise. Twenty-seven years on, gaps remain. Waiting lists for community-based services remain long. In many states, including Oregon at times, the demand for HCBS waivers has exceeded the supply. Oregon does not currently maintain a waiting list for I/DD waiver services, which is something the state should be commended for. But the workforce shortage in direct support — caused largely by stagnant wages — has created a different kind of access problem: services are authorized but providers can't be found to deliver them. People in nursing homes are still under-served by Olmstead. A significant share of the Olmstead litigation in recent years has focused on people with disabilities living in nursing facilities who could be supported in the community but aren't, because the state's system is structured around institutional rather than community placements. People with the most complex needs sometimes still struggle. The integration mandate is for everyone, but the rhetoric of community-based services can sometimes leave behind people whose support needs are intensive, especially when funding doesn't keep pace with the cost of high-quality community supports for those individuals. Segregation can take subtler forms. A person can technically live "in the community" while still being functionally segregated — going from a group home to a sheltered workshop and back, with little real participation in community life. Olmstead requires not just physical placement in the community but meaningful integration. Living in a community is not the same as being part of one. The work is not done. Why Olmstead Matters at North Star Oregon We think about Olmstead often, even when we're not naming it. When a parent-caregiver chooses to be hired as a W-2 employee to care for their own adult son in a shared-home setting — that's Olmstead. The person isn't being moved into an institution; they're being supported at home with their family. When a young woman in our Eugene DSA program decides she wants to spend her Tuesdays volunteering at the humane society and her Thursdays taking a community college painting class — that's Olmstead. Her day looks like the day of any other young adult in Eugene with similar interests, not a clinical setting. When a man in our Salem program rides the bus to work, eats lunch at a downtown café where the staff know his name, and goes home to an apartment he shares with a friend — that's Olmstead. He is not in an institution. He is a member of a community. When we reject the term "clients" in favor of "the individuals we support," that's a small linguistic choice rooted in a much larger philosophical one: the people we work with are people first, with their own preferences, dreams, and rights, not subjects of a service. What This Means for Families If you are a parent, sibling, spouse, or family member of someone with I/DD, the Olmstead decision gives you legal grounding for some of the things you instinctively want for the person you love: They have a right to live in the most integrated setting appropriate to their needs. They have a right to participate in planning their own services and lives. They have a right to refuse institutional placement when community-based services would meet their needs. They have a right to providers who treat them as members of the community, not as patients to be managed. If you ever feel like you are being pushed toward a more segregated, more institutional, more restrictive setting than your loved one needs — you have legal and moral standing to push back. Olmstead is part of the bedrock you can stand on. If a service system is not working for your family, you can advocate for change. You can contact your CDDP services coordinator. You can reach out to advocacy organizations like Disability Rights Oregon, which is Oregon's federally designated Protection and Advocacy agency. You can talk to your state legislator. You can connect with other families who have walked similar paths. Looking Forward A generation ago, the future for many people with I/DD was institutional. That future is no longer the default — and that is largely because of the women and men, like Lois Curtis and Elaine Wilson, who refused to accept it as inevitable, and the courts and legislatures that listened. The next chapter of disability rights is being written now, by today's self-advocates, today's families, today's direct support professionals, and today's policymakers. The work is incomplete, but the direction is clear: more inclusion, more choice, more community. At North Star Oregon, we consider it a privilege to be part of that work. The people we support are not "served" by us; they are walking through their own lives with us walking beside them, and we are better for the company. To learn more about our community-based services — In-Home Attendant Care across Oregon and Day Support Activities in Albany, Corvallis, Eugene, Springfield, Salem, and Tangent — visit northstaroregon.com or reach out to our team. We'd be honored to be a part of your community.

Summer in Oregon is a season worth celebrating. After a long gray winter and a rainy spring, the sun returns with real conviction — and with it comes the chance to spend time outdoors, visit the coast, work in the garden, or simply sit on the porch and listen to the neighborhood come alive. For the individuals we support — children, adults, and seniors with intellectual and developmental disabilities (I/DD) — summer opens up possibilities that matter. It also opens up a handful of safety considerations that caregivers do well to think through in advance. Heat, sun, hydration, sensory overload, water safety, medication interactions, and changes in routine can all affect individuals with I/DD in distinct ways. A little preparation goes a long way toward making summer a season of joy rather than one of crisis management. This guide is for Oregon parents, parent-caregivers, Direct Support Professionals (DSPs), and family members who want to help the people they love have the best summer possible. It draws on what we've learned over years of supporting families across the Willamette Valley, and it's written to be practical — not to lecture you or add to the mental load you're already carrying. Why Summer Requires Extra Thought Many individuals with I/DD experience the body and the environment differently than their neurotypical peers. Some of the factors that can make summer trickier include: Difficulty recognizing or communicating discomfort. A person who can't easily say "I'm hot" or "I'm thirsty" may not realize — or may not be able to tell a caregiver — that something is wrong until symptoms are more advanced. Medication effects. A number of medications commonly prescribed to individuals with I/DD (certain antipsychotics, anticholinergics, some seizure medications, ADHD stimulants, and others) can reduce the body's ability to regulate temperature or increase sensitivity to sun. Sensory processing differences. Heat, humidity, bright light, sunscreen textures, swimsuit fabrics, bugs, and sudden loud sounds (fireworks, lawnmowers, crowds at festivals) can push a sensitive nervous system past its comfort zone quickly. Routine disruptions. Summer often means schedule changes — no school, different staff, travel, vacations, or different daily rhythms. Predictability is soothing. Unpredictability can be stressful. Hydration challenges. Individuals who have trouble swallowing, who forget to drink, or who are dependent on others for fluids need more active support in hot weather. None of these challenges are reasons to stay inside. They are reasons to plan well and to pay close attention. Heat Safety: The Basics Oregon summers have been running warmer in recent years, and multi-day heat waves are no longer unusual in the valley. That's a meaningful shift. A few foundations: Know the early signs of heat illness. Heat exhaustion and heat stroke don't usually arrive all at once. Earlier signs include flushed skin, unusual tiredness, irritability, headache, nausea, dizziness, and a pulse that feels faster than usual. Heavy sweating may slow or stop as things get worse. In a person who struggles to report symptoms, you are looking for changes — a quieter mood, a reluctance to keep playing, a sudden request to sit down, a change in skin color. Move quickly when you see them. Get the person into shade or air conditioning. Offer cool (not ice-cold) fluids if they can drink safely. Use cool, damp cloths on the neck, wrists, and forehead. Remove excess clothing. If symptoms don't clear up within 15 to 20 minutes — or if they seem to be worsening, especially with confusion, loss of consciousness, or very high body temperature — call 911. Heat stroke is a medical emergency. Plan around the heat, not through it. Schedule outdoor time for mornings and evenings during hot stretches. Save the middle of the day for the library, the mall, an indoor pool, a movie, or time at home with the AC on. This isn't giving up on summer — it's working with it. Check medications. A five-minute conversation with your pharmacist about heat sensitivity can change the way you approach the season. Some medications need to be stored in cool places; some amplify sun sensitivity; some affect thermoregulation. Knowing which apply to your loved one is worth your time. Cool surfaces aren't always cool. Playground equipment, car seats, metal buckles, sand, and dark asphalt can all reach temperatures that cause burns. Test surfaces with the back of your hand before your loved one touches them. Cars are not safe. This is true for all of us, but especially true for individuals who may not be able to get out on their own or communicate distress. Never leave someone in a parked car in summer, even for a moment, and even with windows cracked. Temperatures rise dramatically within minutes. Hydration That Actually Works "Drink water" is easy advice to give. Making it happen for an individual who doesn't feel thirst, who can't pour their own drink, who has specific preferences, or who has swallowing challenges is another matter. A few strategies that work in real households: Put fluids everywhere. A water bottle in every bag, every room, every vehicle. Out of sight is out of mind — including for caregivers on a hot day. Offer variety. Water is ideal, but it's not the only option. Low-sugar electrolyte drinks, flavored waters, herbal iced teas, milk, smoothies, popsicles, watermelon, cucumbers, and broths all count toward hydration. For someone with a strong preference, meeting them where they are works better than a power struggle. Build hydration into routine. Linking drinks to daily events ("we always have a cup of water when we come inside") creates a habit that doesn't depend on remembering. Watch output. Fewer bathroom trips, darker urine, and dry mouth are early warning signs. In a nonverbal individual, this kind of practical tracking can catch dehydration before it becomes dangerous. Respect swallowing needs. Individuals with dysphagia may need thickened fluids or specific positioning. If you're unsure, check in with a speech-language pathologist or healthcare provider. Don't just push fluids without considering safety. Sun Protection That Respects Sensory Needs Sunscreen, hats, and UV-protective clothing are great — in theory. In practice, they can run into sensory barriers that caregivers know all too well. A few things that help: Try different formulations. Mineral sunscreens, lotions, sticks, sprays, and creams all feel different on skin. A brand that one person hates, another might tolerate. Test small patches at home before a big outing. Apply before other things. Sunscreen on clean, cool, dry skin sinks in better. Applying it in a rushed way right before leaving the house — when everyone is already overstimulated — rarely goes well. Use clothing where possible. UV-protective swim shirts, wide-brimmed hats, and lightweight long sleeves can reduce the amount of sunscreen needed on skin, which is often easier for people with sensory sensitivity. Sunglasses matter. Bright light can be genuinely painful for sensitive individuals. Good sunglasses, especially paired with a brimmed hat, can turn an overwhelming outdoor experience into a comfortable one. Water Safety Drowning is a leading cause of accidental death for children with autism, and water risks apply to adults too — especially those who are drawn to water but may not understand depth, currents, or their own swimming limits. If your loved one will be around water this summer — pools, rivers, lakes, the coast, even bathtubs — make a plan: Use a well-fitted, Coast Guard-approved life jacket for any open water activity, regardless of the individual's swimming ability. Always have a designated water watcher whose only job is watching. Not grilling, not chatting, not scrolling. Watching. Be honest about your loved one's skills. "Can swim" and "is safe swimming alone" are two very different things. Consider adaptive swim lessons. Organizations across Oregon offer instruction designed for people with disabilities. Even basic water safety skills can save lives. Treat rivers with respect. The Willamette and other Oregon rivers can be swift and cold even when they look calm. Current hazards aren't always visible. Sensory-Friendly Summer Summer brings a lot of sensory input: heat, bright sun, new smells, insects, crowds, fireworks, changing clothes, different foods. For some individuals, those changes are exciting. For others, they're exhausting. A few principles for sensory-friendly summer planning: Map the day before you live it. Preview outings with pictures, video, or social stories when possible. Knowing what's coming reduces anxiety. Build in recovery time. If you're planning a big outing, plan a quiet day on either side. Stamina for sensory input is a finite resource. Pack a comfort kit. Noise-reducing headphones, a favorite fidget, a weighted lap pad, sunglasses, extra water, a change of clothes, and any essential food or snacks can turn a possibly-hard day into a manageable one. Pay attention to fireworks. Fourth of July and other summer celebrations can be deeply distressing for individuals with sensory sensitivities.  Planning ahead — staying home with a calm activity, using headphones, or traveling somewhere quieter — is not "missing out." It's respecting a real need. Have an exit plan. For every outing, know how you will leave early if needed. Knowing the exit exists can be what allows someone to stay. The pressure to tough it out is what causes meltdowns; permission to leave is what allows enjoyment. Maintaining Routine in an Unstructured Season For children who thrive on school schedules and for adults whose day programs take a summer break, the unstructured parts of summer can be harder than the heat. Loss of structure, staff, transportation, and social contact can lead to increased anxiety, behavior changes, and regression on skills. A few supports that help: Keep some anchors. Wake-up and bedtime routines, meal times, and a few predictable weekly activities create structure even when the calendar is otherwise loose. Use visual schedules. A simple morning-to-evening picture schedule, updated daily, does more than you'd think. Maintain some connection with day programming when possible. Our DSA programs run through the summer in most locations, with schedules built to respect summer rhythms while still offering meaningful community engagement. Plan for transitions back to school. A few weeks before September, start easing back into school-year routines — bedtime, morning prep, lunchboxes, the works. Emergency Preparedness for Summer Hazards Oregon summers bring some specific environmental risks worth preparing for: Wildfire smoke. During smoke events, keep indoor air as clean as possible, use air purifiers if you have them, stay inside, and reschedule outdoor plans. For individuals with asthma or other respiratory conditions, a plan with your healthcare provider is essential. Power outages. Heat waves can strain the grid. If your loved one depends on powered medical equipment, refrigerated medications, or cooling, have a backup plan — generator access, identifying a cool place to go, knowing where chargers are. Ticks and other pests. Oregon has ticks in much of the valley and coast range. Light-colored clothing, repellents you tolerate, and checking skin after outdoor time are all worth building in. Travel kits. If you're heading to the coast or on a longer trip, a kit with medications, essential documents, comfort items, sensory supports, backup clothing, and snacks will save you. A Note on Caregivers You cannot take care of someone else well if you are running on empty. Summer, with its unstructured days and altered routines, can be particularly tough on parent-caregivers. Make sure you have: Someone to call. A trusted person who will pick up the phone on a hard day. Some physical relief. Relief care hours, a short break, time alone to drink a cup of coffee that doesn't get cold. Permission to scale back. Not every week needs to be packed with adventure. A quiet summer is also a good summer. If you could use more support with relief care, attendant care hours, or day programming for your loved one this summer, we're here for that. You don't have to be in crisis to ask. In fact, the best time to build support is before you need it. Bringing It All Together The goal isn't a perfect summer. No family has one. The goal is a summer full of small good moments — moments made possible because you thought ahead about the water bottles, the shaded bench, the backup plan, the favorite snack, the quieter route home. That kind of thoughtful planning isn't hovering or overprotective. It's what caregiving looks like when it's done well. The individuals we support deserve to experience Oregon summers fully. They deserve lake days, ice cream cones, trail walks, and long evenings on the porch. And they deserve caregivers — family and professional alike — who have the support and knowledge to make those experiences possible. If you'd like to talk through how North Star Oregon can help your family this summer, whether through in-home attendant care, relief care, or Day Support Activities in Albany, Corvallis, Eugene, Springfield, Salem, or Tangent, please reach out. Visit northstaroregon.com to learn more or contact our team directly. Summer is here — let's make it a good one. --- North Star Oregon provides In-Home Attendant Care and Day Support Activities for individuals with intellectual and developmental disabilities across Oregon, funded through the K Plan and 1915(c) Medicaid waivers. This article is general information and not a substitute for medical advice. Always consult your loved one's healthcare team about specific medical, medication, and safety questions.