The court recognized that the ADA does not necessarily require a State to serve everyone in the community but that decisions regarding services and where they are to be provided must be made based on whether community placement is appropriate for a particular individual in addition to whether such placement would fundamentally alter the State's programs and services.

In the wake of the Olmstead decision, the federal government has issued a series of directives and suggestions for states to comply with the ADA.

Federal grants have been made available to expand community-based services. Dozens of states organized task forces to develop implementation plans.