New DOJ Opinion Could Affect Access to Community-Based Services for People With Disabilities

July 2, 2026

The U.S. Department of Justice's (DOJ) Office of Legal Counsel (OLC) recently issued a legal opinion that could restrict the rights of people with disabilities to receive services where they want to.

The opinion focuses on a long-standing disability rights principle often referred to as the "integration mandate." This means that people with disabilities should receive services in the most integrated setting appropriate to their needs. For many, that means living, learning, working, and receiving care in their homes, schools, clinics, and communities rather than in institutions or other segregated settings.

This principle has been central to disability rights policy for decades. In 1999, the U.S. Supreme Court's decision in Olmstead v. L.C. held that unjustified isolation of people with disabilities can be a form of discrimination. Since then, federal agencies, states, advocates, providers, and courts have generally understood Olmstead to support policies that help people with disabilities access services in community-based settings when appropriate.

The new DOJ opinion takes a narrower view. It argues that federal disability laws do not require states to prioritize community-based services in all circumstances. Instead, the opinion says that states may consider factors such as medical needs, safety, available resources, and other legitimate reasons when deciding where services are provided.

The opinion does not change the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, or the Individuals with Disabilities Education Act (IDEA). It also does not have the same legal effect as a statute or regulation. However, DOJ legal opinions can influence how federal agencies enforce the law and how states interpret their obligations.

Why This Matters for Audiologists and SLPs

Audiologists and speech-language pathologists (SLPs) serve many individuals who may be affected by this shift, including people with intellectual and developmental disabilities, autism, traumatic brain injury, mental health conditions, complex communication needs, hearing loss, and other disabilities.

Many of these individuals receive audiology and speech-language pathology services in community-based settings such as their homes, outpatient clinics, schools, early intervention programs, group homes, and other integrated environments. These services can help individuals communicate, learn, participate in daily life, maintain independence, and avoid unnecessary institutional care.

If federal enforcement of the integration mandate becomes more limited, states may divest in community-based systems of care, impacting access to care in many settings.
Possible Impact on Medicaid and Home- and Community-Based Services
A significant portion of audiology and speech-language pathology services for people with disabilities is supported through Medicaid, including Medicaid home- and community-based services waivers.

These programs help people receive services outside of institutional settings. Depending on the state, they may support services in a person's home, community program, supported living arrangement, or other noninstitutional setting.

If states interpret the DOJ opinion as giving them more flexibility to limit community-based services, they may be more likely to reduce waiver slots, limit service authorizations, maintain waiting lists, or shift funding toward institutional care. These changes could reduce access to services in the settings where many individuals and families rely on them.

Possible Impact on Schools and Early Intervention

The broadened shift in federal interpretation could influence future debates about how strongly federal agencies support integrated settings across disability programs. For schools and early intervention systems, this may raise concerns about whether future policy changes could affect access to inclusive educational environments, related services, and supports.

At this time, IDEA's requirements remain in place. Children with disabilities continue to have the rights outlined under IDEA, including access to a free appropriate public education and services provided in the least restrictive environment consistent with their individualized needs.

Possible Impact on Institutional Settings

For audiologists and SLPs working in hospitals, skilled nursing facilities, intermediate care facilities, or other institutional settings, the immediate impact may be less clear.

However, if states rely more heavily on institutional placements over time, service patterns could shift. Audiologists and SLPs may see changes in where services are delivered, which populations are served in different settings, and how community-based and institutional systems are funded.

What This Opinion Does-and Does Not-Do

This DOJ opinion does not eliminate the ADA, Section 504, IDEA, Medicaid requirements, or other federal protections for people with disabilities. It also does not automatically change state laws, Medicaid programs, school obligations, or payer coverage policies.

However, it may signal a shift in how the federal government interprets and enforces disability rights laws related to community-based care. That shift could influence future federal enforcement, state policy decisions, litigation, and funding priorities.

What ASHA Is Doing

ASHA remains committed to protecting access to high-quality audiology and speech-language pathology services in settings that support communication, learning, independence, participation, and quality of life. ASHA will continue to monitor these developments, assess their potential impact on audiologists, SLPs, and the individuals and families they serve, and share additional updates as more information becomes available.

In the meantime, ASHA continues to advocate for access to care by fighting to protect Medicaid, fully fund IDEA, and maintain a cabinet-level Department of Education so that all students have the support they need to succeed. Advocates can join us in taking action by participating in any of the above campaigns or the dozens of other campaigns on ASHA's Take Action webpage.

Questions?

Email Bill Knudsen, ASHA's director of education policy, at [email protected].