HHS’ Office for Civil Rights Works with North Carolina to Help Young Adult Living in a Hospital Move to the Community

Resolution Marks the 6th Voluntary Resolution in OCR’s Olmstead Initiative to Support Integration of Persons with Disabilities into Community Life

Today, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), announced a resolution agreement with the North Carolina Department of Health and Human Services (North Carolina) to memorialize actions to resolve a civil rights complaint filed by Disability Rights North Carolina alleging the unnecessary institutionalization of Alexis Ratcliff, a young woman with a disability.  Alexis became quadriplegic while a young child.  Due to a lack of appropriate community services, North Carolina placed her in an acute care hospital six years ago at the age of 13.  Living in the hospital, she graduated high school by taking classes virtually and received a full scholarship to attend college.  As a result of OCR’s actions, Alexis will be moving to her new community home this month.

“Sixty years ago, my father, as a new U.S. Senator, called for reform of institutions that confined people with disabilities to be ‘condemned to a life without hope,’” said HHS Secretary Robert F. Kennedy, Jr. “Today, the Office for Civil Rights fulfilled that vision by ending unnecessary segregation and helping a young woman build the future she deserves. This resolution brings Make America Healthy Again to life—empowering people like Alexis to live healthy, productive lives in their communities.”

OCR’s action is based on three federal laws: Section 504 of the Rehabilitation Act of 1973, Section 1557 of the Affordable Care Act, and Title II of the Americans with Disabilities Act.  Each of these laws, and the U.S. Supreme Court’s 1999 Olmstead v. L.C. decision, requires that services are provided in the most integrated setting appropriate to the needs of a person with a disability.  OCR’s actions ensure Alexis Ratcliff can leave the hospital and reside in her apartment within a family home while living an independent life and being a contributing member of her community.

“Placement in a hospital should never be a long-term option for an individual with a disability who wants to live in their own home and/or community,” said OCR Director Paula M. Stannard.  “People with disabilities are entitled to live alongside their non-disabled friends and peers and pursue meaningful and productive lives.  Today’s resolution reaffirms OCR’s commitment to enforce the integration mandate.”

As a result of facilitated discussions with the Complainant, Alexis, and the State of North Carolina under OCR’s Expedited Complaint Resolution process, the State took the following corrective actions: 

• Approved home modifications, equipment, and technology necessary for Alexis to lease an apartment in a family home in the community.
• Developed a comprehensive transition plan to put in place the needed individualized and person-centered assessments and services for her discharge from the hospital and transfer to the community.

The State also agreed to continue to provide needed support to Alexis, including:

• Ensuring upon her discharge from the hospital and transition to her new home, there is an adequate care plan in place to support her needs in the community.
• Assisting her with securing the necessary providers for direct care and nursing support services.
• Ensuring she has the necessary skill building and educational services and supports that she requires to live her most independent life, integrated into the community, and to accomplish her personal goals. 
• Assisting her in her pursuit to live in a fully integrated setting in the community by ensuring she has needed behavioral supports and access to peer mentorship programs and has opportunities to work and engage in activities in the community.

OCR will monitor North Carolina’s commitments during the transition for one year and the State will report to OCR on the adequacy of continuing services to support Alexis’ community placement, and a mechanism for her and her representatives to report and resolve any issues that arise. 

The resolution can be found at: https://www.hhs.gov/sites/default/files/ocr-nc-dhhs-agreement-olmstead.pdf.

Today’s blog post commemorating the 26th Anniversary of Olmstead may be found at: https://www.hhs.gov/blog/2025/06/23/commemorating-26th-olmstead-anniversary-and-importance-olmstead-decision-make-america-healthy-again.html.

OCR is committed to working with states to help them meet their legal obligations under Federal laws to ensure that individuals with disabilities can live in the most integrated setting appropriate to their needs and avoid unnecessary institutionalization.  If you believe that your or another person’s civil rights or health information privacy rights have been violated, you can file a complaint with OCR at: https://www.hhs.gov/ocr/complaints/index.html.

To learn more about recent developments in OCR’s Olmstead Initiative, visit OCR’s website on Community Living and Olmstead.

Follow HHS OCR on X (formerly Twitter) at @HHSOCR.