by Dave "Doctor" Gonzo

Tuesday, June 22, 1999 --- New York (APJP) -- It's ironic: voters send representatives to Congress to do something.

But it just isn't happening.

The GOP-dominated House of Representatives has done less than nothing during the first five-plus months of the 106th Congress. Judicial nominations are stalled. Gun control is DeLayed. Nutcase Congressmen claim that posting the Ten Commandments in schools will help put a stop to gun violence. HMO reform legislation and the Patients' Bill of Rights are stalled..

And the Supreme Court has done it again: issued a ruling that has more impact on the health of Americans and the financing and structure of public health programs than anything the two houses of Congress have cooked up in the last two-and-a-quarter years.

Late this afternoon, the Court issued three separate decisions stating that the Americans with Disabilities Act does not apply to more than 100 million Americans with physical impairments such as poor eyesight or other medically remediable or correctable conditions.

No surprise there -- this particular ruling was predicted by the judicial pundits (yes, there actually are judicial pundits). The reasoning behind the majority rulings was that people with correctable physical impairments generally cannot rely on the AWDA to sue their employers or prospective employers over alleged discrimination -- otherwise, over 160 million Americans would be protected by the act. The lawsuits which the Court ruled on were brought by plaintiffs with vision problems and high blood pressure.

But the Court, as it is sometimes wont to do, also issued a dramatic ruling. In a separate case, the Court ruled that the very same Americans with Disabilities Act may require states to shift mentally disabled people out of state hospitals and mental facilities and into group homes and/or more domestic settings.

This ruling, despite being characterized as a "narrow, middle-of-the-road" decision by some press outlets, constitutes a major victory for advocates of better public support for mental health patients, recovering drug addicts and the homeless. Advocacy groups such as ADAPT (American Disabled for Accessible Public Transit) had argued that the federal law best known for requiring such features as access ramps to allow access to public buildings also mandated better treatment and community access for the mentally ill.

The three other rulings which narrowed the scope of disabilities covered by the AWDA did not please many advocates for the disabled, including The Center for an Accessible Society, which characterized the rulings as "erroneously turn[ing AWDA] into a benefits law under which only a select group of Americans can qualify." Moreover, there are sure to be more court battles over interpretation of the AWDA -- some practically guaranteed to reach the Supreme Court in the coming years.

But the ruling concerning the treatment of the mentally ill is likely to have a wide-ranging affect on health care in the United States and, specifically, the financing and logistics of state health programs. One thing is certain -- the Supreme Court rulings will have more of an impact on the nation's social and health environment than any recent Congressional actions.