What does the ADA "Integration Mandate" really mean?

Title II of the Americans with Disabilities Act (ADA) prohibits discrimination on the basis of disability in State and local government services. Federal policy on the provision of services and benefits to people with disabilities is far more flexible and less restrictive than many advocates of full community inclusion are willing to admit. There are no mandates that prohibit particular settings or services for individuals with disabilities in general, and the needs and choice of the individual are a primary consideration.

Here is the link to § 35.130 of ADA regulations on "General prohibitions against discrimination" that describe requirements for State and local governments in providing services to people with disabilities.

Below are some of the requirements that may at first seem contradictory, but are written to assure that individual needs take precedence over general presumptions and bias based on preconceived ideas of what individuals are capable or not capable of doing as a class:

Paragraph (b) (1) (iv): A public entity, in providing any aid, benefit, or service, may not, directly or through contractual, licensing, or other arrangements, on the basis of disability…

Provide different or separate aids, benefits, or services to individuals with disabilities or to any class of individuals with disabilities than is provided to others unless such action is necessary to provide qualified individuals with disabilities with aids, benefits, or services that are as effective as those provided to others;

Paragraph (b)(2): A public entity may not deny a qualified individual with a disability the opportunity to participate in services, programs, or activities that are not separate separate or different, despite the existence of permissibly separate or different programs or activities.
 
Paragraph (d): A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.

Paragraph (e): Nothing in this part shall be construed to require an individual with a disability to accept an accommodation, aid, service, opportunity, or benefit provided under the ADA or this part which such individual chooses not to accept….
  
An analysis of the regulations discusses requirements that allow for both the effective provision of services and choice, as well as assuring that individuals are not restricted from equal participation in a public entity’s programs or activities. Page 193 of the regulations includes an analysis that clarifies the meaning of these important paragraphs:

Paragraph (b)(1)(iv) permits the public entity to develop separate or different aids, benefits, or services when necessary to provide individuals with disabilities with an equal opportunity to participate in or benefit from the public entity’s programs or activities, but only when necessary to ensure that the aids, benefits, or services are as effective as those provided to others.

[This] paragraph must be read in conjunction with paragraphs (b)(2), (d), and (e). Even when separate or different aids, benefits, or services would be more effective, paragraph (b)(2) provides that a qualified individual with a disability still has the right to choose to participate in the program that is not designed to accommodate individuals with disabilities.

Paragraph (d) requires that a public entity administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.
 
Paragraph (b)(2) specifies that, notwithstanding the existence of separate or different programs or activities provided in accordance with this section, an individual with a disability shall not be denied the opportunity to participate in such programs or activities that are not separate or different.

Paragraph (e), … states that nothing in this part shall be construed to require an individual with a disability to accept an accommodation, aid, service, opportunity, or benefit that he or she chooses not to accept.

Taken together, these provisions are intended to prohibit exclusion and segregation of individuals with disabilities and the denial of equal opportunities enjoyed by others, based on, among other things, presumptions, patronizing attitudes, fears, and stereotypes about individuals with disabilities. Consistent with these standards, public entities are required to ensure that their actions are based on facts applicable to individuals and not on presumptions as to what a class of individuals with disabilities can or cannot do. [emphasis added]

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In short, the ADA does not restrict individuals from receiving services in specialized settings for people with disabilities nor does it allow public entities to prevent access to services and benefits available to all. 

The 1999 U.S. Supreme Court Olmstead decision affirms this interpretation of the ADA and includes protections and choice for people in institutional settings.