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This article argues that the Supreme Court's decision in Olmstead v. L.C., 119 S. Ct. 2176 (1999), finding a qualified right to community treatment and services for certain institutionalized persons under the Americans with Disabilities Act (ADA) and endorsing an "integration mandate," forces us to reconsider the role of the "least restrictive alternative" in institutional mental disability law, and may serve to resuscitate and revitalize the constitutional foundations of that principle in this area of the law. In this context, Olmstead has the capacity to be the Supreme Court's most therapeutic mental disability law decision since that Court decided, in Jackson v. Indiana, 406 U.S. 715 (1972), that the "nature and duration" of civil commitment were constitutionally bound.