Olmstead v L.C. (Olmstead) is a 1999 United States Supreme Court case regarding discrimination against people with mental disabilities. In Olmstead, the Court found mental illness is a form of disability and unjustified isolation of a person with a disability is a form of discrimination under Title II of the federal Americans with Disabilities Act (ADA). The Court held community placement is required and appropriate if "[a] the State's treatment professionals have determined that community placement is appropriate, [b] the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and [c] the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities."

The North Dakota Olmstead Commission was created in 2001 through an executive order issued by Governor John Hoeven. The order provided the commission was to develop a plan to implement the Olmstead decision by providing appropriate community-based placement for individuals with disabilities in a manner consistent with the needs and resources of the state.

In 2002, the Olmstead Commission held public meetings across the state to gather information on how to serve individuals with disabilities. The commission developed a working plan that included historical information regarding efforts to serve individuals in less restrictive settings and a record of state actions to comply with the Olmstead decision.

Executive orders issued by the Governor in 2010 and 2018 continued the Olmstead Commission and adjusted the membership of the commission. The 2018 executive order also provided the commission may create subgroups for purposes of seeking expertise and input on community services and supports, health care, housing employment, education, and transportation. The 2018 executive order provides for the commission to consist of 10 voting members and 8 nonvoting members with a representative of the Governor's office and a member representing the public to serve as co-chairs.