On July 15, 2011, the State of Delaware entered into a comprehensive settlement agreement with the Department that will transform the state of Delaware's mental health system and resolve violations of the ADA. The federal court in Wilmington approved the settlement the same day. The agreement requires Delaware to expand community mental health services so people with severe and persistent mental illnesses can be served in the most integrated settings appropriate to those individuals' needs. Over the next five years, Delaware will prevent unnecessary hospitalization by expanding and deepening its crisis services, including a hotline, crisis walk-in centers, mobile crisis teams, crisis apartments, and short term crisis stabilization programs. Delaware will also provide Assertive Community Treatment (ACT) teams, intensive case management, and targeted case management to individuals living in the community who need support to remain stable. In addition, the state will offer scattered-site supported housing to everyone in the agreement's target population who needs that housing support. Finally, Delaware will offer supports for daily life, including supported employment, rehabilitation services, and peer and family supports.

Thomas E. Perez, Assistant Attorney General for the Civil Rights Division, commented that "the services that the State of Delaware has agreed to provide under this agreement will enable people with mental illnesses living in Delaware to remain successfully in their homes and communities, rather than entering costly segregated facilities. As states around the country work to breathe life into the rights established in the ADA and Olmstead, this agreement demonstrates Governor Markell and Attorney General Biden's vision and leadership."

In 2009, the Justice Department began its investigation of Delaware's state hospital and, in 2010, modified the scope of the investigation to focus on violations of the ADA throughout the state's mental health system. The state worked cooperatively with the Department to negotiate a settlement resolving the violations.