What is Together for Choice?

Together for Choice is a 501(c)(3) organization whose purpose is to promote the right of all individuals with developmental disabilities and their families to choose where to live and how to spend their days.

How does Together for Choice promote the right of individuals with developmental disabilities to choose where to live and how to spend their days?

Together for Choice identifies federal and state laws, regulations and policies that limit choice and advocates for change in those laws, regulations and policies.  TFC meets with legislators and agency officials in Washington and in state capitals to explain the importance of policies and that allow individuals with developmental disabilities to have the same life choices as non-disabled individuals.

Which federal laws, regulations and policies inhibit the choices of individuals with developmental disabilities?

One of the most significant regulations that inhibits choice is the Settings Rule issued by the Centers for Medicare and Medicaid Services (CMS) in 2014.  The Settings Rule does not honor the right of the individual to choose where to live or how to spend his or her day.  Instead, the Rule limits Medicaid waiver funding to small homes in neighborhoods and to certain work sites that also employ non-disabled individuals. It discriminates against campus settings, farmsteads and disability specific work and residential settings that many individuals with developmental disaiblities find preferable because they better meet their diverse needs.  It does so by making the unwarranted presumption that these settings isolate individuals with developmental disabilities from non-disabled individuals.

Do Farmsteads, Campus-Style or Disability-Specific Communities have the effect of isolating individuals with developmental disabilities  from non-disabled individuals?  

No.  Many of these settings actively promote engaging the individuals they serve with non-disabled individuals through a variety of vocational and recreational activities chosen by the individual and his or her family.  In fact, many of these individuals have tried living in small homes in neighborhoods and have found such settings to be extremely isolating and detrimental to their health and happiness.

What is your position on the  Settings Rule?

TFC believes that the Settings Rule was well-intentioned but misguided because it does not accommodate the diverse needs of the broad spectrum of individuals with developmental disabilities and does not give paramount consideration to individual choice.  Instead, the Rule narrows the types of settings that can receive Medicaid waiver funding and allows bureaucrats in Washington to dictate where individuals with developmental disabilities can live and spend their days.  TFC believes that modest changes to the Rule can preserve its main purposes while honoring individual choice and expanding residential and vocational options eligible for Medicaid waiver funding.

My child wants to live in a non-disability specific building and receive services that are not designed for individuals with disabilities.  Do you support my child’s choice?

Absolutely. TFC believes that individual choice is paramount and should be honored.  

Do you support long-term care facilities and those who wish to receive services in such settings?  

Absolutely. Again, TFC believes that individual choice is paramount.  For those who believe that long term care facilities best meet their needs, that option should be available to them.

Does the Supreme Court’s decision in Olmstead prohibit “institutions?”  

No.  The Supreme Court was very clear in its decision that institutional care should remain available to those who need or prefer such care.  The Court held that an individual should be placed in a community setting only when such placement “is not opposed by the affected individual.”  Thus, the Court made clear that choice must be honored.  The Court went on to say:  “We emphasize that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings.”  Justice Kennedy added that it would be “tragic” if the ADA were interpreted to force individuals “into settings with too little assistance and supervision.”  The bottom line is that Olmstead recognizes the need for a wide range of facilities to meet the diverse needs and preferences of individuals with disabilities.

Do you only focus on the HCBS Settings Rule?  

No our focus is on all federal and state laws, regulations and policies that limit the ability of individuals with disabilities and their families to choose the life that is best for them.

Does TFC only focus on residential options for individuals with developmental disabilities?

No.  TFC is equally focused on preserving individual choice and expanding options in day programming and vocational opportunities for individuals with developmental disabilities.  The Settings Rule applies to both residential facilities, day programs and work programs.  The changes to the Rule proposed by TFC would ensure individual choice in day and work programs.  TFC also supports changes in other laws, regulations and policies that have the effect of denying choice and limiting options in day and work programs.

I want to help preserve choice and expand options for individuals with I/DD.  What can I do?

You can become a member of Together for Choice!  We will keep you informed of our work and ask you to join us in our advocacy efforts.