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.  Together for Choice focuses particularly on the needs and preferences of those with significant disabilities.

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 how particular policies affect the ability of individuals with developmental disabilities to choose the housing and program options that best meet their needs and preferences.  There is a tendency among other advocacy groups and government policymakers to favor one-size-fits-all solutions.  Often, these solutions do not take into account the needs and preferences of those with the most significant disabilities.  Together for Choice works hard to educate policymakers on this issue and to propose legislative or regulatory changes that accommodate the needs and preferences of this segment of the disabilities community.

One of the most significant regulations affecting choice is the Settings Rule issued by the Centers for Medicare and Medicaid Services (CMS) in 2014.  The main purpose of the Settings Rule is to require person-centered planning, which Together for Choice strongly supports.  However, the Rule contains a number of restrictions that can limit the residential and vocational options available to individuals with disabilities.  These restrictions can make home and community-based settings unavailable to those with the most significant disabilities.  Together for Choice worked with CMS on the issuance of new guidance in March 2019 that made it clear that campus settings, farmsteads and other disability specific settings are not automatically disqualified from Medicaid waiver funding.  However, some states still interpret the Settings Rule as restricting waiver funding to services received in an individual’s own home or in a small group home.  Such interpretations do not honor the right of the individual to choose where to live or how to spend his or her day.  This has a particularly adverse impact on individuals with the most significant disabilities, some of whom find that campus settings, farmsteads and other disability-specific settings best meet their needs.

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.

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

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 and should be adequately funded.  

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.

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.

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.

Together for Choice supports the preservation of Section 14(c) of the Fair Labor Standards Act and similar provisions at the state and local levels.  The vast majority of employers who hold Section 14(c) certificates today are non-profit programs designed to serve individuals with significant disabilities.  If Section 14(c) is repealed, many of these programs will no longer exist and the one opportunity individuals with significant disabilities have to obtain employment will disappear.  There has been no comprehensive study of the impact in those states and localities that have repealed their versions of Section 14(c).  However, the data that does exist shows that those with the most significant disabilities are no longer employed and instead now spend their days in adult day care or going to movies or the mall.  Section 14(c) and the state and local equivalents should be maintained for those that need these programs.

Yes.  Any person who wants the opportunity to seek competitive integrated employment should receive the supports they need to pursue competitive integrated employment.

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.