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FORConn
Friends
of Retarded Citizens
of Connecticut
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Choices
Why Choice is So Important
Why
does FORConn advocate for a full range of services and supports?
We
believe that our citizens with mental retardation have such a
wide range of mental capacity, physical ability or disability,
unique talents and interests that the range of opportunities offered
them should be as diverse as possible.
We
believe that the same ideological approach for all persons with
mental retardation does not work and may even be harmful for some
individuals. A full range of choices should be offered in education,
community and living settings. Persons outside the immediate family
and/or legal guardians should not be allowed to push their ideologies
or personal views on persons with mental retardation.
FORConn
is respectful of each person's individuality and, when and where
realistic, each person's right to envision and choose a lifestyle
he feels is right for him. When the individual cannot make informed
decisions, their guardians speak for them. When a person with
mental retardation has been ruled by the Probate Court to be unable
to make informed decisions about matters related to his care,
decisions about his care should be made by their legal guardians.
We
believe those who live with mental retardation every day of their
lives and their families and guardians who support them "come
first" when it comes to how and where they will live, go
to school, work and play on a day to day basis.
Choices
for a lifetime: Options for all
(Special thanks to VOR, our national
affiliate, for text used in this section)
Throughout
the lifetime of a family member with special needs, families are
faced with difficult decisions. When a child has mental retardation
or violent and uncontrollable behavior, these decisions are made
even more difficult as families struggle to provide their children
with a life full of experiences and opportunity for maximum potential.
Appropriate educational and residential options are among the
many decisions families of children with special needs must face.
Recognizing that every person with special needs has unique strengths,
abilities and needs, FORConn supports a full array of educational
and residential options. This includes options ranging from educational
services in regular classrooms to self-contained special education
schools or specialized residential settings. Similarly, FORConn
believes that residential options should mirror the diversity
of people with special needs from in-home supports to Intermediate
Care Facilities for the Mentally Retarded (i.e., institutions).
In every case, FORConn advocates that the final determination
of what is appropriate depends on the needs of the individual.
Other groups may oppose specialized educational and residential
opportunities in favor of full mainstreaming, closed admissions
and elimination of the ICF/MR option. FORConn opposes these initiatives
because they limit legitimate choice and dismantle programs that
are specially designed to assist individuals with severe mental
retardation, medical complexities, and extreme behavioral challenges.
Furthermore, elimination of many ICFs/MR across the country have
meant that adults with severe mental retardation, medical complexities
and/or behavioral issues are without adequate services, especially
when they age out of an educational program.
FORConn wants to preserve the full continuum of educational and
residential placement options. FORConn has people across Connecticut
that can help get information on all types of schools and residential
placements. Please consider supporting FORConn through your membership
contribution. All people with mental retardation need your help
and support. If you agree with our philosophy, pleas
Join Us!
The
Law Supports Choice
(Special thanks to VOR, our
national affiliate, for text used in this section)
The
Developmental Disabilities Assistance and Bill of Rights Act, 42
U.S.C. §2001(c)(3)
(c) POLICY. -It is the policy of the United States that all pro-grams,
projects, and activities receiving assistance under this title shall
be carried out in a manner consistent with the principles that-
* * *
(3) individuals with developmental disabilities and their families
are the primary decision makers regarding the services and supports
such individuals and their families receive, including regarding
choosing where the individuals live from available options, and
play decision-making roles in policies and programs that affect
the lives of such individuals and their families.
Individuals with Disabilities Education Act Regulation
34 C.F.R. § 300.551 Continuum of Alternative Placements (a)
Each public agency shall ensure that a continuum of alternative
placements is available to meet the needs of children with disabilities
for special education and related services.
“Continuum” shall include “instruction in regular
classes, special classes, special schools, home instruction, and
instruction in hospitals and institutions.” 34 CFR §300.551(b).
Medicaid Law:
42 U.S.C. §1396n(c)(2)(C)
A Medicaid Home and Community-Based Waiver shall not be granted
unless the state provides satisfactory assurances that –
such individuals who are determined to be likely to require the
level of care provided in a hospital, nursing facility or intermediate
care facility for the mentally retarded are informed of the feasible
alternatives, if available under the waiver, at the choice of such
individuals, to the provision of inpatient hospital, nursing facility
services or services in an intermediate care facility for the mentally
retarded.
Medicaid regulation:
42 C.F.R. §441.302
(d) When a recipient is determined to be likely to require the level
of care provided in a hospital, nursing facility, or intermediate
care facility for the mentally retarded, the recipient or his or
her legal representative will be –
(1) Informed of any feasible alternatives available under the waiver,
and
(2)Given the choice of either institutional or home and community-based
services.
Medicaid Regulation:
42 C.F.R. §441.303
The [state] agency must furnish CMS with sufficient information
to support the assurances required by §441.302, including
* * *
(d) A description of the agency’s plan for informing eligible
recipients of the feasible alternatives available under the waiver
and allowing recipients to choose either institutional services
or home and community-based services.
Penny Thompson, (former) Acting Director, Center for Medicaid
and State Operations, HHS, in a letter to Carole Sherman (February
5, 2001) (excerpt):
Federal Medicaid policy supports an individual’s
right to choose where they receive Medicaid services for which they
are eligible. For example, States are required by Federal law to
offer individuals who are eligible for Medicaid home and community-based
waiver services the choice between community-based care under the
waiver program or institutional services.
Olmstead v. L.C.,
119 S. Ct. 2176 (1999)
Olmstead set forth a three part test to determine if community placement
is appropriate (i.e., institutionalization is unjustified):
“(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.” 119 S. Ct. at 2181 (emphasis added).
A majority of Justices in Olmstead recognized an ongoing role for
publicly and privately-operated institutions:
“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...Nor is there any
federal requirement that community-based treatment be imposed on
patients who do not desire it.” 119 S. Ct. at 2187.
“The Olmstead “choice” provision and guardianship
rights,” by Patricia Williams, Esq., September 6, 2000 (The
Voice, Spring 2001)
Although there has been much discussion within the disability community
of the meaning of “choice” and how “choice”
can be exercised by persons with severe developmental disabilities,
there has been no genuine legal challenge to the authority of parents
of minor children and guardians or conservators of adults with developmental
disabilities to be primary decisionmakers in those areas recognized
by competent courts of jurisdiction.
Glossary of Acronyms
ADA:
Americans with Disabilities Act
C.F.R.: Code
of Federal Regulations
CMS: Centers
for Medicare and Medicaid Services
HHS: U.
S. Department of Health and Human Services
S.Ct.: Supreme
Court
U.S.C.: United
States Code (federal statutes)
VOR: Voice
of the Retarded
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FORConn
- Working since 1984 For Connecticut Residents
who have Mental Retardation.
Contact Us!
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