In light of the growing concern about the federal rule changes issued by Centers for Medicare and Medicaid Services (CMS) to its Home and Community Based Services program, Bittersweet and many other advocates are taking action.   

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These changes affect where waiver money can be used.  The new rule may limit choice by excluding some settings that CMS considers isolating, such as farmsteads and congregate settings. 

The state of Ohio is in the process of putting together a transition plan that must be presented to the Federal CMS by March.  Ohio will post the Transition Plan online by December 1, and will be open for comment for 30 days.  The CMS can then approve Ohio’s plan or ask for changes or clarifications.   

Help us preserve the right for individuals with development disabilities to choose where they receive services, whether it is farmsteads or congregate settings.  To join the awareness and advocacy campaign, please visit and sign the petition to support people with disabilities and to ensure fewer barriers are implemented in the process of determining state criteria. 

We encourage you to download this general letter and reach out to your state representative. 

For more information on this growing concern, visit the Coalition for Community Choice website.   

Thank you for your continued support to positively improve the lives of individuals with autism!