Self-determination has been a dominant theme in the movement for the enhancement of the lives of adults with developmental disabilities, but who actually chooses the careproviders funded by state and federal dollars? Officials from all 50 states were interviewed to ascertain who chose the careprovider for youth transitioning from educational to adult services for each year from 1992 to 2004. The choices fell into roughly three levels: state-dictated, restricted individual choice, and unlimited individual choice. The highest level of choice offered in that state for a given year was tracked. The change in level of choice has been dramatic. In 1992, government dictated all careproviders in 42 states; by 2004, this was reduced to 9 states.

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