She has been an independent consultant working with individuals with complex physical and medical challenges since 1977. She has worked on a number of class action court cases, including Partlow in Alabama, Willowbrook in New York, and is currently a member of the Quality Review Panel for the state of Tennessee. She is one of the developers of the Health Risk Screening Tool (otherwise known as the Physical Status Review), which is an eletronic instrument designed to identify and track health risk in persons with developmental and other disabilities that increase health vulnerability. She has also written extensively about health and other issues impacting services to persons with intellectual and developmental disabilities.