As a professional who has dedicated their life’s work to community driven and inclusionary programs, I have long been appalled by the rebranding of community as in Vanguard Landing.  A segregated, separate community with an in-house cafeteria with operating hours is an adapted institution, not a home. It may be the service a family wants, but it is not the community integration hcbs demands and it should not be funded by the same cache of funding that hcbs compliant agencies utilize, especially when those organizations had to photograph doorknobs, closet doors, menu options, refrigerator contents to prove their normalcy when  Vanguard cottages don't have full kitchen, have gated off roads, etc.  If families of means want to build a program where “only the best” disabled people and their families can come, that is fine, but it should not receive waiver dollars, as those dollars come with rules and regulations about integration and inclusion and choice. 

I am bothered by stories of deposits required for applications and trusts being signed over to an organization that is getting medicaid dollars, when other providers are required to accept medicaid funding as their FULL payment along with a portion of the person’s benefits. I am bothered by stories of fee for service menus that mean families have to come out of pocket if their person takes meds, or needs shower support or bathroom help. I am horrified quite frankly on the whitewashing of “separation and disempowerment” as best practice that has been allowed with Vanguard Landing.

We should be moving the services forward to ensure all people get the supports they need near their homes in regular neighborhoods with friends and hobbies and true community. We should be holding all Medicaid waiver programs to the same standard, and that standard should be a safe, fulfilling, supported life driven and chosen by individuals in a real community.