My name is Becky Hartman. I'm Anna's mom and an occupational therapist. Anna has chosen Vanguard Landing as her future home. I am writing from our family's experience, but the decision before you reaches every person who will access Medicaid waiver services to receive support in the home they choose.

 

I understand why reviewers are cautious about a setting intentionally designed to support people with disabilities. They are responsible for ensuring that Medicaid services do not isolate people or recreate institutional life under another name. The goal is meaningful choice, relationships, and access to the wider community. That is exactly what I want for Anna and for every person who chooses to live there.

 

Early in my career, I completed fieldwork at the Northern Virginia Training Center. The staff cared deeply, but institutional life was still organized around the facility rather than around each person's choices. Meals, activities, and access to the outside community happened on the institution's terms. There was support, but very little autonomy.

 

My professional degree allowed me to work in a field I love. Before I became Anna's mother and caregiver, I thought I understood far more about the lives of people with disabilities and their families than I did. I could not know what I was not living. Becoming Anna's mom showed me the limitations of what I thought I knew. Yet, I still do not know what it feels like to be Anna. That is why her choices must remain hers, and living at Vanguard Landing is one of them.

 

Anna currently lives in a single-family home in the community, surrounded by people who love her. Yet most days her world is the four walls of our home and a screen through which she connects with her friends and loved ones. How is that inclusion?

 

At Vanguard Landing, Anna has chosen a cottage with her own bedroom and bathroom and a full kitchen where she can cook with support. Transportation will connect her with the wider Virginia Beach community. People without disabilities have chosen homes there too—we have met some of them. Vanguard Landing has invited the public to events and tours on the property, and its plans include businesses and event spaces intended to welcome the wider community. Anna's siblings ask to spend time there because they want to be there. She can build friendships with people who share her experience of living with a disability and with people without disabilities. Opportunities at Vanguard Landing do not replace outside relationships or activities. They give Anna more ways to participate, not fewer.

 

The difference I saw firsthand was not the presence of support. It was who held control. At NVTC, the institution determined the rhythms and options of daily life. At Vanguard Landing, support is designed to help each resident make and act on their own choices.

 

Professional experience can help identify the support a person needs. It does not give any of us the authority to substitute our judgment for that person's choices. The laws governing these services were changed to give people with disabilities more autonomy. When those same laws are used to let professionals decide where a person should live because they believe they know better, they do the opposite of what they were meant to do.

 

Denying waiver services at Vanguard Landing would not prevent people with private resources from choosing this thoughtfully designed, supportive home. It would exclude people who rely on Medicaid from a choice that remains available to those who can pay privately. Even if no one intends to create that divide, that is the practical effect—and it troubles me deeply.

 

Choosing Vanguard Landing does not change a person's assessed support needs; waiver services are authorized according to those needs. How does limiting where a person may use that support protect their autonomy? What does meaningful integration mean if remaining inside the four walls of our home is acceptable, but living in the community Anna chose is not?

 

Anna chose Vanguard Landing, and others have chosen it too. Please approve Medicaid waiver services there so that this choice is available to people who rely on Medicaid, not only to those who can pay privately.