We strongly support allowing people who qualify for Medicaid waiver-funded services to use those services at Vanguard Landing (VGL). Vanguard Landing is a much-needed community of homes in the Tidewater area where people with disabilities can receive individualized support while remaining connected to the wider Virginia Beach community. Autism is a lifelong condition, yet little attention is given to the needs of autistic adults. Families of autistic children spend their lives attending school meetings, arranging therapies, managing physical health needs, and providing other support, and those efforts continue into adulthood. Aging parents are desperate to find high-quality and affordable homes where their adult children can have support and build lives of their own.

We are one such family. Our daughter, Liz, now 35 years old, is a bright woman with autism who cannot navigate the world around her without support. She needs substantial support in daily life. Although Liz graduated with honors from ODU and knows which medications she takes, she needs daily support to manage them correctly. Without that support, she routinely forgets them or takes the wrong ones. At Vanguard Landing, she would have help with this crucial task while preserving her independence and dignity in other daily activities. That is how it should be.

Like many autistic adults, Liz has a relatively limited diet and is not able to shop and cook independently. Her home at Vanguard Landing has a full kitchen where, with support, Liz can make one of her preferred meals—a peanut butter and jelly sandwich. She will have plenty of food choices in the café as well. If she chooses, she can also attend voluntary cooking classes at Vanguard Landing to work on developing those skills.

Liz worked for six years as a part-time doggie daycare assistant, a job she loved, but she has not worked for the past year due to depression—a common occurrence for adults with autism who become isolated in their homes. We hope the support and transportation available to her at Vanguard Landing will help her begin a new vocational search and return to a part-time job of her choice. This support would be of immense benefit to her self-worth and mental health.

For several years now, we have been looking across the country for a community like Vanguard Landing for our daughter Liz. Unfortunately, communities like Vanguard Landing are few and far between, and many are available only to families who can pay privately. We are thrilled to have Vanguard Landing available here in our home area, and Liz is excited to live in the home and community she chose, where she can make choices about her own life, remain connected to the wider community, and receive the support she needs.

Vanguard Landing has finally come into existence, but making it affordable for families of autistic adults remains a challenge. Vanguard Landing is a unique and valuable resource for autistic adults and their families. People who qualify for Medicaid waiver services should be able to use them there. We cannot overstate our support for making that possible. Without that option, Vanguard Landing will remain out of reach for many people who have chosen it but cannot afford to pay privately for all of the support they need.

Maria R. Urbano, M.D.

Thomas Manser, M.D.

8/30/2026