Thank you for the opportunity to provide public comment on the heightened scrutiny review of Vanguard Landing.

The Arc of Virginia recognizes the very real need that Vanguard Landing and the families who helped create it are trying to address. Virginia does not have enough housing, services, or reliable supports for people with developmental disabilities. Families are trying to fill gaps that should not exist, and we do not dismiss the experiences of individuals and families who believe Vanguard Landing offers something they have not been able to find elsewhere.

But the shortage of good options cannot determine whether a setting meets federal Home and Community-Based Services (HCBS) standards. In fact, that shortage is part of what makes this decision so important.

For decades, people with disabilities and families fought to move Virginia away from a system that separated people with disabilities from the rest of community life. They fought for something that once seemed impossible: for people with developmental disabilities to live in homes of their own, have jobs, make friends, choose how they spend their days, and belong in their communities.

We have learned a lot along the way. One of the most important things we have learned is that people with every level of support need can live successfully in individualized homes in the community when we build the supports around them. People do not have to be grouped together because they need significant support. Safety and community are not opposites. Neither are support and independence.

We also know Virginia has not built enough of that system yet.

The Arc of Virginia works every day to change that. Our responsibility as a statewide advocacy organization is to continue pushing Virginia to build a strong public system that gives all people with developmental disabilities access to individualized housing, adequate services, a stable workforce, meaningful relationships, employment, and community life—not only those who can find or create alternatives when the public system falls short.

We believe choice matters deeply. If someone chooses Vanguard Landing and loves living there, their experience matters. We are not questioning that choice. But choosing a place to live and determining whether Medicaid-funded HCBS should be provided in that setting are two different questions. 

The HCBS Settings Rule asks us to look beyond whether a setting is attractive, safe, well-intentioned, or wanted by some families. It asks what life is actually like for people receiving services there. Do people have control over their own lives? Can they come and go? Are their days built around their individual interests and choices? Do they have meaningful opportunities for work, friendships, activities, and relationships in the broader community? Is their home truly their home, separate from the provider delivering their services?

That is especially important when so much of daily life can happen within a disability-specific community. A community can have homes, sidewalks, activities, friends, and gathering places and still leave us with the question the HCBS rule requires us to ask: Are people being supported to be part of the broader community, or have we created a separate community for people with disabilities?

The review identified significant concerns about whether transportation and access to the broader community are truly individualized or built around scheduled group activities. DMAS found records that did not demonstrate individual choice or meaningful interaction with people without disabilities in the broader community. It identified concerns about opportunities for employment and individualized community engagement. And the circumstances surrounding individuals who were discharged raise important questions about the separation between a person's home and the provider delivering their services.

We recognize that Vanguard Landing has responded to these findings and has made or proposed changes. Those responses matter, but the heightened scrutiny decision must be based on evidence that people actually experience the qualities of HCBS, not only on policies or changes that have not yet been demonstrated in practice.

Based on the current record, The Arc of Virginia does not support a finding that Vanguard Landing is HCBS compliant.

Virginia's shortage of good options is real. The answer cannot be to redefine what we mean by community. The answer is to build the supports that allow every person to belong in it.