Who Is Responsible for the Whole Person? Virginia should create a permanent Autism and Developmental Disabilities Commission with independent research staff. Families do not experience autism, intellectual disability, behavioral health, residential services, Medicaid waivers, crisis response, and provider shortages as separate compartments. They experience them as one life, one family, one urgent set of needs. Right now, the structure is fragmented. The Autism Advisory Council focuses on autism. The Behavioral Health Commission focuses on mental health and substance-use systems, though autism and developmental-disability issues often appear there in crisis. The Disability Commission, despite its broad-sounding name, appears focused mainly on physical and sensory disabilities. But who is responsible for the whole person when the whole person does not fit neatly into one government box? That is the gap Virginia needs to close. My son has an intellectual disability. He needs residential services, trained staff, behavioral support, medical coordination, day programming, and a functioning crisis system. Many people with autism rely on those same services. So do many others with developmental disabilities. A shortage of residential providers is not exclusively an autism issue. A shortage of trained staff is not exclusively an intellectual-disability issue. Inadequate waiver rates, gaps in day services, medical access, and crisis failures affect people across the developmental-disability community. The problem is not that autism receives too much attention. Autism needs serious, sustained attention. The problem is that shared services are treated as if they belong in separate rooms. That may make sense on an organizational chart. It does not make sense at the kitchen table. Case managers and support coordinators are important, but they cannot solve structural problems. They cannot create residential capacity, raise provider rates, stabilize the workforce, or repair gaps between Medicaid, DBHDS, providers, and crisis systems. Those are legislative and policy problems. They require a clear legislative home. Virginia should not preserve the current Autism Advisory Council under another name. Nor should it create an autism-only commission so narrow that shared problems keep falling between agencies and boards. The better approach is a permanent Autism and Developmental Disabilities Commission with independent research staff. It could preserve a strong focus on autism while addressing the shared system used by people with intellectual and developmental disabilities. Its work should include residential capacity, DD Waiver rates, provider sustainability, workforce shortages, day services, medical access, crisis response, and accountability. Virginia knows these problems exist. Families know it. Providers know it. Case managers know it. Legislators hear about it year after year. What is missing is not another meeting where everyone nods solemnly and admires the problem. What is missing is a focused legislative body with the authority, staff, and mandate to follow the problem across the whole system. Families should not have to knock on three doors, explain the same crisis three times, and then discover that no one owns the full picture. An Autism and Developmental Disabilities Commission would give Virginia one central legislative place where these issues can be studied together, tracked together, and addressed as connected problems.

Virginia’s Group Homes Are Being Asked to Survive on Pocket Change I am submitting this comment to the Autism Advisory Council because residential capacity is directly relevant to autistic adults and their families. Many autistic adults rely on Developmental Disability waiver services, including group home residential, sponsored residential, supported living, day support, and related community supports. Autism policy cannot be separated from the residential system that many autistic adults depend on every day. Virginia’s budget discussion around Developmental Disability waiver rates should worry anyone who cares about community living. Public discussions have included only modest proposed increases for certain waiver services. Whether the number is 2%, 3%, or something close to that, it is not stabilization. It is pocket change offered to a system already under strain. A small increase is not nothing. But it does not match what providers face. Inflation has raised wages, insurance, transportation, food, utilities, maintenance, supervision, compliance, and staffing costs. Group homes are where adults with autism and other developmental disabilities live, take medications, go to appointments, and depend on trained staff for safety. That takes people. And people need wages. Many providers are stretched thin. Direct support professionals can often earn comparable or better wages in jobs with less stress, less risk, and fewer regulatory burdens. Nobody pays the electric bill with “mission.” If reimbursement does not cover the real cost of care, providers may stop accepting new residents, reduce capacity, or close homes. That is the plain result of asking providers to absorb costs the state does not fund. When a group home closes, the disruption is not administrative. It is human. These are adults with autism, communication challenges, medical needs, behavioral needs, trauma histories, and established routines. A group home is where staff know how a person communicates, what triggers distress, what helps calm them, and when something is wrong even if they cannot explain it. Virginia does not have a large reserve of residential capacity waiting in the hallway. DBHDS reported that, as of November 25, 2025, Virginia’s Developmental Disability waiver waiting list included 14,258 people, including 2,727 people in Priority One. That is not an autism-only number, but it includes Virginians with developmental disabilities, including autistic adults who need residential supports. If homes close or stop taking residents, where do people go? Back to aging parents? Into emergency placements? Into hospitals? Farther away from family and familiar supports? Into settings that are available but poorly matched? This is how systems fail: delay, underfunding, denial, and polite phrases like “modest increase.” Virginia does not have to solve every problem in one budget cycle. But it does have to be honest about what a tiny rate increase can and cannot do. It may ease a little pressure. But it does not match the cost of keeping adult residential services stable. For autistic adults who need residential support, this is not a side issue. It is whether they can keep living safely in the community. It is whether families can sleep at night. If the plan is to stabilize group homes, then the funding needs to look like stabilization. We are not solving the problem. We are walking toward the cliff and congratulating ourselves for slowing down slightly.