When the bus stopped coming
Michigan law names thirteen services it must provide to people headed for a nursing home. Adult day care is one of them. For adults with autism, it names nothing at all.
One signature, one minute. It is delivered to MDHHS Legislative Affairs with your name on it, and you get back a letter already addressed to your own state representative and senator. You do not have to know anything about Medicaid to do this.
13
The list that exists
MCL 400.109c(2) names thirteen services the department shall provide to a person who would otherwise need nursing home care.
Adult day care
Written into the statute by name. Not encouraged. Not funded if the budget allows. Listed.
October 1, 2024
Michigan removed prevocational services from the Habilitation Supports Waiver by amendment. No bill was introduced. No legislator voted. Most families found out from a supports coordinator, if they found out at all.
What Massachusetts wrote down
Day habilitation is a MassHealth service tied to eligibility, not to a slot the state decided to fund this year. A developmental disability that began before age 22 and MassHealth coverage is the door. Programs are open today.
8,268
Total people Michigan’s Habilitation Supports Waiver is approved to serve in a year. Authorized is not the same as available.
What two years bought
One family’s actual service after two years of applications and delay: a case manager who visited once a month. Medicaid paid for every visit.
What each government actually wrote down
There are simply no services for your adult autistic child. That is the sentence. It is true, it takes eight seconds to say, and in two years not one trained professional would say it to my face.
Four people can move this, and here is the order
Escalation ladder
- 1MDHHS Legislative Affairs. A department recommendation moves a bill years faster than a family-driven one.
- 2The MDHHS office that holds HCBS policy authority.
- 3Your own state representative and senator. Ask for co-sponsorship by statute number.
- 4The Governor’s office. The signature, and the department’s marching orders.
Put these in your letter
- Your county, so it counts as constituent mail
- Your adult’s age and what they lost
- The statute number, MCL 400.109f
- The comparison: MCL 400.109c(2)(f)
- One specific ask, not a general concern
- What it costs you, in hours and dollars
- A request for a written reply
Every letter on this page is written for you already. Download, add two sentences about your own family, send.
Put your name on the list Michigan forgot to write
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Michigan families who have signed
This petition asks MDHHS to do two things: open rulemaking that gives providers a compliance pathway for community-based day services, and recommend to the Legislature that day services be named and protected in statute the way adult day care already is for another population.
We collect your name, email, ZIP, and relationship to an autistic adult. Your name and county go to MDHHS Legislative Affairs with the petition. Your email is used to tell you what happened next, and nothing else. Ask us to remove you at any time and we will, without a conversation about it.
The eighteen-year line
A short film on what Michigan built for autistic students, and what it stopped building on their twenty-sixth birthday.
Deep dive and debate
A long-form audio walkthrough of the statute, plus a debate episode that argues both sides of the integration question honestly.
The infographics
Eighteen Years Then Nothing. The Gap, in the law’s own words. A Tuesday in Two States. All free, all sourced, all printable.
What you will be told, and what is actually true
Federal law required Michigan to eliminate these programs.
It did not. 42 CFR 441.301(c)(5) names four settings that cannot be home and community based: a nursing facility, an institution for mental diseases, an intermediate care facility, and a hospital. A day program is not on that list. A setting someone believes may isolate people is presumed institutional only until the state shows otherwise, and CMS published a State Medicaid Director letter in March 2019 explaining how to make that showing. A rebuttable presumption with a federal process for rebutting it is not a prohibition. Massachusetts and Colorado read the same rule and kept their programs.
This costs too much.
The amendment itself costs nothing. It changes the law, not the budget. And Michigan is already spending money here. One family in Genesee County went through roughly two years of applications and received one case manager visit per month, every one of them billed to Medicaid. The money is already moving. It is not buying anyone a day. Ask the department what it spent on supports coordination for adults with developmental disabilities last year, then ask how many of them have somewhere to go on Tuesday.
The department needs flexibility to design services as it sees fit.
It keeps that flexibility. The amendment protects the service type, not the design. The department still decides what a day service looks like, what standards providers meet, how they qualify, and how compliance is monitored. The statute would say only that the service must exist. That is exactly the structure Michigan already uses in MCL 400.109c(2), where thirteen services are named and the department retains full authority over how each one is delivered.
Congregate settings are segregation, and integration is the goal.
The people who wrote the integration rules were not wrong about history. Institutions did terrible things and the instinct never to return there is a decent one. This campaign is not asking for that. What we are asking for is the difference between separation and segregation. Segregation is what gets done to people, out of sight, without consent, because it is convenient for the system. Separation is a designed environment, chosen, staffed by people trained for it, where a person with high support needs can function and learn. A rule written to get a young woman out of a warehouse has instead left her on a couch in her father’s living room. She is not integrated. She is home. Those are not the same thing.
COVID closed the programs, not state law.
COVID closed programs temporarily everywhere. What determined whether they came back was whether a state had written anything down. Michigan’s statute contains no requirement that any day service exist for this population, so nothing obligated anyone to restore one. Silence is not neutral. It let inaction become elimination, and then it let elimination become permanent.
Felicia is my daughter. This is our life. Tomas, later in this piece, is not a real person. I built him out of what families in Massachusetts describe, so that I could stand him next to her and show you what a state line does.
For eight years, Felicia and I sat on the couch together every morning and waited for the bus. That was the shape of our day. She had somewhere to be. The bus came to Burton and took her to the Elmer A. Knopf Learning Center over in Flint, a center based school the Genesee Intermediate School District runs for students with autism and moderate cognitive impairment. Twenty one districts send their kids there. The curriculum they use has a name. It is called Supported Independence.
Then she turned twenty six, and the bus stopped coming.
The last day it came was June 19, 2025. The first day it did not come was June 20, 2025. I can give you both dates without looking them up.
She did not understand. Why would she. We still sat on the couch every morning, because that is what we did, except now there was nothing at the end of it.
So I lied to her.
I told her it was summer vacation. Summer vacation was a concept she had grudgingly come to terms with over the years, the way you come to terms with weather. It buys you a few weeks. It does not buy you the rest of a life.
I loathe lying to people I love. I did it anyway, most mornings, for months, because I did not have a better answer and neither did anyone else.
For six or seven months she asked. She asked about the bus. She asked about the bus driver. She asked about her friend James. She asked about her teacher, and she told me how much she missed Ms. Anisa.
Then she stopped asking.
I want to be careful with that sentence, because it would be easy to read it as relief. It was not. A person stops asking when they have worked out that the answer is not coming. My daughter is more observant than she has any right to be. She adapted. She should not have had to.
In our house we have a name for what happened. Felicia graduated to the couch.
Let me tell you who she is, before anyone turns her into a case
Felicia is funny. Not funny the way people say about someone who cannot answer back. Actually funny, on purpose, with timing. She is also close to impossible to distract. The old hey, look over there routine has never once worked on her, and I have watched professionals try it and watched her decline to play along.
When she was small, she would watch the same disks over and over and over. Hour after hour, forever, the way a lot of autistic kids do. I left the closed captions on the whole time. Every disk, every time, for years.
There was a method to the madness. I used the thing she already wanted to do a thousand times to teach her to read, quietly, without either of us calling it a lesson.
It worked, mostly.
Before Knopf, she did not know one side of a touchscreen from the other. In her first year there they put an iPad in front of her, and according to her teacher she took to it naturally, like it had been waiting for her. Now she runs YouTube on an Android tablet all day. She can find anything she wants by typing the first couple of letters and letting autofill do the rest. Having a computer nerd for a father has its benefits.
Every so often she brings me the tablet and asks for a particular show, or a particular character, and I find it, and she takes it back and returns to her routine.
That is my kid. She learns things. She always has. The learning did not stop when the bus did. Only the teaching did.
Cold turkey is not a plan
Felicia is adaptive. What she needs is a segue. Persistent, deliberate, repeated, patient handoffs from the old thing to the new thing. That is not a preference and it is not a luxury. It is how she is built, and anyone who has spent ten minutes with an autistic person knows it.
What she got at twenty six was the exact opposite of a segue. She got cold turkey.
Her entire structure was built on routine. Everything she had achieved stood on that floor. Nobody replaced the floor. Nobody offered to. Not one professional I dealt with sat me down and explained plainly what was about to happen to her, and it was the elephant in every room I walked into for a year.
Here is what I have landed on calling it. Administrative abandonment. Educational abandonment. All of it perfectly legal.
I have my own disability to manage on top of it, and the two of us had to relearn how to live a day from scratch. We have a groove now. It more or less works.
What we do not have, and cannot manufacture in a living room, is the thing a structured program actually gave her. The sense of achievement. The peers. The specific pride of learning something new in front of people who noticed. A reason to get on a bus.
That is gone. I can do a lot for my daughter. I cannot be her classmates.
Nobody would say the sentence
About a year before she finished school, I signed Felicia up for prevocational services. That is the Medicaid service meant to build work and life skills for exactly her situation, and signing up early was supposed to be the responsible thing to do.
She never received a single session.
In October 2024, while my daughter was on the books waiting for it, Michigan removed prevocational services from the Habilitation Supports Waiver entirely. No bill. No vote. A waiver amendment.
I do not know whether that is why nothing ever came. Nobody has told me. That is a question MDHHS can answer, and I would like them to.
What she got instead, for roughly two years, was a case manager who came to the house once a month.
That was the service. A monthly visit, a form, and a conversation that circled the same drain every time. Meanwhile Medicaid was paying for it, because supports coordination is a billable service and somebody bills it.
I want to be fair to the people who walked into my house. They were trained. Most of them were genuinely dedicated. They had been handed a job with nothing in it, and they spent their expertise apologizing for a system that had nothing to hand me. That is not a failure of the workers. That is a failure of what the workers were given to work with.
But not one of them could bring themselves to say the sentence out loud.
Today Felicia receives no day service. No community living supports. No respite. Nothing.
The part that should interest the fiscal conservatives
I am not here asking Michigan to spend money it has not already spent.
Michigan spent money on my daughter for two years. It bought her twenty four home visits and a folder. Whatever that cost, it was not zero, and it did not put her anywhere, teach her anything, or give me back a single hour.
The money is already moving. It is just not buying my kid a day.
Seven hundred miles east
Tomas is twenty four. He lives in Brockton, Massachusetts, with his mother Marisol. Level 3 autism, minimally speaking, a device he uses well and hands he uses better.
A van comes for him at a quarter to eight. He spends the day at a day habilitation program where the staff know he needs a quiet room by eleven and that he will do just about anything for the person who runs the Thursday cooking group.
Nobody in Massachusetts had to win a slot for that van. Day habilitation is a MassHealth service tied to his eligibility. He has a developmental disability that began before he was twenty two, he is on MassHealth, and so he goes. It is written into regulation where his mother can put her finger on it.
Marisol works. It has never once crossed her mind that a state might make a mother choose.
Same diagnosis as my daughter. Same support needs. Different state.
There is a list. Her name is not on it.
Michigan law contains a list.
It is in the Social Welfare Act, section 400.109c, and it names thirteen services the department must provide to a person who would otherwise need nursing home care. Home delivered meals. Chore services. Homemaker services. Respite care. Personal care. Private duty nursing. Emergency response systems. Home modification. Transportation.
Item (f) on that list is adult day care.
Not encouraged. Not provided if the budget allows. Listed, by name, in statute, as a thing the department shall provide.
Felicia has been on Medicaid her entire adult life. There is no list anywhere in Michigan law with her name on it, or with her kind of need on it. Not one service is guaranteed by name to an adult with a developmental disability. Everything she might receive lives inside a waiver document that the department writes, amends, and rewrites at its own discretion, and in October 2024 the department rewrote it and took a service out of it.
An eighty one year old with dementia in Genesee County is guaranteed adult day care by name.
My twenty seven year old, in my living room, is not mentioned.
And here is the part that should end the argument
For eight years the State of Michigan paid to put my daughter on a bus to a center based day program, built specifically for autistic students, with a specialized curriculum and staff trained for exactly her needs.
The state built that. The state ran that. The state was right to.
On her twenty sixth birthday, the state’s position on whether Felicia benefits from a center based program with trained staff and a bus did not change because of anything about Felicia. It changed because of her age, and because after twenty six she comes out of a different pot of money with different rules, and nobody ever wrote her name on a list.
Somebody is going to tell me those are different legal systems. They are right. Schools run on education law. Adult services run on Medicaid. The federal settings rule that Michigan pointed to when the adult programs went away does not apply to a public school district. I will say that out loud myself so nobody has to catch me on it.
It is also beside the point. The question was never which statute applies. The question is what the State of Michigan believes is good for my daughter. For eighteen years it believed one thing, and it spent real money proving it, and then she had a birthday.
Separation, not segregation
When I went looking for help, I was told that day programs now only exist in non segregated public locations. The separation that special needs students are given, and that Felicia spent eighteen years learning to work inside, is now classified as segregation. Medicaid will not touch it.
That is what I was told. It is not what the federal rule says.
And the distinction that got lost somewhere between Washington and my living room is the whole argument.
Segregation is what gets done to people, out of sight, without their consent, because the people running things find it convenient. Separation is a designed environment, chosen, staffed by people who know what they are doing, where a person like my daughter can actually function and learn.
The people who wrote the integration rules were not wrong about history. Institutions did terrible things, and the instinct to never go back there is a decent one. I am not asking anyone to go back there.
I am telling you that a rule written to get my daughter out of a warehouse has instead put her on a couch, and calling that integration does not make it integration. She is not integrated. She is home. There is a difference, and every family living this can see it from space.
What federal law actually says
The federal regulation names four kinds of settings that cannot be home and community based. A nursing facility. An institution for mental diseases. An intermediate care facility. A hospital.
Day programs are not on that list.
A setting somebody believes might isolate people is presumed institutional only until the state shows otherwise, and there is a federal process for making that showing, and CMS put it in writing in March 2019.
Massachusetts did not get a different rulebook. Massachusetts made a different choice, and then wrote the choice down somewhere families could hold them to it.
What it costs
It cost me everything that made up a normal life.
Lunch out. Shopping without a clock running. Sleeping in. A regular sleep schedule. For a couple of hours on most weekdays I got to be a person and a special needs parent at the same time.
Now I can only be one.
It is Felicia and me. It has been for a long time, and there is nobody else coming. That is fourteen months now, since June 20 of last year, with no program, no staff, and no plan from anyone whose job it is to have one.
So the thing that keeps me up is not the day program. It is the arithmetic. I am the only thing standing between my daughter and a lifetime of subpar group housing or a hospital bed, and on the day I am not here anymore she becomes a number and a case file instead of a person.
That is the same abandonment we felt when the bus stopped coming. Michigan has simply scheduled the next one.
The ask
Michigan already knows how to write the list. It wrote one, in the same act, for somebody else’s mother.
Write one for our kids.
Sign the petition above. Download the letter with your legislator’s name already on it. Send it this week, not this year. And if you have a family member in this situation, write down what happened to them, because in eighteen months the thing that will move this is not my daughter’s story. It is four hundred of them.
Felicia’s story appears here at her family’s decision and comes down at her family’s decision.
Every claim on this page, and where it comes from





