Hiring and vetting direct support staff Self-directing your family member’s care means you are now, unofficially, a hiring manager, an HR department, and a scheduler, with none of the training...
Teaching independent living skills with realistic goals “Independent” was always the wrong word. Nobody does laundry, cooking, or hygiene entirely alone; they do it with habits, reminders, and tools nobody...
Creating sustainable daily structure for high-support adults Boredom is not a mood. For a high-support adult with long unstructured stretches, it is a predictable risk factor for the exact behaviors...
How to document harm when services disappear When a service ends, the harm doesn’t announce itself with a diagnosis code. It shows up as lost skills, disrupted sleep, and a...
Why ERs and police become the default crisis response There is no missing phone number that would have prevented most of these calls. There is a missing service system, and...
Budget methodologies and ‘medical necessity’ language Two phrases do most of the damage: “more cost-effective option available” and “not medically necessary.” Neither one is a medical judgment. Both are budget...
Building a paper trail that actually matters Not every piece of paper protects you. A notebook full of feelings does not win an appeal. Four specific documents do: the incident...
Advocacy without burnout: pacing, paper trails, choosing battles The advocate who wins in year fifteen is not the advocate who fought hardest in year three. It is the one who...
Building natural supports and community inclusion Seventy percent of autistic adults report loneliness. The intervention is not another program. It is two named community members who know his story and...
Transportation barriers: building mobility without driving Two out of three autistic young adults do not have a driver’s license by 21. The mobility plan for the other two thirds is...
