A Real Home. Not Just a Placement.

A dream that shouldn’t have to be a dream (and what we can build right now)

If you removed the budget caps. If you lifted the policies built more for paperwork than people. If you stopped playing musical chairs with staff just to get through the shift. If none of that stood in the way… then here’s what I would build.

Not a program. Not a placement.

A home.

And I don’t just mean a house — I mean a life where the individual is centered in every part of it. Where dignity isn’t a goal but the baseline. Where staff aren’t just assigned, they’re invited, and where routine doesn’t mean control, but comfort.

Every house would be unique, because every person is unique. There’d be no more standardized weekly menus designed by a nutritionist who’s never met the people they’re feeding. Instead, each individual would have a personalized food plan that actually considers what they like, what they need, and what they crave on hard days. Because when someone’s energy is low or they’re overstimulated or overwhelmed, they shouldn’t have to eat something that feels foreign or forced. Their favorite meal — whatever that may be, within their medical and dietary needs — would always be available. Always.

And there’d be no more forced outings. If someone wants to be a homebody? Then they get to be one. No pressure, no judgment, no “but we need the ISP goal minutes.” Just respectful presence. Staff would still gently offer community experiences that fit the person’s interests, but never as coercion. Never as compliance. Because some of the most meaningful lives are lived quietly.

There would be no more bedtimes. I know that technically there aren’t now — but let’s be real, there are still staff who impose them. That ends here. If this is truly their home, then we are the guests. We’re the ones permitted into their space, not the other way around. We support, we don’t dictate.

And staffing? Staffing would be built around fit. No more “warm body coverage.” Every staff assigned to a home would be individually selected based on personality match, training, lived experience, and emotional capacity — not just whether they passed background check and showed up to orientation. People change, dynamics shift, and when they do, we’d solve it. Not with vague “we’ll figure it out eventually” promises, but with actual, timely solutions.

Guardians would be as involved as they want to be, and their involvement would be met with full transparency — not filtered half-truths or “oops, we forgot to mention” moments. I’m done with that kind of gatekeeping. Of course, the autonomy and privacy of the individual comes first, always. But beyond that, families should be informed. Not when it’s convenient. Always.

And this part’s big: I’d make sure every manager knew what they were doing — not just in title, but in skill, in accountability, in integrity. Staff would be empowered to speak up, bring ideas, raise concerns, and push for change without retaliation. No “stay in your lane.” No “you’re just direct care.” Every person in the house — staff and resident alike — would be seen as fully human. With voice. With value.

If I were running it? I wouldn’t be some distant name on a title page. I’d show up. I’d be in every home, at least once a month, in person. Not for show. Not with a clipboard. But to talk. To check. To read the notes and feel the atmosphere and listen. I don’t want surprises. I want truth. I want presence.

Because here’s the thing: you can’t care for someone well if you only know them through forms and reports. And you can’t claim excellence if you’ve never witnessed the corners where the system fails.

I want a home that bends to the individual, not the other way around. Where their quirks aren’t corrected — they’re protected. Where staff are safe enough to stay, and supported enough to care. Where we stop talking about “level of care” like it’s a fixed number, and start asking: What does this person need today? And then we meet it. Without delay. Without excuses. Without pre-authorization from some invisible committee.

So yeah, if nothing stood in the way, this is what I’d do.

But here’s the part that burns:

None of this should be radical.

None of this should be a fantasy.

And yet here we are — still calling common decency “unrealistic.”

So what now?

If we can’t build the dream, what can we build?

It’s easy to feel stuck — especially with Medicaid cuts on the table and staff turnover so high you’re lucky if anyone shows up at all. But the truth is: we are not powerless. There are things we can do right now, even with what we have.

We just have to be willing to stop making excuses.

Menus? Still individualized. There is nothing stopping a house from letting individuals choose their preferred foods during the monthly grocery planning, within budget and health limits. Favorite comfort meals can be stocked right now. It doesn’t cost more to buy someone’s actual preferences instead of whatever was on last month’s copy-pasted plan. It just takes giving a damn.

Outings? Make them optional. Genuinely optional. Build in consent. A person choosing to stay home is not “noncompliant.” They’re exercising autonomy. Support it. Get creative. Bring the world in — sensory bins, community videos, crafts, whatever resonates. Stop writing goals that force proximity instead of connection.

Staffing? We may not be able to fully control who gets hired, but we can push for better matches. We can advocate for staff to shadow before they're assigned. We can speak up when a dynamic clearly isn’t working. We can stop treating compatibility as a luxury. Because it’s not.

Training? If agencies can’t afford high-end workshops, then let the experienced staff teach. Let DSPs train DSPs. Create quick-share guides, sensory cheat sheets, behavior insight logs. Keep the knowledge moving. Stop hoarding wisdom behind paywalls and titles.

Transparency? Be honest with guardians. Be clear with staff. Stop papering over mistakes. There is no budget restriction on truth. When you mess up, own it. When something goes well, share it. Let everyone breathe in a little more trust.

Documentation review? Management can make monthly walkthroughs a standard — even if they’re short. 30 minutes. Read the logs. Look at patterns. Ask staff what’s working. Ask the individual how they feel. You’d be shocked how much gets missed until someone just looks.

Culture? This one’s the biggest and the smallest. Culture doesn’t cost anything. It’s in how we talk, how we listen, how we treat people who can’t “earn” our respect in conventional ways. It’s in whether we say “let them stim” or “that’s inappropriate.” It’s in whether we assume intent or give grace.

Because look — Medicaid can slash and burn. Lawmakers can cut us off at the knees. But they can’t stop us from giving a shit.

They can’t stop us from asking better questions.

They can’t stop us from saying: this isn’t good enough yet.

And no, we can’t fix everything at once.

But we can stop pretending we’re powerless.

Start with one person. One house. One shift.

Build the bones of the future in the cracks of the present.

Because even in the face of scarcity, we still have a choice:

Do we run the system, or do we let it run us?

I know which one I’m choosing.

And one day, I want to look someone in the eye — someone who’s spent a lifetime being forced to fit in boxes — and say with complete honesty:

“This is your home. Not ours. Yours.”

And I want them to believe it.