At the recent Profound Autism Alliance Summit, Governor Maura Healey delivered prepared remarks highlighting her administration’s focus on adults with profound autism. She referenced the executive order she signed last month, describing it as a directive to improve coordination across state agencies, promote innovation, and explore “new models of care combining housing and services.”
She stated that the administration’s goal is “to make possible better lives for adults with profound autism and their families,” and emphasized a statewide plan intended to improve data collection, strengthen cross‑system coordination, and expand access to housing, health care, community‑based services, and meaningful daily activities.
For families who have spent years fighting for recognition of high‑acuity needs, the acknowledgment matters. But acknowledgment alone does not resolve the structural failures that have left thousands of adults without appropriate services, placements, or crisis supports.
And the state’s own oversight agencies have made that reality unmistakably clear.
The Auditor’s Report: A System Already Failing Adults with High‑Acuity Needs
See the Auditor’s report at https://www.mass.gov/audit/audit-of-the-department-of-developmental-services-april-15-2026
The Massachusetts State Auditor’s most recent report on the Department of Developmental Services (DDS) documented systemic deficiencies that directly contradict the idea that coordination alone will solve the crisis. The report identified:
- Inadequate oversight of group homes, including failures to ensure safety, staffing, and regulatory compliance
- Insufficient monitoring of provider performance, leaving individuals vulnerable to inconsistent or substandard care
- Weaknesses in data collection and reporting, which limit the state’s ability to plan for high‑acuity needs
- Gaps in crisis response capacity, resulting in families and providers struggling without timely support
- Lack of transparency and accountability mechanisms, making it difficult to track outcomes or enforce standards
These findings reinforce what families and frontline staff have been reporting for years: the system is not merely strained, it is structurally incapable of meeting the needs of adults with profound autism under the current HCBS‑only framework.
A statewide plan cannot succeed if it is built on top of a system the Auditor has already found to be failing.
What the Governor’s Remarks Signal and What They Do Not
The Governor’s comments at the Summit reflect a growing recognition that adults with profound autism require a distinct policy response. Her reference to “new models of care combining housing and services” aligns with what families have been calling for: integrated, high‑acuity options that do not currently exist in Massachusetts.
However, the remarks did not address:
- The absence of high‑acuity day programs
- The lack of crisis stabilization capacity
- The shortage of specialized residential placements
- The collapse of the workforce pipeline for complex‑care settings
- The need for a full continuum of care, including ICF(intermediate care facility)‑level options
Coordination is important, but coordination cannot replace capacity. Innovation is welcome, but innovation cannot substitute for infrastructure.
Families are not asking for symbolic recognition. They are asking for functioning systems.
Where Saving Wrentham and Hogan Alliance (SWHA) Stands
SWHA welcomes any public acknowledgment of the needs of adults with profound autism. But our mission is grounded in evidence, not symbolism. The Auditor’s report makes clear that Massachusetts must confront the structural deficits in its disability service system before any statewide plan can succeed.
A real strategy for adults with profound autism must include:
- A high‑acuity continuum of care, including intensive day services, crisis stabilization, and specialized residential options
- Integrated housing‑and‑services models designed for individuals with complex behavioral, medical, and sensory profiles
- Accurate, transparent data that reflects the true number of adults with profound autism and their unmet needs
- Accountability mechanisms that ensure safety, quality, and compliance across all provider settings
- A workforce strategy that recognizes the skill, training, and compensation required for high‑acuity care
Massachusetts families have waited too long for systems that match the complexity of their loved ones’ needs. SWHA will continue to advocate for a statewide approach that is not only coordinated, but capable — not only innovative, but implementable — and above all, grounded in the lived reality of the adults and families who depend on it.