Cristina Gaudio of the National Council on Severe Autism (NCSA) published one of the clearest, most unflinching accounts of what families living with profound autism face when systems fail. Her story about Zack — a 25‑year‑old man with severe autism whose planned Senate meeting collapsed into a crisis — is not sensational. It is not embellished. It is simply the truth of what happens when states lack high‑acuity services, realistic Medicaid structures, and residential programs capable of supporting people with the most intensive needs.
Cristina writes:
“Zack is a 25-year-old man with severe autism… nonverbal, requires 24/7 supervision, and needs extraordinarily intensive behavioral and medical support.”
“Despite being approved for residential placement… there are no providers in the state that are able and willing to provide his level of support need.”
Her full piece is linked below, and I encourage every policymaker, clinician, advocate, and family in Massachusetts to read it in full.
Cristina Gaudio: “A Profound Day on Capitol Hill” National Council on Severe Autism https://www.ncsautism.org/blog/capitolhill
The Connecticut crisis is the Massachusetts crisis
What happened in Senator Murphy’s office is not an isolated event. It is not a “Connecticut problem.” It is the predictable outcome of a national policy pattern — one that Massachusetts is deeply entangled in.
Families here face the same impossible conditions:
- Residential programs that cannot accept high‑acuity individuals
- HCBS models that assume independence that does not exist
- Caregivers providing toddler‑level care to adult children for decades
- Police becoming the default crisis responders for what are fundamentally healthcare failures
- A shrinking continuum of care that leaves the most profoundly affected people with nowhere to go
The Saving Wrentham and Hogan Alliance hears these stories every week. We live them. We know what it means when a state insists that “community placement” is the only acceptable model, even when the community lacks the staffing, structure, and clinical capacity to safely support people with profound autism.
Cristina’s account is a vivid illustration of what happens when policy is built around ideology rather than acuity and clinical needs.
Why this story matters for Hogan and Wrentham
Massachusetts is currently debating the future of its state-operated programs — including Hogan and Wrentham — without fully acknowledging the population they serve. Zack’s experience shows exactly why a full continuum of care is not optional. It is essential.
When states eliminate or restrict high‑acuity options:
- Families are left with no long‑term plan.
- Adults with profound autism cycle through unsafe placements.
- Crises escalate into police involvement.
- Caregivers lose their health, jobs, savings, and stability.
- Policymakers only understand the stakes when a crisis becomes impossible to ignore.
Cristina’s piece is a reminder that the people with the highest needs cannot be served by wishful thinking. They require structured environments, trained staff, predictable routines, and programs designed for profound disability — not theoretical community models that collapse under real-world conditions.
A message Massachusetts needs to hear
Cristina writes:
“It is an argument for systems capable of understanding why crises happen and preventing them before police intervention becomes necessary.”
This is the heart of the matter.
Massachusetts must build — and preserve — systems that can actually serve people like Zack, and the many families who are quietly holding up the world with their bare hands. We cannot pretend that profound autism does not exist. We cannot pretend that every person can be safely supported in the same model. And we cannot continue asking families to do the impossible.
SWHA is committed to ensuring that our state recognizes the full spectrum of need and invests in the continuum of care required to keep people safe, supported, and dignified.
Read Cristina’s full piece
It is powerful, honest, and essential reading for anyone involved in disability policy.
“A Profound Day on Capitol Hill” — by Cristina Gaudio, NCSA