Month: May 2025

Balancing Care and Cost: What Medicaid Means for Mental Health

As Congress works through this year’s federal budget, one topic is drawing more attention: Medicaid. While it might not always make the headlines, decisions about how this program is funded could have a lasting impact on how people across the country access mental health and substance use services.

Medicaid plays a major role in the nation’s behavioral health system. It’s the single largest payer for mental health and substance use disorder care in the United States. More than 44 million people use Medicaid to get the support they need, including over one in four adults living with serious mental illness and one in three adults with an opioid use disorder (Center on Budget and Policy Priorities [CBPP], 2025).

For children, the numbers are even higher. Medicaid and the Children’s Health Insurance Program (CHIP) cover 54 percent of all children in the country, and nearly three out of four children with mental health conditions rely on these programs to receive care.

This support reaches into all corners of the system. Medicaid helps fund community clinics, outpatient programs, medication, inpatient care, and mental health services in schools. In fact, more than 70 percent of school-based health centers depend on Medicaid funding. Almost half of school-age children who get mental health care do so at school, and many of them are covered by Medicaid (CBPP, 2025).

Right now, lawmakers are considering whether to change how Medicaid is funded. Some of the ideas being discussed include shifting to block grants or setting per-person spending caps. These changes would set annual limits on how much the federal government contributes to state Medicaid programs. Supporters say this approach could make spending more predictable and give states more flexibility to tailor their programs.

Others worry that, over time, this might lead to fewer resources, especially during tough economic times or health emergencies, when demand is high and costs often rise. There’s some precedent for concern. In earlier budget crunches, several states had to scale back behavioral health services.

This meant fewer psychiatric hospital beds, reduced outpatient services, and cuts to school-based programs. That said, not every state responded the same way. Some were able to create targeted programs or maintain access by adapting their resources creatively.

What we do know is that the need for mental health services remains strong. About one in five U.S. adults lives with a mental illness. Suicide is now the second leading cause of death for children ages 10 to 14. In 2021, nearly 40 percent of adults reported experiencing anxiety or depression, and those levels have stayed high in the years since the COVID-19 pandemic began (CBPP, 2025). These trends suggest that the demand for care is unlikely to decrease.

In states that expanded Medicaid under the Affordable Care Act, coverage improved significantly for people with behavioral health needs. In fact, the uninsured rate among this group dropped by almost half. Medicaid also funds mobile crisis teams, peer support specialists, and other community-based services that are often more effective and less expensive than hospital or emergency care (CBPP, 2025).

As the debate continues, it brings up some important questions. How do we balance budget goals with the realities of public health? What role should the federal government play in making sure people have access to care? And how can we plan for future needs when both costs and demand are so unpredictable?

There aren’t easy answers to any of these questions. What is clear is that Medicaid plays a central role in helping people access mental health and substance use care. Any changes to the program are likely to have real effects on the ground, particularly for people who are already navigating complex or ongoing challenges.

In moments like these, staying informed matters. If mental health is an issue that touches your life, your work, or your community, this is a time to pay closer attention, ask thoughtful questions, and follow how this conversation unfolds. Even quiet policy shifts can ripple widely—and being aware is often the first step toward meaningful engagement.

Two actions can help make a difference. One is to spend a few minutes learning how Medicaid works in your state—whether through your state’s health department website or a trusted local resource—just enough to understand who it helps and how it connects to care in your community.

Another is to reach out, whether by writing a note to a local policymaker or checking in with a community organization you trust, to ask how Medicaid policy is shaping care in your area.

Even as other issues take the spotlight, the conversation about Medicaid continues—with potential far-reaching impacts. Behind each decision are everyday moments—children learning, families managing, communities doing their best with what they have. Paying attention to how care is supported, and to the people it reaches, is a small but meaningful way to stay connected. Sometimes, awareness itself is a kind of care.

Reference
Center on Budget and Policy Priorities. (2025, May). On the chopping block: How Medicaid cuts will impact mental health. https://www.cbpp.org/research/health/on-the-chopping-block-how-medicaid-cuts-will-impact-mental-health

One More Step

“Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.”
– Thomas Edison

At first glance, these words appear reassuring. However, a more careful examination reveals a deeper truth: they do not guarantee success, but rather recognize the reality of struggle.

Trying again doesn’t always come with boldness or resolve. At times, it arrives quietly, without confidence, and far from certain. It may feel hesitant, even exposed, taking shape in solitary moments where effort continues in the shadow of doubt, and where no clear outcome is promised. Yet, there is weight in even the most faltering attempt. Its value lies not in the assurance of success, but in the quiet insistence that the effort itself holds meaning.

Living with Detours

Living with cerebral palsy or any disability rarely means walking a straight path. Progress winds through switchbacks and detours, over terrain that shifts without warning. Switchbacks, the zigzagging paths used to climb steep ground, symbolize how forward movement often requires turning back, changing direction, and finding new ways up when the way ahead isn’t clear.

Some days, even the simplest task can feel like a summit. On those days, trying again isn’t about chasing success. It’s about choosing to move forward, even without knowing where the path leads.

Edison’s words resonate not because they ensure triumph, but because they honor the reality of the struggle. They reflect the truth that success is often less about brilliance and more about persistence.

The Weight and Worth of Trying

Trying again doesn’t always feel meaningful. It can be tedious. It can be frustrating. It often demands effort without any promise of change. It means confronting the same barriers—and choosing to persist anyway. It means refusing to let failure define the ending.

Participation, inclusion, and advocacy demand more than hope. They require a sustained, often invisible commitment. They ask us to show up repeatedly, even when the way forward is uncertain. They call for the determination to develop and share a voice—especially in spaces where that voice has long been overlooked.

This work is rarely about individual recognition. It is about pursuing outcomes that serve entire communities. Even when progress is slow, and acknowledgment is rare, the act of continuing holds its own quiet power. That steady, often unseen effort carries intrinsic worth. It communicates something more enduring than praise: it says we matter, and so does the work.

Creating Lasting Connections

We often speak of building bridges—between people, ideas, and lived experiences. Every choice to connect, to listen, and to include strengthens those bridges. Every decision to try again reinforces the belief that change is not only possible but necessary.

These small, sustained efforts are more than personal milestones. They push back against apathy. They quietly resist indifference. Whether it’s advocating for accessibility, challenging outdated perceptions, or simply making it through a hard day, it is the belief behind the effort that fuels change.

The Power in Persistence

Endurance begins where certainty ends. It continues without reward and without any promise of success. Persistence advances through the unknown—silent, steady, and often unseen. Its truth is simple: the path was never abandoned.

In the most uncertain moments of the journey, Edison’s words do not insist. They arrive as a quiet reminder—to try again, to hold on, to keep going. They whisper that effort still matters, even when no one sees it. Each hesitant step becomes part of something larger, shaped silently through struggle and resolve.

These moments of trying again are more than personal victories. They become acts of connection, quiet resistance, and unwavering belief. Each one forms a quiet revolution. This revolution is not driven by spectacle, but by the steady, deliberate choice to keep going and to shape a new way forward. Even when the way is unclear, one more step still matters.

Keep walking. The path is made by it.

Opening the Conversation

Wiley’s Walk has grown into a space where I share what life looks like from my particular vantage point—living with Cerebral Palsy, navigating systems that aren’t always built for us, and holding onto hope, humor, and honesty along the way.

It’s part storytelling, part reflection, and part sorting-through. Sometimes the posts come from personal experience. Other times, they’re sparked by something I’ve read, seen, or heard—something that made me stop and think, This matters.

But lately, I’ve been thinking more about the people on the other side of the screen. You. What brings you here? What keeps you coming back?

Would you like to read more about the daily realities—what accessibility really looks like, or how small things can add up to big barriers (or breakthroughs)? Are you drawn to the more reflective pieces, the ones that slow down and try to name what’s often hard to describe?

Maybe you’re curious about how advocacy works behind the scenes. Or maybe it’s the personal stories that connect us.

Whatever it is, I’d love to hear from you. Leave me a comment with your ideas.

Thanks for being here.

—Kerry

Skimming Light

It is late summer, the kind of evening when heat clings to wood and skin, even after the sun has slipped behind the trees. A dock stretches out over the water, quiet except for the occasional creak beneath bare feet. The lake lies still, almost mirror-like, its surface holding its breath between day and night.

A child stands at the edge, holding a stone. It’s too smooth to skip, but that hardly matters. The stone is still worth throwing. When it hits the water, the splash touches the quiet—not loud, just certain. Laughter follows, thin and sharp. It doesn’t just fill the air. It shifts something.

What follows is not just a poem, but a moment re-entered. A stillness remembered and re-seen. A world suspended between day and night, silence and sound, childhood and everything after.

Skimming Light

By Kerry Ann Wiley

The Dock radiated the day’s warmth—
still pulsing with heat beneath bare feet.
Long after the sun has gone.
Boards hum low.
Weightless footsteps leave no mark.

Water mirrors sky—
fractured, silver-edged.
Stillness, not silence.
Not quite memory.
Not quite now.

A stone, lifted—
small hand, tight grip.
Too round. Too smooth.
Still worth the throw.

Ripple breaks.
Then laughter,
thin and sudden,
carrying more future than sound.

It lingered—
not long,
just long enough to be real.

No one asks the question.
The question is always there.

A breath.
Then:

Did anything go missing,
or did it arrive
in pieces?

Another stone arcs.
This one skips—
once,
then again,
then under.

No need to count.
The splash answers everything.
Even what wasn’t asked.

Light holds a little longer.
Long enough.

No name for this.
Not peace.

“Skimming Light” rests in a quiet, familiar moment: a lake, a dock warmed by sunlight, a child holding a stone.

Nothing moves forward in the usual sense. The poem doesn’t press for emotion or push a story. Instead, it invites attention—to the small tensions in the body, to the silence that surrounds them, to the feeling that something just out of reach is waiting.

The images in the poem do more than describe a place—they hold feeling. The dock is warm, not from the present sun, but from the memory of it. Footsteps pass without a sound, not because the path is empty, but because no one wants to disturb what has been left behind.

The water, mirroring a fractured sky, feels held in suspension. Nothing moves, yet something shifts quietly. The moment ends, but it does not leave; it lingers. When the child throws the stone, it isn’t about the stone. It is about what it stirs up.

The splash is more than noise. It is a mark in time. It breaks the surface and reveals something that had been hiding just beneath. Then comes the laughter: sudden, thin, and carrying more than sound. It arrives without reason, and although it fades quickly, it leaves behind the warmth of having been there at all.

The poem asks quietly, “Did anything go missing, or did it arrive in pieces?” It is a feeling to be held. It points to how people carry change—silently, sometimes unknowingly—until something small reveals it.

By the time the poem reaches its final lines, the light is nearly gone. It holds just a little longer, as if offering time to absorb what has happened. In the stillness that follows, nothing appears to have changed, yet everything feels subtly different.

The splash subsides, and the laughter fades. Light lingers briefly, then slips away. Something has passed through. Time moves on, indifferent, but the moment remains. It was never meant to last—only to be lived.

Threaded Fire

There are times when a person returns, and everything seems almost the same. The door still opens easily. The chair waits exactly where it was left. A familiar voice echoes faintly down the hall.

Yet, something in the air has shifted. The difference is invisible but felt. A person returns, but not entirely. There is a reserve in their movements, restraint in their voice. Something is withheld, unnamed.

This change might follow illness, loss, or something more elusive. Sometimes there is no obvious reason at all. That uncertainty is the foundation of Threaded Fire. This poem does not recount an event—it explores what remains.

Threaded Fire

By Kerry Ann Wiley

The room folds around a quiet
too alert for silence.
Something smaller than memory
waits beneath careful scaffolding—
still,
watching.

A glance hesitates—
almost touching.
Something soft,
outstretched.

A mouth shaped wrong, deliberately—
as if words might betray.
The color of old vows
held tight,
a shield refusing to pretend.

There are rules here,
none spoken aloud.
One does not name darkness—
only gestures toward its absence.

Pain is bartered in fractions—
half-truths exchanged for gentleness.
No lies, but close enough.
The question becomes
everything left unsaid.

What’s given is not the thing itself.
It is the offering—
the way a hand doesn’t tremble
but nearly does.

Even a small fire
knows its lineage.

At the threshold,
supported by what was nearly lost,
a vessel shifts form—
not broken,
not quite whole.

Care emerges in increments.
Metal clicks softly—
perhaps the latch of a box.
No words necessary.

A color catches in the corner,
placed gently,
purposefully.
Waiting patiently
to be noticed.

This one wears blue.
Some burdens aren’t set down—
only carried differently.

Between the spaces something flickers—
a thread,
a fire,
not extinguished,
still glowing.

Threaded Fire begins in a room heavy with unspoken tension. Something significant has occurred, though the poem refrains from revealing precisely what. There is no direct explanation. Instead, the reader inhabits a suspended moment, thick with implication.

The poem instead dwells within a subtle, uncertain moment: a hesitant glance, an outstretched hand—steady yet on the edge of trembling. These gestures move beyond physical, becoming quiet revelations of vulnerability and muted resilience.

What’s given is not the thing itself.
It is the offering—
the way a hand doesn’t tremble
but nearly does.

In this careful moment, connection remains fragile, yet it is still possible. What matters is not the offering’s literal content, but the gesture itself, which becomes an act of trust and quiet bravery.

Unspoken rules dictate the exchange. Pain is not communicated through words, but through gestures, absences, and careful omissions. Survival is expressed as a subtle and determined acknowledgment of what it means to remain.

There are rules here,
none spoken aloud.
One does not name darkness—
only gestures toward its absence.

As focus sharpens, attention settles on a figure who has returned—familiar, yet not quite the same. Something in their presence has shifted. Their voice carries a faint unfamiliarity, as though it belongs to someone else. Movements are slow, deliberate, shaped by caution rather than ease. They place something down with quiet care. There is no spectacle, no outcry—only small, precise gestures that speak of effort and endurance.

A color catches in the corner,
placed gently,
purposefully.
Waiting patiently
to be noticed.

The poem moves into quiet recognition. The heaviness does not lift, but it is carried in a new way. It is no longer denied, but accepted. Being there, with quiet purpose, becomes sufficient.

Between the spaces something flickers—
a thread,
a fire,
not extinguished,
still glowing.

After change settles, a return isn’t marked by a dramatic reunion, but by subtle gestures: the warmth left in a recently vacated chair, the hesitation before meeting someone’s eyes, the tremble in a voice that used to be steady.

Small gestures hold significance because they convey what words often cannot. They reflect steadiness, patience, and the quiet kindness of being present—of showing up, listening, and staying close.

Pain does not disappear, but over time it begins to soften, gradually making room for gentleness. Within that space, a thread of fire continues to glow—a quiet reminder that survival often means carrying what remains in a different way.

Healing often reveals itself in quiet, unremarkable ways. It is present in the deliberate choice to move forward, even with hesitation or tenderness. The burden may not grow lighter, but it is carried differently—with intention and with care.

When a return feels both near and distant, and the change cannot be named but is undeniably felt: What reveals that something has changed, when nothing looks different but everything feels altered?
Is it the silence, the pause, the way a hand lingers just a moment longer?

Perhaps it is the way someone stands, no longer bracing for impact.
The way the chest no longer tightens at the sound of a familiar door.
The way the day begins without needing to be overcome.

It may not be a return to what was, but to a quieter way of being within what remains. Not a conclusion, but a way forward that no longer feels like a question.

The Shape of Reception

At a dinner party, someone begins telling a story— a story about a flight delay, and a memory of thunderstorms and kids stomping in puddles at recess. The delivery is smooth, almost rehearsed, each sentence arriving after a thoughtful pause, more rhythm than hesitation. People listen politely, nodding along, their smiles faint and fixed. Their eyes drift—to their wine, their plates.

Later, another guest tells a story of their own. It covers similar ground—weather, waiting—but something in the delivery is different. The rhythm is familiar, the nostalgia just as gentle, yet this time the room responds. People laugh, lean in. They ask questions. The story lingers. Moments like these seem forgettable—until they repeat.

Then a quiet question begins to form: why do some voices hold attention while others quietly fade?

The difference is rarely the story itself. What changes is how the room listens. The clearest message can land differently with each listener, shaped less by the words than by the voice delivering them. Some draw attention effortlessly; others strain for the same result. What separates them is often not volume or meaning, but rhythm—a steady cadence, a kind of ease, or a confidence that cues others to listen more closely.

It is not about intent. The slight is rarely deliberate. Most people don’t even realize it is happening. They aren’t trying to exclude or dismiss. Yet, the effect remains—subtle but real, quietly shaping who gets heard, and who ends up just outside the circle of attention.

Some people come to recognize it early. In response, they start to adjust—repeating themselves, softening their language, or editing their thoughts to align with what they sense will be more acceptable.

The shift starts small. Words come more slowly. The delivery changes. Each phrase is chosen with care. Over time, this becomes a habit—not from doubt, but from knowing the voice has to work harder to be heard. This effort often goes unnoticed. Once seen, however, it is hard to ignore.

Some voices command credibility instantly; others must earn it word by word. A confident tone signals authority before any point is made, while a quieter delivery must continually prove itself. The difference is subtle, yet it shapes the entire conversation.

Listening goes beyond silence. Letting someone speak is only the beginning. True listening means being present with both the words and the pauses—the spaces where meaning settles, shifts, or takes shape. A slower, less polished voice is often mistaken for a lack of substance, but the real tension often lies not in what is said, but in the gap between expectation and perception.

Some rooms make it easier to speak—not because of the topic or the setting, but because of who is listening, and how. The same story, told the same way, can fall flat in one space and resonate deeply in another. It is not the story that changes. It’s the reception that transforms it.

People come to recognize which spaces welcome their voices and which ones do not. Some people adapt to these environments. Others grow quiet. Still others learn to speak louder—not simply by choice, but through repetition and necessity. Over time, this becomes a skill, shaped by memory and experience.

Listening is never neutral. It is shaped by habit, assumption, and preference. Noticing who is heard and who is not opens the door to change. The pause is a hinge; a voice can be welcomed or missed.

A voice is often pressured to bend, to echo others in order to be accepted. The answer may lie not in changing how it speaks, but in the stillness of listening—not for perfect words, but for the voice as it is.

A voice doesn’t need to be louder to be heard—it needs room to exist without reshaping itself to fit. When listening becomes intentional, it reshapes not the voice, but the space around it. In that space, something quiet yet powerful begins to shift.

Disability and Aging Services: Examining the Proposal to Eliminate the Administration for Community Living

On April 16, 2025, the Federal Office of Management and Budget released a 64-page draft budget proposal that has prompted concern among some advocates for older adults and people with disabilities.

Among the provisions attracting attention is a proposal to eliminate the Administration for Community Living (ACL), an agency within the Department of Health and Human Services (HHS) that focuses on supporting independence and community living.

At its core, this proposal represents more than a structural reorganization. It signals a potential redefinition of the federal government’s role in advancing inclusion, independence, and civil rights protections for millions.

Understanding the ACL’s Role

The Administration for Community Living (ACL), was created to consolidate federal programs that assist older adults and individuals with disabilities. Its mission is to support the development of policies and the delivery of services that enable people to live independently, remain engaged in their communities, and access non-institutional care options whenever possible. Programs administered by the ACL include:

  • University Centers for Excellence in Developmental Disabilities (UCEDDs), which provided services, training, and research to support over 1.3 million people in the last year alone.
  • Developmental Disabilities Councils (DD Councils), which supported more than 900 state-led initiatives focused on improving access to education, employment, and housing, while also fostering public involvement and encouraging active participation in the community.
  • Protection and Advocacy Systems (P&As), which protected the civil rights of 11.5 million people through legal advocacy, investigations, and public education.

These programs do not operate in isolation; together, they create a network of support that reaches into schools, hospitals, workplaces, housing, and family care-giving systems across the country.

Broader Context: Additional Federal Program Changes

The proposed elimination of the ACL does not exist in a vacuum. It comes alongside other proposed budgetary reductions that could disproportionately affect older adults and people with disabilities:

  • Medicaid Cuts: A proposed $880 billion reduction to Medicaid would have major implications for long-term care. Medicaid currently funds care for 63% of nursing home residents and 20% of those in assisted living. Cuts of this magnitude could lead to facility closures, reduced access, and fewer home- and community-based service options.
  • Meals on Wheels and Nutrition Programs: Reductions to funding streams such as the Social Services Block Grant (SSBG), Medicaid, and SNAP (Supplemental Nutrition Assistance Program) could limit the reach of Meals on Wheels and similar programs, which provide essential nutrition and social contact to over 2 million older adults annually.
  • Affordable Housing Supports: Proposed reductions to HUD programs and staffing could strain the infrastructure that supports older adults and people with disabilities in maintaining independent housing. Without accessible and affordable housing, the risk of unnecessary institutionalization or homelessness increases sharply.

These simultaneous proposals raise broader concerns about their potential combined impact. There is growing uncertainty about whether they could make it more difficult for communities to support full inclusion, promote self-determination—the opportunity for people to have a say in decisions that affect their lives—and protect the well-being of those who may need the most support.

Supporting Inclusion Through the ACL and Similar Programs

As advocates have emphasized, inclusion is not an ancillary benefit. Inclusion isn’t charity — it is about community. The concept reflects a shared belief that everyone, regardless of age or disability, should have the opportunity to belong, contribute, and thrive.

ACL programs are one of the federal government’s tools for helping ensure that inclusion is intentional and widespread. The programs support efforts that allow a student with a disability to participate in public education, a person recovering from a brain injury to access job training, or an older adult to receive caregiver support at home rather than move into a care facility.

Eliminating ACL would not make these needs disappear. It would simply make them harder to meet, increasing the burden on states, families, and already stretched local service systems.

A Historical Perspective

ACL was created through years of bipartisan efforts aimed at protecting the rights of people with disabilities and improving their day-to-day lives. A major step in this work was the Developmental Disabilities Assistance and Bill of Rights Act of 1975, which laid the foundation for many of the programs the ACL runs today.

Building on this legislative milestone, these programs were specifically designed to address the persistent challenges of exclusion and segregation experienced by individuals with developmental and other disabilities. They strive to foster inclusion and promote dignity and respect, while also working to expand access to education, employment, and a broad range of opportunities that enable participation in community life.

In 2012, the Administration for Community Living (ACL) was established to streamline and unify related programs—an effort to enhance efficiency and accountability while reinforcing the principle that older adults and people with disabilities should have a voice in shaping the policies that impact their lives.

The current proposal would represent a sharp departure from that legacy — and from a long-standing bipartisan commitment to locally driven, inclusive approaches.

Beyond Budgets: A Conversation About Values

Policy decisions are never just about dollars and cents—they are also about values. They reveal who and what we choose to prioritize. As Wiley’s Walk reminds its readers, true access and inclusion aren’t measured solely in budget lines or policy documents.

They are reflected in daily life: Can people of all ages and abilities navigate schools, workplaces, and neighborhoods with confidence and dignity? Are our communities intentionally designed to welcome everyone, or do they, even unintentionally, leave some behind?

The proposed elimination of the ACL cannot be viewed in isolation. While framed as a structural or fiscal decision, it raises broader questions about our shared responsibilities. The programs at risk help shape whether a student is supported at school, whether an older adult can remain in their home, and whether someone navigating a new disability can continue to participate fully in community life. These are not just policy points — they are personal realities.

Inclusion depends not only on the individual, but also on the systems and supports that surround and influence them. Flexible programs that remove barriers and service providers who adapt to diverse needs can make a profound difference in people’s lives. These improvements don’t happen by chance—they result from intentional choices, sustained investment, and a deep belief in the value of every person.

Programs supported by the Administration for Community Living (ACL) help make this possible. They promote not just access, but meaningful involvement—supporting people of all abilities and ages in engaging with and contributing to their communities. Without these programs, the responsibility for care and coordination often falls to individual families, local nonprofits, and already stretched service networks, making inclusion harder instead of easier.

The Urban Institute has warned that dismantling these supports could ‘undercut community-based systems of support, and potentially reverse decades of progress.’ Just as importantly, it could shift the national conversation away from a focus on belonging and interdependence—resulting in a loss not only for people with disabilities and older adults, but for everyone.

This moment calls for reflection: What defines a strong and inclusive community? What ensures that every person feels they belong? What role can public policy play in shaping that future?

A Call to Center People in Policy

Stakeholders across the political spectrum are urging Congress to reject the elimination of the ACL and the programs it funds and oversees. These stakeholders include disability organizations, advocates for older adults, healthcare professionals, and families.

Advocates are united in calling for the preservation of the ACL’s mission. This is not just about keeping an agency in place. It is about preserving what the agency represents—a belief in treating people with respect, ensuring fair access to opportunity, and fostering inclusive, supportive communities.

As policy discussions move forward, it’s essential to focus on the people behind the programs. These aren’t just budget lines—they represent support that individuals and families depend on every day.

Eliminating the ACL would signal a major shift in national priorities. While fiscal debates are expected, decisions about disability and aging services reflect deeper values: promoting independence, inclusion, and recognizing each person’s value.

The proposed elimination of the Administration for Community Living is more than a budget decision — it raises broader questions about national priorities. The ACL supports programs that enable older adults and people with disabilities to live independently, remain connected, and participate fully in community life.

Without these supports, meeting those needs could become more challenging, increasing pressure on families, local organizations, and service systems. This shift could slow progress toward greater inclusion and access. As discussions move forward, it remains essential to keep people at the center — and to consider whether policies reflect a commitment to dignity, opportunity, and meaningful support. Now is the time to reaffirm a focus on inclusion — not just in words, but through deliberate, person-centered policy.

References

Belonging Without Bending

True inclusion requires more than presence—it calls for shared participation.

Equity involves recognizing the different challenges people may face and making sure everyone has the support, resources, and opportunities they need to be fully included. As groups grow, the goal is not just to add more people, but to build an environment where everyone feels genuinely welcome and able to take part.

When a group grows, it is typically with a clear intention—to create space for broader participation and belonging. At times, that intention succeeds. New voices enter the room and are welcomed. A different perspective finds space and is heard. However, even in these moments, subtle dynamics may remain unchanged.

The ways in which people communicate, shaped by tone, pace, and clarity, often continue to reflect the norms established by those who have been present the longest and whose styles of engagement have traditionally set the standard.

New participants often sense this instinctively. Some join in easily and speak with confidence, quickly picking up the group’s rhythm. Others hesitate, observing and noticing the subtle cues that shape the space. They begin to see which contributions are acknowledged and which are quietly dismissed. They pay attention to tone and timing, and to how decisions are made. Over time, they come to understand what the room seems to expect of them.

In response, people may shift their tone or word choice depending on the setting. For instance, a person who typically uses humor to express themselves might suppress that instinct in formal meetings, having noticed that seriousness is more often equated with competence. Someone who tends to think by talking might start filtering out ideas before speaking, choosing only the ones that sound most complete.

These changes may seem small, but they take real effort. They show up in the quiet pause before someone speaks, or in the uneasy feeling that lingers afterward. Over time, inclusion can start to feel less like being welcomed and more like learning to adjust. It becomes less about an open door, and more about who can adapt to fit the room.

What if inclusion didn’t rely so much on individuals learning to fit in? What if the room could shift—even a little—in response to the people in it? It might start with something as simple as leaving more time between agenda items, giving slower thinkers a chance to catch up.

It could mean offering different ways to contribute: speaking aloud, writing afterward, or sharing in pairs instead of in front of the whole group. It might also involve seeing stories as a form of insight, even when they wander. There could be room for ideas still taking shape, without the pressure to rush them to a conclusion.

When spaces allow for this kind of attention, something begins to shift. People feel they no longer have to leave parts of themselves outside. They start to participate in ways that feel natural instead of calculated. The room itself becomes more than just a setting—it becomes part of the conversation, shaped by the people in it and shaping them in return.

This transition requires deliberate focus. It challenges people to pay attention—not just to what is said, but to how it is said, and who is speaking. Which ideas gain traction easily? Who receives credit, and whose words are echoed without acknowledgment?

Some wait before speaking, listening for a tone that feels familiar or safe. These are difficult questions, with few easy answers. Still, asking them creates space for reflection. And reflection, more often than not, is where real change begins. Small adjustments can open the door to broader shifts. A team might begin meetings with a short written reflection, giving quieter members a chance to articulate their thinking before discussion begins.

A facilitator might develop the habit of asking, “Is there someone we haven’t heard from yet?” instead of relying solely on open-ended invitations. Leaders could begin to notice who tends to speak first and who tends to wait. Rather than drawing conclusions, they might get curious. They might ask whether the structure itself favors certain styles of contribution. These actions show that people are ready to listen and engage. Not every idea will be groundbreaking, but something meaningful is more likely to emerge when people don’t feel the need to filter themselves to fit in. Inclusion then becomes less about who is in the room and more about how they are received.

It is not only about who is present. It is also about how that presence is received. Do people feel truly listened to? Are their words met with thoughtful responses? Are they taken seriously? Often, the smallest moments carry the most weight. A colleague pauses, allowing time for a slow-forming thought to emerge. A leader gives space to someone who rarely speaks. They listen fully, without rushing to reply.

Over time, these gestures begin to reshape the culture of a space. The changes may seem subtle, but their impact is lasting. Sometimes, it’s the simple act of being noticed—even when the words come slowly, the story trails off, or the thought remains unfinished.

Attention, when given with care, fosters understanding. It creates an atmosphere that is intentional rather than rigid, grounded in respect rather than control. It allows people to show up fully. It also does not assume there is only one right way to participate.

In some spaces, participation looks like confident debate. In others, it may involve deep listening. Expression takes many forms—sometimes in asking, sometimes in simply being present. Each style brings something valuable, and when a space is willing to stretch, it allows these differences to coexist. These differences can even inform one another.

This willingness to stretch is not about treating everyone the same. It’s about creating space in different ways for different people. The goal isn’t perfect inclusion or the rejection of structure altogether. Rather, it’s the understanding that structure can evolve. That evolution—often slow and sometimes uncomfortable—helps shape a culture of belonging.

Inclusion is not a fixed outcome but an ongoing practice of care. It takes shape through everyday choices—in how people listen, how spaces are designed, and how difference is acknowledged and valued. It calls for openness to change, even when that change is slow or unfamiliar. What might be possible if spaces adapted to the people in them, instead of expecting people to adapt to the space?