March is Developmental Disabilities Awareness Month, a time to recognize the strength, contributions, and everyday victories of people in our communities. And Danielle’s story is one worth celebrating. In January 2024, Danielle began her journey at Countryside Meadows as a housekeeper. What started as a new opportunity quickly became something more meaningful a place where she could grow, contribute, and truly belong. Every day brings its own set of challenges, but Danielle meets them with quiet determination. She has learned how to persevere, even on the harder days, never letting those moments stop her from doing what she loves most going to work and being part of a team. Through her role, Danielle has developed important life skills that extend far beyond the workplace. She manages her time, communicates effectively with others, and takes pride in managing the money she earns. These are milestones that reflect not just independence, but confidence. If you walk the halls of Countryside Meadows, you will likely hear Danielle before you see her a warm hello, a cheerful greeting, and a smile that brightens the day of residents and staff alike. She creates a positive environment simply by being herself. Danielle takes great pride in her work. From keeping rooms clean to maintaining shared spaces, she understands the importance of what she does and the impact it has on others. Her motivation shows in every shift, every task, and every interaction. She has also reached an important milestone by completing the Vocational Rehabilitation milestone program and now receives extended services continuing her path of growth and success. Danielle’s story is a reminder of what Developmental Disabilities Awareness Month is all about recognizing ability, celebrating progress, and understanding that meaningful employment is more than a job. It is purpose, connection, and pride. And Danielle shows us that every single day.

For individuals with autism and developmental disabilities, the idea of “home” means more than just a place to live. It represents independence, dignity, and the opportunity to build a life rooted in personal choice and community connection. At Sycamore Services, we believe everyone deserves that opportunity. And research continues to affirm what we see every day—when individuals are supported in the right residential environment, they don’t just live, they thrive. What the Research Tells Us About Moving Into Independent Living A recent systematic review, “Autistic People and Moving Home”  (2023), highlights the importance of transitioning into independent or supported living environments for individuals with autism. The study found that moving into more independent living situations is associated with: Increased autonomy and self-determination Improved daily living skills Greater confidence and personal growth Enhanced quality of life Importantly, the research emphasizes that independence does not mean doing everything alone. Instead, it often involves structured supports that empower individuals to make their own choices while receiving the assistance they need to succeed. This aligns closely with what families are searching for today: not just care, but opportunity. Why Residential Services Matter More Than Ever For many families, the transition into residential services can feel overwhelming. Questions often include: Will my loved one be safe? Will they be supported in meaningful ways? Will they have the opportunity to grow and become more independent? The research provides reassurance. When residential environments are designed with intention—focusing on independence, inclusion, and individualized support—outcomes improve significantly. At Sycamore Services, our residential programs are built around these principles. How Sycamore Services Supports Independent Living Our approach to residential services is simple: meet people where they are and support where they’re going. We offer a range of residential options across Indiana that prioritize: Independence We help individuals build skills for everyday living, from cooking and budgeting to managing routines and making personal decisions. Personalized Support No two individuals are the same. Our team develops individualized plans that provide the right level of support—whether that’s 24/7 care or more independent living with periodic assistance. Growth and Development We believe in progress. Our staff works alongside individuals to build confidence, develop new skills, and create pathways toward greater independence. Community Connection A home should be part of a community. We support individuals in building relationships, accessing local resources, and participating in meaningful activities. Independence Is a Journey—And We Walk It Together The research is clear: individuals with autism benefit from opportunities to live more independently. But that journey looks different for everyone. At Sycamore Services, we don’t define independence as a destination. We see it as a process—one that unfolds over time, with the right support, encouragement, and environment. Whether someone is taking their first step into residential living or looking for a setting that better supports their growth, we’re here to help. Explore Residential Opportunities If you or someone you love is looking for a safe, supportive, and empowering place to call home, we invite you to learn more. View our available residences: www.sycamoreservices.com/residences Together, we can build a future where everyone has the opportunity to live as independently as possible. References Anderson, K. A., et al. (2023). Autistic people and moving home: A systematic review.  Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10468557/

March is Developmental Disabilities Awareness Month (DDAM)—a time to recognize the importance of inclusion, opportunity, and meaningful employment for individuals of all abilities. At Sycamore Services, this month is especially meaningful as we celebrate stories like Elijah’s—stories that highlight how the right support can lead to independence, confidence, and long-term success. Building a Path to Employment Elijah graduated from Avon High School in 2021 with a goal shared by many young adults: to enter the workforce and build a future. With the support of the Sycamore Services employment team, Elijah began exploring different career paths and opportunities that matched his interests and strengths. During this process, Elijah found inspiration close to home. He became interested in working at the very school he had graduated from—Avon High School. With guidance from his employment coach, Elijah visited the school, connected with staff, and learned about opportunities within the food services department. Turning Opportunity into Employment After an initial visit and interview, Elijah was offered a position in the food services department at Avon Community School Corporation. He officially began working in August 2023, stepping into a structured, fast-paced environment where teamwork and reliability are essential. Elijah quickly became a valued part of the team. His responsibilities include: Preparing food items for service Supporting kitchen operations during busy lunch periods Assisting with cleanup and tray collection between lunch waves Through consistent support from his employment coach at Sycamore Services, Elijah built the skills needed to succeed in an integrated work environment. Growth, Confidence, and Independence Elijah’s journey reflects the core mission of Sycamore Services employment programs: helping individuals develop the skills needed for long-term success. Along the way, Elijah has: Strengthened his time management skills Learned to navigate workplace expectations Built confidence in a team-based environment Achieved personal and professional growth Most importantly, Elijah has found pride in his work—especially in contributing to the same school community where his journey began. Ongoing Support for Long-Term Success Elijah successfully completed the Vocational Rehabilitation milestone program, a key step in achieving sustainable employment. Today, he continues to receive support through extended services, ensuring he maintains stability and continues to grow in his role. This ongoing support is critical. Employment is not just about getting a job—it is about keeping it, growing within it, and building a meaningful life through it. Why Employment Matters During Developmental Disabilities Awareness Month Elijah’s story is a powerful reminder that employment is a cornerstone of independence and inclusion. During Developmental Disabilities Awareness Month, we recognize that: Everyone deserves the opportunity to work and contribute Inclusive workplaces strengthen communities Support systems make long-term success possible At Sycamore Services, we are proud to provide employment services for individuals with developmental disabilities, helping people move from possibility to purpose. Let’s Keep Building Opportunities Elijah’s success is just one example of what is possible when individuals are supported, encouraged, and given the opportunity to thrive. If you are an employer looking to build a more inclusive workforce, or a family exploring employment services for a loved one, Sycamore Services is here to help. Together, we can continue creating pathways to meaningful employment—this month and every month.

March is Developmental Disabilities Awareness Month (DDAM), a time to recognize the contributions, talents, and achievements of people with developmental disabilities while also raising awareness about opportunities for inclusion in our communities. At Sycamore Services, one of the most powerful ways we support independence and community connection is through employment services that help people with disabilities find and keep meaningful jobs. Jeremiah’s story is a great example of how the right support can lead to lasting success. Jeremiah is a 19 year old young man who began working with Sycamore Services’ employment support program in January 2025. With assistance from our team and Indiana Vocational Rehabilitation, Jeremiah secured a job at Meijer in Mooresville as a utility worker. More than a year later, he is still thriving in his role. Jeremiah’s responsibilities include collecting shopping carts and scooters for customers, helping shoppers take groceries to their cars, and keeping the parking lot clean. From the beginning of his job search, Jeremiah knew he wanted a job that would keep him active. He enjoys walking and especially enjoys helping people, making his role a natural fit. Like many individuals entering the workforce, Jeremiah needed some support at the beginning as he learned workplace expectations and job routines. Through Sycamore Services’ supported employment program, our team worked alongside Jeremiah to help him build skills, understand job expectations, and gain confidence. Jeremiah successfully completed the Vocational Rehabilitation milestone program and now receives ongoing support through extended employment services, helping ensure long term success in his job. His work has made a strong impression at Meijer. Jeremiah’s manager, Blaine, consistently shares positive feedback, saying Jeremiah is a pleasure to have on the team. Coworkers describe him as friendly, reliable, and always willing to help. Front door greeters have also shared that Jeremiah is always pleasant with customers and clearly enjoys assisting people. Stories like Jeremiah’s show how employment services for people with developmental disabilities can create real opportunities for independence, confidence, and community participation. When individuals receive the right support, they can build careers, develop valuable skills, and become important members of their workplaces. During Developmental Disabilities Awareness Month, Sycamore Services celebrates Jeremiah and many others who are proving every day that ability, determination, and the right support can open doors to meaningful employment. Looking for Employment Support for People with Disabilities? If you or someone you love is looking for job training, supported employment, or help finding a job for someone with a disability, Sycamore Services is here to help. Our employment team works with individuals, families, and employers to create opportunities for meaningful work, career development, and long term success. Contact Sycamore Services today to learn more about our employment services and how we can help you take the next step toward meaningful employment.

Residential Openings Available at Sycamore Services At Sycamore Services, we believe that home should be more than just a place to live. It should be a place of comfort, stability, dignity, and personal growth. Our Residential Services Program is designed to provide individualized support in welcoming, thoughtfully designed homes located throughout Indiana. We are currently accepting inquiries for residential openings. What Are Residential Services? Sycamore Services’ Residential Program supports adults in community-based homes where individuals receive assistance tailored to their unique needs, preferences, and goals. Supports may include: Daily living assistance Skill development and independence training Health and wellness support Community engagement Social and recreational opportunities Our approach is person-centered, meaning services are built around the individual. Among the Nicest Homes in Indiana Sycamore Services’ residences are considered among the nicest in Indiana . Each home is intentionally designed to feel warm, comfortable, and inviting, while also supporting safety, accessibility, and independence. Features often include: Modern, well-maintained living spaces Comfortable private or shared bedrooms Accessible layouts Welcoming common areas Safe, residential neighborhoods We believe the environment matters. A beautiful, well-cared-for home supports wellbeing, confidence, and quality of life. Tour Homes Online Choosing a home is an important decision. That’s why we invite you to tour Sycamore Services residences directly on our website. Explore photos, layouts, and get a feel for the spaces that individuals proudly call home. View available homes and take a virtual tour: 👉 https://www.sycamoreservices.com/residential Support That Respects Choice and Independence Every individual deserves the opportunity to live in an environment where they feel valued and supported. Our residential teams work alongside each person to encourage: Self-determination Life skills development Personal interests and routines Meaningful community involvement Support is provided with compassion, professionalism, and respect. Now Accepting Inquiries If you or someone you support is exploring residential services in Indiana, Sycamore Services is here to help guide you through the process. About Sycamore Services Sycamore Services is a trusted Indiana nonprofit organization dedicated to empowering individuals through residential, employment, behavioral health, and community-based supports. Our mission is to help people live with greater independence, confidence, and quality of life.

Meet David Abe. David has been part of the Sycamore Services team for 4 years and 7 months, and he says he’s still loving every minute. He brings passion, support, and dedication to his role, sharing that seeing residents thrive and achieve their goals is what makes each day fulfilling. What David Enjoys Most About Sycamore: Learning new skills and collaborating with like-minded teammates while continuing to grow Leading a team where everyone feels safe, valued, and at home Sparking meaningful conversations and sharing life lessons that inspire. As a proud husband, dad, and self-described “word teacher,” David says he’s grateful to work in an environment that encourages growth both professionally and personally. He especially values the support shown by leadership, noting that the care from coordinators and directors makes Sycamore feel like family. David moved from Pennsylvania in 2021 to join Sycamore’s mission — a decision he describes as a true game-changer. His approach to both work and life centers on positivity, respect, and good vibes. We’re glad David is part of the Sycamore Services team! Want to join our team? Learn about our exciting opportunities below!

Understanding Early Signs of Autism in Babies and Toddlers Through Awareness and Early Support For parents and caregivers, the first months and years of a child’s life are filled with milestones, wonder, and constant learning. Much of the focus is rightly placed on meeting basic needs like nutrition, sleep, safety, and love. At the same time, paying attention to a child’s early social and communication development can provide important insights into how they experience the world. Autism Spectrum Disorder (ASD) is a neurodevelopmental disability that can begin to show signs very early in life—sometimes as young as six months. While autism can be difficult to identify in infancy, recognizing early differences and pursuing professional autism diagnostic testing can help families connect to resources, supports, and services that allow children to thrive. What Is Autism Spectrum Disorder? Autism Spectrum Disorder is a neurological developmental disability that affects how individuals communicate, interact socially, and process sensory information. Autism exists on a spectrum, meaning each individual has unique strengths, challenges, and support needs. Autism is not a disease and does not need to be cured. Being autistic simply means someone is neurodivergent—experiencing and interpreting the world differently than others. Researchers believe autism results from a combination of genetic and non-genetic factors, and current estimates suggest that approximately 1 to 2 percent of the population is autistic. Because autism presents differently in every child, a comprehensive, individualized autism evaluation and diagnostic testing process is essential to ensure an accurate diagnosis and appropriate recommendations. Early Signs of Autism in Babies Autism can be challenging to detect in children under two years old because early signs may be subtle. However, differences in social engagement and communication may begin to emerge during infancy. Possible early signs of autism in babies include: Limited or no social smiling by six months Difficulty engaging in simple social games such as peekaboo Little back-and-forth vocalization like cooing or babbling Limited response to hearing their name Avoiding eye contact Appearing unaware of people coming and going Arching away from physical contact or avoiding being held Developmental milestones often referenced by pediatric specialists include: No babbling, pointing, or use of gestures by 12 months No single words by 16 months No two-word phrases by 24 months Loss of previously acquired language or social skills Every child develops at their own pace, and a delay in one skill does not automatically indicate autism. However, caregivers know their children best. If something feels concerning, it is always appropriate to discuss observations with a pediatrician or seek a referral for autism diagnostic testing to gain clarity and guidance. Signs of Autism in Toddlers As children grow, signs of autism may become more noticeable. Toddlers with autism may show differences in communication, play, or social interaction. Common signs in toddlers may include: Limited sharing or engagement during play Little or unusual pointing to show interest Pulling caregivers toward desired objects instead of pointing or speaking Difficulty gaining attention when their name is called Toe walking or repetitive hand and finger movements Delayed speech or atypical speech patterns, such as echolalia (repeating words or phrases) Research shows that autism can often be diagnosed accurately as early as 14 months of age. However, routine autism screening typically occurs at 18- and 24-month well-child visits. If concerns arise earlier, caregivers are encouraged to bring them up with their child’s provider and ask about a referral for a comprehensive autism evaluation and diagnostic assessment. What to Expect From Autism Diagnostic Testing If a child is referred for autism diagnostic testing, the evaluation process typically includes: Developmental history and caregiver interviews Standardized autism assessment tools Observation of social communication and play Evaluation of language, cognitive, and adaptive skills Autism diagnostic testing is conducted by trained professionals and is designed to identify strengths as well as areas where support may be helpful. A clear diagnosis can open the door to early intervention services, therapy options, educational planning, and community resources. Conditions That May Look Similar to Autism Some developmental or behavioral conditions can resemble autism, which can make diagnosis complex. These may include: Global developmental delays, where multiple areas of development are affected Isolated speech delays, where communication is delayed but social engagement remains intact Anxiety, which may present as rigidity, difficulty with transitions, or strong attachment to comfort items This is why thorough, evidence-based autism diagnostic testing is so important. Clinicians carefully evaluate social communication skills—such as eye contact, facial expressions, and social motivation—to help distinguish autism from other developmental differences. The Importance of Early Diagnosis and Intervention Early identification of developmental differences through formal autism diagnostic testing allows children and families to access support during critical periods of brain development. Research consistently shows that early intervention can lead to meaningful gains in communication, social engagement, and daily living skills. While early childhood is an especially powerful time for intervention, support can be beneficial at any age. An early autism diagnosis helps families better understand how their child experiences the world and equips caregivers with tools to advocate, support, and empower their child. Just as importantly, early intervention helps create environments where children are respected, understood, and supported for who they are. Autism Diagnostic Testing and Support at Sycamore Services At Sycamore Services, we believe every individual deserves opportunities to grow, connect, and live a meaningful life. In addition to providing early intervention and community-based services, we offer comprehensive autism diagnostic testing to help families gain clarity, answers, and a path forward. Our autism evaluations are designed to be thorough, compassionate, and family-centered. We work closely with caregivers to understand each child’s developmental history, strengths, and unique needs. Following diagnostic testing, our team helps connect families to appropriate therapies, educational supports, and ongoing services. Understanding early signs of autism can help families take proactive steps toward support—but pursuing professional autism diagnostic testing can provide the confirmation and guidance needed to move forward with confidence. We encourage families to trust their instincts, ask questions, and seek guidance when concerns arise. Through early diagnosis, compassionate care, autism diagnostic testing, and community-based services, children with autism can build skills, confidence, and independence—and families never have to navigate that journey alone. References American Academy of Pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder . Pediatrics, 145(1), e20193447. Centers for Disease Control and Prevention. (2024). Autism spectrum disorder: Early signs and screening . Johnson, C. P., & Myers, S. M. (2007). Identification and evaluation of children with autism spectrum disorders . Pediatrics, 120(5), 1183–1215. Lord, C., Elsabbagh, M., Baird, G., & Veenstra-VanderWeele, J. (2020). Autism spectrum disorder . The Lancet, 392(10146), 508–520. Zwaigenbaum, L., Bauman, M. L., Choueiri, R., et al. (2015). Early identification of autism spectrum disorder: Recommendations for practice and research . Pediatrics, 136(Suppl 1), S10–S40.

A commitment to transparency, accountability, and measurable impact We are proud to share that Sycamore Services has achieved Platinum status with GuideStar, a service of Candid. This recognition represents the highest level of transparency a nonprofit can earn within the GuideStar/Candid framework and reflects our ongoing dedication to openness, integrity, and results. What is GuideStar Platinum? GuideStar Platinum is awarded to organizations that go beyond basic profile information and provide a comprehensive, data-rich picture of their operations and outcomes. At the Platinum level, nonprofits publicly share: Clear descriptions of mission, programs, and strategy Leadership, governance, and financial information Quantitative measures of progress and results Evidence of how programs create meaningful change In short, Platinum status signals that an organization is not only transparent about who it is and how it operates, but also accountable for what it achieves. Why transparency matters Research consistently shows that transparency strengthens trust, improves decision-making, and supports long-term sustainability in the nonprofit sector. Donors, families, employees, and community partners increasingly seek organizations that demonstrate both fiscal responsibility and measurable impact. Transparency: Builds credibility and public confidence Helps stakeholders understand organizational effectiveness Encourages continuous improvement Aligns resources with mission-driven outcomes By maintaining a Platinum profile, Sycamore Services ensures that anyone can easily access reliable, up-to-date information about our work and performance. How foundations and donors use GuideStar GuideStar profiles are widely used by foundations, grantmakers, and individual donors as part of their due diligence and evaluation processes. According to Candid, funders rely on GuideStar data to: Verify an organization’s mission, leadership, and financial health Assess transparency and governance practices Review programmatic priorities and populations served Evaluate reported outcomes and organizational impact For many institutional funders, a robust GuideStar/Candid profile is an important factor in building trust and informing funding decisions. Platinum status signals that Sycamore Services openly shares both operational information and measurable results. What this means for our community For the individuals and families we serve, GuideStar Platinum status reinforces that Sycamore Services: Operates with strong governance and ethical standards Uses resources responsibly Tracks, evaluates, and reports outcomes Focuses on evidence-informed practices For donors and partners, it provides additional confidence that contributions support an organization committed to accountability and measurable impact. A special note of thanks We would like to extend special thanks to Alison Wilcox for her dedication and hard work in pushing this project through. Achieving Platinum status requires careful coordination, accurate reporting, and persistent attention to detail. Alison’s efforts played a key role in reaching this milestone. Our ongoing commitment Earning Platinum status is not a one-time achievement. It requires continual updates, accurate reporting, and a sustained culture of transparency. Sycamore Services remains dedicated to sharing our progress, learning from data, and strengthening the impact of our programs. We thank our staff, supporters, and community for making this possible. References Candid. (n.d.). GuideStar Seals of Transparency.  Candid. https://www.candid.org Candid. (n.d.). How Funders Use Nonprofit Profiles.  Candid. https://www.candid.org Saxton, G. D., & Guo, C. (2011). Accountability online: Understanding the web-based accountability practices of nonprofit organizations. Nonprofit and Voluntary Sector Quarterly, 40 (2), 270–295. Behn, B. K., DeVries, D. D., & Lin, J. (2010). The determinants of transparency in nonprofit organizations: An exploratory study. Advances in Accounting, 26 (1), 6–12. Connolly, C., & Hyndman, N. (2013). Charity accountability in the UK: Through the eyes of the donor. Qualitative Research in Accounting & Management, 10 (3/4), 259–278.

Across decades, U.S. presidents have helped shape policies that improved access, protections, and support systems for people with disabilities—including many individuals with autism and Down syndrome. Presidents’ Day invites reflection on the ways leadership influences everyday American life. While history often highlights moments of conflict or crisis, some of the most enduring presidential legacies are found in policies that widened access to education, strengthened civil rights protections, and advanced research and services for people with disabilities. Disability rights progress in the United States has been driven by self-advocates, families, clinicians, educators, and communities. At key moments, presidential leadership helped translate those efforts into national policy—laying foundations that continue to shape opportunities today. Presidential milestones that continue to matter John F. Kennedy: Elevating intellectual and developmental disabilities During the early 1960s, the White House helped bring national attention to intellectual and developmental disabilities through initiatives such as the President’s Panel on Mental Retardation  (terminology of the era). The panel emphasized prevention, research, and community-based services rather than institutionalization (President’s Panel on Mental Retardation, 1962). Why it matters:  This period accelerated federal engagement in disability research and services, influencing how the nation approached developmental disabilities in healthcare and education (Trent, 2017). Richard Nixon: Civil rights protections under Section 504 In 1973, President Nixon signed the Rehabilitation Act , which included Section 504 —a landmark provision prohibiting disability-based discrimination in programs receiving federal financial assistance (Rehabilitation Act of 1973). Why it matters:  Section 504 established a civil rights framework that reshaped expectations for accessibility in schools, healthcare systems, and public services (Scotch, 2001). Gerald Ford: Guaranteeing educational access President Ford signed the Education for All Handicapped Children Act (1975) , ensuring children with disabilities the right to a free appropriate public education. The law later evolved into the Individuals with Disabilities Education Act (IDEA) . Why it matters:  IDEA formalized individualized supports and services in education—principles that remain central to special education today (Yell, Rogers, & Lodge Rogers, 1998). George H. W. Bush: The Americans with Disabilities Act In 1990, President George H. W. Bush signed the Americans with Disabilities Act (ADA) , extending comprehensive civil rights protections to individuals with disabilities across employment, public accommodations, transportation, and government services. Why it matters:  The ADA became a cornerstone of disability rights, embedding accessibility and nondiscrimination into public life (Bagenstos, 2009). George W. Bush: Clarifying and strengthening ADA protections The ADA Amendments Act (2008)  broadened the interpretation of disability after court rulings had narrowed coverage. Why it matters:  The amendments reinforced the law’s original intent, ensuring broader protection and clearer guidance (Colker, 2013). Barack Obama: Financial security and autism support Two notable laws signed during this era include: The ABLE Act (2014):  Created tax-advantaged savings accounts for individuals with disabilities and their families (ABLE Act of 2014). Autism CARES Act (2014):  Strengthened federal coordination, training, research, and surveillance efforts related to autism. Why it matters:  These measures improved long-term planning tools and expanded infrastructure supporting autism research and services (Rizzolo, Friedman, & Braddock, 2015). Continued national focus on autism Subsequent presidential administrations reauthorized Autism CARES , sustaining research, professional training, and service system development (Autism CARES Act Reauthorizations). Why it matters:  Reauthorizations maintain stability for multi-year programs that families, providers, and researchers rely upon (Interagency Autism Coordinating Committee, 2022). The larger story of disability progress Disability rights advancements rarely emerge from a single law or leader. Instead, progress unfolds over time—through research discoveries, evolving educational practices, community advocacy, and policies that improve equity and access. Scholars of disability history emphasize that these legal and policy milestones collectively shifted national perspectives: from charity to rights, from segregation to inclusion, and from limitation to possibility (Longmore & Umansky, 2001). Reflecting on Presidents’ Day Presidents’ Day offers a moment to recognize how leadership decisions—often made years or decades ago—continue to shape classrooms, workplaces, healthcare systems, and communities. At Sycamore Services, we see the living impact of these changes every day: individuals pursuing independence, families navigating support systems, and communities growing more inclusive. Honoring this history is not about politics. It is about acknowledging progress, understanding its roots, and continuing the shared work of building environments where people of all abilities can thrive. References Bagenstos, S. R. (2009). Law and the Contradictions of the Disability Rights Movement.  Yale University Press. Colker, R. (2013). The ADA Amendments Act: An Overview of Recent Changes to the Americans with Disabilities Act.  University of Pittsburgh Law Review. Interagency Autism Coordinating Committee (IACC). (2022). Summary of Advances in Autism Spectrum Disorder Research.  U.S. Department of Health and Human Services. Longmore, P. K., & Umansky, L. (2001). The New Disability History: American Perspectives.  NYU Press. Rehabilitation Act of 1973, 29 U.S.C. § 701. Rizzolo, M. C., Friedman, C., & Braddock, D. (2015). The ABLE Act: A New Resource for Disability Financial Planning. Intellectual and Developmental Disabilities. Scotch, R. K. (2001). From Good Will to Civil Rights: Transforming Federal Disability Policy.  Temple University Press. Trent, J. W. (2017). Inventing the Feeble Mind.  University of California Press. Yell, M. L., Rogers, D., & Lodge Rogers, E. (1998). The Legal History of Special Education. The Journal of Special Education. Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act.

We’re excited to share that Sycamore Services currently has four openings in our Applied Behavior Analysis (ABA) Clinic for children with an autism diagnosis. If you’re a parent or caregiver seeking supportive, individualized therapy for your child, this is a great opportunity to connect with a team that focuses on growth, independence, and meaningful progress—at your child’s pace. GET STARTED WITH ABA What Is ABA Therapy? Applied Behavior Analysis, commonly known as ABA , is a research-based approach to therapy that helps children develop important life skills while reducing barriers to learning. ABA therapy focuses on understanding behavior and how it is influenced by the environment, then using positive reinforcement to encourage skill development. ABA programs are highly individualized and may support skills such as: Communication and language Social interaction and play Daily living and self-help skills Emotional regulation Attention, learning, and flexibility At its core, ABA is about helping children succeed in ways that are meaningful to them and their families. Why ABA Can Be Helpful ABA therapy is widely recognized as an effective, evidence-based treatment for children with autism. When delivered by a skilled, compassionate team, it can help children: Build confidence and independence Strengthen communication and social connections Learn strategies that support success at home, school, and in the community Develop skills that carry over into everyday life Our clinic environment is designed to be welcoming, engaging, and supportive—encouraging learning through play, structure, and positive relationships. Autism Testing Available at Sycamore Services In addition to therapy services, Sycamore Services also offers autism diagnostic testing . This allows families to take an important first step toward understanding their child’s needs and accessing appropriate supports—all within one trusted organization. Our team works closely with families throughout the evaluation process and can help guide next steps following a diagnosis. Take the Next Step With four ABA clinic openings currently available , now is a great time to explore services at Sycamore Services. Whether you’re seeking therapy, diagnostic testing, or simply want to learn more, our team is here to help. To inquire about availability or get started, contact Sycamore Services today and learn how our ABA clinic can support your child’s journey.

How policy decisions shape access, workforce stability, and the future of community based supports When a family reaches out to Sycamore Services, they are usually focused on one thing: getting the right support, at the right time, for someone they love. What they do not see is the network of systems working quietly in the background to determine how quickly that support can begin, what services are available, and whether a provider has the resources needed to sustain quality care. Behind every residential placement, employment support, or day program is a structure shaped by federal rules, state level decisions, and funding frameworks that evolve over time. These systems influence how services are designed, how staff are compensated, and how many people can be served at once. While these decisions are often made far from the day to day lives of the individuals who rely on services, their effects are felt in very real ways across communities. Understanding how these systems function helps explain why access can expand in some years and tighten in others, why workforce investments have become a growing focus, and why providers like Sycamore Services must continually adapt to meet both community needs and regulatory expectations. Federal policies shaping disability and community based services Medicaid access expectations and workforce investment In 2024, the Centers for Medicare and Medicaid Services finalized the Ensuring Access to Medicaid Services  rule. One component that has received significant attention is the expectation that, over time, states generally ensure that at least 80 percent of Medicaid payments  for certain home care services (including personal care, homemaker, and home health aide services) are spent on direct care worker compensation , with defined flexibilities and exceptions. For providers, this signals a broader shift toward transparency and accountability in how reimbursement rates support the workforce. It also means that states are increasingly examining rate setting, pass through requirements, and reporting mechanisms as workforce shortages continue to challenge service capacity nationwide. Community integration requirements under the HCBS Settings Rule The federal Home and Community Based Services (HCBS) Settings Rule  establishes standards to ensure that services funded through Medicaid support community inclusion, individual choice, and personal autonomy. With the formal transition period complete, states and providers are now expected to operate in full alignment with these requirements. This affects how day services are structured, how employment supports are delivered, and how residential environments promote meaningful access to the broader community. Compliance is no longer a future goal but an ongoing operational expectation. Federal oversight influences state planning Even when no immediate statutory changes occur, federal oversight, audits, and rulemaking influence how states approach Medicaid expansion, rate increases, and waiver growth. In practice, uncertainty at the federal level often translates into cautious planning at the state level, shaping how quickly systems can respond to growing demand. Indiana’s current landscape and its impact on services Waiver restructuring and system transitions On July 1, 2024, Indiana restructured its Aged and Disabled Waiver into two distinct programs: Health and Wellness Waiver , generally serving individuals under age 60 PathWays Waiver , generally serving individuals age 60 and older Transitions of this scale often bring changes in eligibility processes, care coordination, billing workflows, and provider compliance requirements. For organizations delivering services across multiple settings, adaptability becomes essential during and after such restructuring. Waiver capacity limits and waiting lists Indiana reached its federally approved waiver capacity in April 2024 and implemented a waiting list. The state publishes capacity data and monthly invitation counts to provide transparency around access. As of December 2025: 6,174 individuals  were on the Health and Wellness Waiver waiting list 10,405 individuals  were on the PathWays Waiver waiting list Waiting lists directly affect how quickly services can begin, how providers plan staffing and housing availability, and how families navigate transitions. Even when provider capacity exists, waiver availability ultimately determines access. Direct care pass through requirements Indiana also implemented a direct care compensation requirement tied to House Enrolled Act 1120 . Under this policy: At least 70 percent  of reimbursement for Attendant Care must be used for direct service compensation At least 60 percent  of reimbursement for Structured Family Caregiving must be used for direct service compensation This reflects a growing emphasis on ensuring Medicaid dollars directly support the workforce while increasing the importance of accurate cost reporting and audit readiness for providers. How other states compare A state reducing access barriers: Maryland According to the Kaiser Family Foundation, Maryland experienced one of the largest reductions in HCBS waiting lists  after increasing waiver slot capacity. The state reduced its home care waiting list by more than 2,000 individuals , demonstrating how targeted investment and slot expansion can directly improve access. This example highlights how policy decisions that align funding with demand can stabilize provider networks and shorten the path to services for individuals and families. A state facing sustained access strain: Texas KFF reports that states which do not screen for eligibility on waiting or interest lists account for more than half of all individuals nationwide  on such lists, approximately 325,000 people . Texas is identified as one of these states. Texas maintains large interest lists for certain long term services and supports programs, and advocacy organizations frequently cite extended wait times and system strain. Large, unscreened lists can make it more difficult to accurately measure need and create added uncertainty for providers attempting to plan services and staffing. What this means for Sycamore Services and the communities we support Several clear themes emerge from these trends: Access is increasingly shaped by capacity , not by demand alone. Indiana’s published waiting list data shows that need continues to exceed available slots. Workforce investment is becoming a structural expectation , reinforced by both federal guidance and state policy. States that reduce waiting lists do so by expanding capacity , not by shifting eligibility rules alone. Maryland’s experience illustrates this clearly. Long and uncertain waiting lists create planning challenges  for providers, families, and communities alike. At Sycamore Services, understanding these systems helps guide responsible growth, workforce sustainability, and long term planning. While the policies themselves may evolve, the focus remains constant: supporting individuals in living meaningful, connected lives within their communities. References Administration for Community Living. (2024, April 24). The Medicaid Access Rule: A Historic Regulation to Strengthen Home and Community Based Services. Centers for Medicare and Medicaid Services. (2024, April 22). Ensuring Access to Medicaid Services Final Rule (CMS 2442 F) Fact Sheet. Centers for Medicare and Medicaid Services. (n.d.). Home and Community Based Services Final Regulation (HCBS Settings Rule resources). Administration for Community Living. (n.d.). HCBS Settings Rule. Indiana Family and Social Services Administration (FSSA), Division of Disability and Rehabilitative Services. (n.d.). Medicaid HCBS overview and waiver structure. Indiana FSSA, Division of Disability and Rehabilitative Services. (n.d.). HCBS Medicaid Waiver Waiting List Information. Indiana Health Coverage Programs. (2025). Provider bulletin on direct care pass through requirements under HEA 1120. Kaiser Family Foundation. (2025, November 20). A Look at Waiting Lists for Medicaid Home and Community Based Services from 2016 to 2025. Texas Health and Human Services Commission. (n.d.). HCS and TxHmL interest list guidance. The Arc of Texas. (n.d.). Medicaid waivers and waitlists in Texas. Medicaid and CHIP Payment and Access Commission (MACPAC). (2025). Rate Setting for Medicaid Home and Community Based Services.

For more than 10 years, Sara Jones has been a steady and compassionate presence at Sycamore Services. Her journey began thanks to a family connection — Sara’s brother worked in the Day Program and believed she would be a great fit for supporting individuals with special needs. That encouragement turned into a long-standing career rooted in service, growth, and genuine care for others. In her current role, Sara oversees the day-to-day operations of Community and Respite services. No two days look exactly the same, but her work consistently centers on supporting individuals and ensuring quality services. From attending meetings and completing administrative paperwork to expanding programs and developing new evening service options, Sara plays a vital role in strengthening and growing these services. When asked about her favorite part of the job, Sara doesn’t hesitate — it’s the individuals she serves. They bring joy to her day, even on the hard ones, and remind her why the work matters. Like many in the field, one of the biggest challenges Sara faces is keeping up with ongoing changes — both across the human services field and within a growing organization like Sycamore. Her ability to adapt and stay committed through change speaks to her dedication and professionalism. Outside of work, Sara describes herself as a bit of a geek at heart. She enjoys playing video games and getting lost in fantasy books and audiobooks. She is also a devoted Christian and attends church every Sunday, finding strength and grounding in her faith. One thing Sara believes is important for others to understand about this work is the impact of simply showing up. Being present every day and supporting the individuals we serve truly makes a difference in their lives. At her core, Sara describes herself as hardworking, caring, and collaborative. She loves working with others and takes pride in making someone’s day a little brighter — qualities that reflect the heart of Sycamore Services.