NCSA Hill Brief: Leveraging the Executive Order on Crime and Disorder to Advance Severe Autism Housing and Civil Commitment Reform — July 2025
Hill Brief | July 25, 2025
To: U.S. Congress
Re: Using the Executive Order on 'Ending Crime and Disorder on America's Streets' to Build Better Systems for Severe Autism
Hill Briefing — Executive Order on "Ending Crime and Disorder on America's Streets"
Prepared by Jackie Kancir, Executive Director
National Council on Severe Autism (NCSA)
Date: July 25, 2025
USING THE EXECUTIVE ORDER TO BUILD BETTER SYSTEMS FOR SEVERE AUTISM
On July 24, 2025, the administration issued an Executive Order titled "Ending Crime and Disorder on America's Streets." While not autism-specific, the EO opens critical policy channels in housing, Medicaid, and civil commitment — areas where adults with severe autism have long been excluded or underserved.
KEY CHALLENGES FACING ADULTS WITH SEVERE AUTISM
HCBS group homes routinely exclude those with complex behavioral needs (aggression, self-injury, elopement). Thousands of Medicaid waivers go unused because no providers are equipped to support high-acuity individuals. Emergency rooms, jails, and law enforcement have become the de facto care system — often unsafe and inappropriate. Federal housing rules restrict development of specialized residential programs that offer meaningful safety and quality of life.
POLICY OPPORTUNITIES CREATED BY THE EO
1. Civil Commitment Reform — Encourages reform of involuntary placement laws. This can be leveraged to support: specialized, trauma-informed, non-carceral care; developmental disability-specific protocols; respect for existing family guardianship rights with due process.
2. Reform of Housing-First Mandates — The EO allows states to prioritize care-linked housing over "Housing First" mandates. This makes room for: Medicaid-integrated housing programs; models that combine residential and multidisciplinary behavioral-medical supports.
3. Federal Rule Modernization — HUD and CMS are instructed to realign rules to support treatment-focused models. This provides an opening to: amend or waive HCBS Settings Rule barriers; support purpose-built, person-centered housing for individuals with high needs.
NCSA LEGISLATIVE RECOMMENDATIONS
Protect Due Process in Civil Commitment: Require DD-specific criteria, trauma-informed practices, and multidisciplinary review; prevent bypass of family guardianship without court oversight; fund crisis stabilization settings tailored to severe/profound autism.
Modernize the HCBS Settings Rule: Allow specialized programs tailored for severe/profound autism when chosen through person-centered planning; approve rural or clustered settings that meet individual needs, not just regulatory form.
Invest in Specialized Residential Infrastructure: Create dedicated federal grant programs for high-acuity autism housing; prioritize integration of behavioral, medical, and habilitative care.
Oversight and Safety Protections: Establish a federal ombudsman system to monitor involuntary placements; fund states to strengthen guardianship training, accountability, and support.
*Trauma-informed care recognizes how past or ongoing adversity can affect a person's behavior and functioning, and seeks to reduce triggers, stress, and coercive interventions.
Contact: Jackie Kancir, Executive Director, National Council on Severe Autism | PO Box 26853, San Jose, CA 95159 | policy@ncsautism.org | (408) 690-6094
