September 19, 2025

VOR's Weekly News Update

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Inside a ‘Hell on Earth’ in Oklahoma

By Danny Hakim and Rachel Nostrant, The New York Times, September 14, 2025

The Greer Center was supposed to be a refuge for people with developmental disabilities. But accounts from inside the secretive facility paint a starkly different picture, depicting a place where helpless patients faced beatings, waterboarding and constant fear.

Two summers ago, Detective Frank Bruno was at the police station in Enid, Okla., when a woman walked in with a story to tell.

In Enid, a city of 50,000 people dotted by Depression-era grain terminals, Mr. Bruno typically worked on robberies and financial crimes. But in this case, the woman, Apera Tobiason, was a treatment specialist at the Robert M. Greer Center, an institution for people with developmental disabilities that sat on a sprawling campus on the main road into town.

She was upset. She told Mr. Bruno that she had started working at Greer the previous summer, writing treatment plans for residents who had the mental capacity of young children. At first, she had been excited. Her brother has a disability, so the work felt personal. But she quickly realized that Greer was no place she would want her brother to be.

In early 2023, she had encountered three residents who had black eyes or head injuries and grew suspicious when they were all explained away as accidental. The problem, she said, was that many of her fellow staff members were barely trained and regarded residents as nuisances requiring discipline.

But her reports to her superiors, which she was soon filing weekly, if not daily, seemed to go nowhere. She told the police that little of what she saw was reported to the state, as required by law, and often only after injuries had healed.

After she raised her concerns, Ms. Tobiason said, a woman she worked with called her a snitch, and deliberately bumped her shoulder in a hallway. She said she was made to feel by her co-workers that her empathy for the residents was the problem.

“They absolutely hated that I was nice to them,” she said.

She had sought a meeting with Mr. Bruno after receiving an alarming phone call from another police officer two days earlier. He told her that fliers with her photo had been found all over town, advertising her for sex work. “Item for sale,” they said. “Want your Popsicle blown?” They included tear-off slips with her phone number. She went looking, and found them on utility poles, in bathrooms, at public parks and at a vocational training site used by Greer.

Her supervisor declined to intervene, saying it wasn’t clearly a company issue. Ms. Tobiason could be heard crying during the conversation, which she secretly recorded. “You have to get your emotion under control,” her supervisor said.

“I have people with my photo, and my number, calling me late at night,” she protested.

He later chided her for “not taking any kind of responsibility for your part in this.”

Mr. Bruno, 30, who had joined the police force after serving as an Army medic, had been looking for a case where he could have an impact, do some good. He thought he might have found one.

“These are probably some of the most vulnerable people in this state, and they’re up there by themselves,” he said in an interview later. “Somebody needs to actually care about these people and do something right by them.”

Reports of abuse and neglect have long been endemic in the care of those with developmental disabilities. For decades, Liberty Healthcare, a private company with contracts in more than a dozen states, has pitched itself as an alternative for disabled adult services that typically are provided directly by states or charities. But in Oklahoma, it has left behind a trail of litigation and outrage, highlighting the potential problems with outsourcing care of a largely powerless population to a profit-making company operating with limited oversight.

While Greer has received widespread attention in Oklahoma, The New York Times interviewed two key insiders for the first time: Ms. Tobiason, as well as an elusive former resident who provided a rare firsthand account of what happened and emerged as a critical potential witness who could open the door to criminal prosecutions.

This article is also based on dozens of accounts from families, regulators, the police and Liberty employees, as well as police reports, court affidavits and personnel records. Photographs and medical records documented years of injuries, as did decades of Greer’s own internal abuse reports, along with recordings of interviews with victims and suspects.

What they showed was how difficult it is to hold the perpetrators of such abuse accountable. Criminal charges were brought against eight Greer employees based on the investigation that Mr. Bruno would undertake. But the cases were dropped before they went to trial. Even after a new contractor took over this year, some managers who failed to heed abuse reports kept their jobs or were promoted.

Together, these accounts told a story of a nightmare that went on behind locked doors for years, its victims often unable to recognize the depravity of what was happening to them, let alone sound an alarm.

“It’s just a tragedy that should never happen,” Gov. Kevin Stitt of Oklahoma, a Republican, said in an interview. “Whatever control that company got in place, it didn’t work.”

During a half-century-long push to deinstitutionalize care for people with mental illness and developmental disabilities, state hospitals that had acted as little more than warehouses were largely emptied out. After federal litigation in the 1980s pushed Oklahoma toward more community-based care, the state contracted work to Liberty, a company that provides a variety of services to support challenging populations.

Liberty’s operations have been the subject of controversy before. A 2007 Times report revealed failures at a Liberty-run sex offender treatment center in Florida, which one mental health counselor called “a cesspool of despair and depression and drug abuse.” In California, State Senator Brian Jones, the Republican minority leader, complained in 2023 that Liberty “sneaks into unsuspecting communities” to “secretly release dangerous” predators.

Company officials declined to answer most questions about Greer, citing continuing litigation. But in court filings, Liberty denied many allegations of abuse and inadequate oversight, contending that it “performed within accepted industry standards.” It fired several Greer employees accused of misconduct and agreed to some corrective actions, including instituting morning meetings to review what happened the previous evening.

As Mr. Bruno began investigating, he learned that state regulators had already cataloged a spate of serious problems, including accusations of beatings by staff members. One resident was blinded in both eyes. Another suffered leg injuries that a doctor likened to those seen in a car crash. Mr. Bruno noticed that injuries were typically reported as accidental. It “got worse and worse and worse with the more that I found out,” he said.

In the months that followed, families of more than 20 residents, including one who died at Greer last year, hired lawyers who gathered evidence backing up abuse claims leveled by Ms. Tobiason and other whistle-blowers.

The lawyers had dozens of photos showing residents with black eyes or covered with large patches of deep purple bruising. Some residents claimed that they had been sexually assaulted, according to state records.

Many accounts focused on a cadre of men on the night shift, several in their early 20s, whom residents accused of routinely engaging in abusive behavior. The residents described enduring “choke-and-revive” games that appeared to be no more than an effort by the night crew to pass time.

But the residents often had trouble understanding what was happening. One told a specialist brought in by Mr. Bruno that a caregiver “tried to choke me with a towel” and in a videotaped interview described getting his head dipped in a toilet.

“Is that a no-no?” he had asked.

As Mr. Bruno widened his inquiry, it appeared that plenty of people had tried to raise alarms. A former Greer nurse filed a lawsuit against Liberty in which she said the facility had become a “hell on earth for many of its residents.”

The Oklahoma Disability Law Center, a federally funded nonprofit, filed formal complaints in May 2023 with two state agencies. RoseAnn Duplan, a policy specialist with the center, said in an interview that her group saw “almost identical bruising in multiple different people.” Joy Turner, the group’s investigations director, added that injuries were routinely “coming from the same unit, with the same staff. I mean, how do you not recognize that?”

The state took little immediate action. The next year, a state-funded report by a consulting firm cited “a series of seriously abusive situations perpetrated by residential staff,” and also found that ongoing management problems were largely allowed to continue.

One of the first things Mr. Bruno did was help track down closed-circuit camera footage where the fliers had been hung. Four of Ms. Tobiason’s co-workers, all women, could be seen taking part.

She went to court and was granted protection orders against the women. But with fliers already seeded across the community, police officers worried about her safety; she took a leave from work and left town, giving her ex-husband partial custody of her children.

Mr. Bruno began digging into abuse episodes detailed by Ms. Tobiason. One common thread was Jonathan Martinez, a care provider hired in 2021 at the age of 19. He was named in abuse or misconduct allegations involving at least seven residents.

He had already come to the Enid police’s attention in a referral in May 2023 from state regulators, after they substantiated allegations that Mr. Martinez had punched a female resident in the face who wasn’t sitting down in a van. An internal Greer report said she had poked herself in the eye.

Another case was that of Jaymee Muns, 28, a nonverbal autistic woman with a history of physical outbursts, according to her mother, Shawna Moore. At Greer, she appeared in 112 injury reports from May 2022 to May 2023, documents show, culminating in two detached retinas that went largely unexplained. She lost sight in both eyes.

Ms. Moore said her daughter had been a prolific creator of pastel drawings, bursting with color and shape. But her injuries changed all that.

“She’s no longer an artist because she doesn’t have eyes,” Ms. Moore said, adding that her daughter is now heavily medicated. “Her life is gone now. She sits in a chair and that’s what she does.”

That same year Mr. Bruno asked Liberty’s internal investigator, responsible for examining reports of abuse and other problems, why her caseload increased 50 percent from a year earlier. He was concerned by her dismissive response. She told him that she normally started investigations believing “the client is lying about what happened,” he said later, describing the conversation.

By early August 2023, Mr. Martinez was the subject of several investigations. (Mr. Martinez and his lawyer declined to discuss the claims.) The state Office of Client Advocacy, which monitors Greer, put in place a safety plan barring Mr. Martinez from working with residents while the inquiries were underway. But Liberty put him back to work weeks later, saying that the company’s own internal inquiry had cleared him, according to police reports.

Mr. Bruno also noted in his case files that reports of abuse became more frequent after Ed Webster, 53, was promoted to night shift supervisor on the facility’s west wing. A Liberty employee and a resident both told Mr. Bruno that Mr. Webster had sometimes acted as a lookout when abuse was taking place, once warning others when a nurse was approaching. (In a text, Mr. Webster said that “none of that is true,” adding that he was “trying to forget and move on.”)

In September 2023, Mr. Martinez was fired.

By then, Mr. Bruno was talking to the office of the district attorney, Tommy Humphries, about bringing criminal charges. Mr. Humphries was skeptical, and in interviews, both he and Mr. Bruno highlighted a common impediment in such cases.

“Oftentimes your victims cannot tell you what happened,” Mr. Bruno said, adding that one resident in his 20s who might have been a witness “has the mentality of a 2- or 3-year-old.”

But a victim would soon emerge who was not like the others.

Richard Lott arrived at Greer in the summer of 2023, a few weeks after Ms. Tobiason had gone to see Mr. Bruno.

Mr. Lott was not supposed to be at Greer. He was not developmentally disabled, but he had been in and out of prison, fighting drug addiction for years. When he once again faced probable prison time after leading police officers on a chase, he decided to “play dumb,” he later told Mr. Bruno, leading the state to declare him mentally incompetent. He ended up at Greer.

For a few weeks, it did seem like a better option than prison. But then, he said, he started hearing strange noises outside his room in the west wing.

There was paper covering the window on his door, blocking his view. But he could hear disturbing sounds: The squeaking of sneakers, almost like a basketball game was being played. What sounded like the thudding of fists against flesh. Moaning and pleading.

Like Ms. Tobiason, he tried alerting Greer supervisors, but made little headway. Then he urged a sympathetic caregiver to pull up the shirt of a resident who had been beaten. The caregiver, alarmed by bruising he saw, informed a supervisor who knew about Mr. Bruno’s investigation and told the detective.

On Oct. 18, 2023, Mr. Bruno approached Mr. Lott at an off-site recycling center that employed Greer residents.

“I’m not big on snitching,” Mr. Lott said as they began talking in a small conference room. “You know, I used to be an outlaw.”

But he was ready to talk. Mr. Lott recounted to Mr. Bruno what he had heard and seen: Beatings. Waterboarding. Victims pleading for mercy.

By mid-November 2023, Mr. Bruno had convinced the district attorney, and arrests began, with Mr. Martinez among the first, charged with felony abuse by a caretaker and conspiracy. A week later, Mr. Webster and two other employees were charged.

Days later, Mr. Bruno and a state investigator sat down with Hugh Sage, Liberty’s top Oklahoma executive, in a conversation later recounted in an interview and a police report. Mr. Sage told them that he had not seen any injuries to residents. Mr. Bruno, exasperated, pulled out several of what he called “black and blue” photos showing injuries.

“I was like, you really want to tell me I made this up?” Mr. Bruno recalled. In a report, he wrote that “over the course of the interview, it became more and more obvious” that the administrator “had little to no idea what was actually going on.”

Mr. Sage stepped down a couple of weeks later and did not respond to requests for comment. After arrests began, Liberty officials promised to “fully cooperate,” releasing a statement saying they were “deeply disturbed by the reports of abuse and consider such behavior to be wholly inappropriate.”

For Mr. Bruno and family members who had pushed to get answers, it seemed as if a reckoning was at hand.

But their optimism was short-lived. In January 2024, five employees who had been suspended for abuse allegations, but were not among those criminally charged, resurfaced at Greer. Under the direction of supervisors from Liberty’s corporate office in Pennsylvania, the employees were told to shred a dozen large trash cans worth of documents, according to court records.

Lawyers for many residents with pending lawsuits got a temporary restraining order halting the shredding, but three days had passed. The company characterized it as routine document destruction and in a statement “categorically denied” any effort “to destroy evidence.” But a few days later, during a civil court hearing, Liberty’s human resources manager in Oklahoma at the time, Stacie Caywood, testified that someone had been sent to a local store to buy five paper shredders to carry out the work.

“You sent somebody to get five shredders during the middle of multiple criminal and civil investigations?” Ross Leonoudakis, a lawyer for one of the plaintiffs, asked during the hearing.

“Yes, sir,” Ms. Caywood replied.

The same week the shredding occurred, the State Department of Health issued a report accusing Greer of failing to investigate allegations of physical or sexual abuse involving six residents.

Mr. Bruno hoped that his own case would finally curtail such episodes.

But then problems emerged. By the summer of 2024, Mr. Lott, the only resident eyewitness without a mental disability, had been released from Greer and left town. When he couldn’t be found, Mr. Humphries, the district attorney, moved to drop all criminal charges.

The controversy over Greer generated months of headlines in local news outlets like The Frontier and The Oklahoman, which reported last year that the Department of Human Services was seeking to continue the state’s contract with Liberty.

The department said in recent statements that it had considered keeping Liberty amid “intensive safety remediation efforts,” and pointed to several actions the state took after the scandal became public, including putting monitors inside Greer and installing cameras. Liberty, in court filings, defended its management, saying that none of its actions were “unlawful, reckless, willful” or “malicious,” and in a brief statement to The Times said its local staff had included “experienced clinical and operations managers.”

The plan to retain Liberty drew immediate pushback.

“I told them they are not renewing that contract,” said Senator Paul Rosino, a Republican who chairs the Legislature’s Health and Human Services Committee. “Why in the world would we renew a contract,” he added, “for people who tortured and abused people?”

The state ultimately terminated the contract, a move that Governor Stitt said was made “as soon as we felt like we legally could,” adding that the situation was “just an absolute tragedy.”

Liberty continues to operate elsewhere, however. In its home base, Pennsylvania, it has contracted with the state since 2015 to oversee investigations of abuse of people with developmental disabilities. The state said it recently reviewed completed cases “to ensure proper handling.”

Greer was taken over in February by Respectful Partners, an Oklahoma company that operates group homes. Concerns linger. Some people currently working at Greer expressed unease to The Times that the new company had retained or promoted several former Liberty officials, including Ms. Tobiason’s old supervisor.

Ms. Tobiason, who has filed her own lawsuit against Liberty, said she found it hard to believe that there were so few repercussions.

“I feel like the D.A. not prosecuting just makes people more scared to stand up and speak out,” she said.

Read the full article here or here

Note: The Greer Center is not an intermediate care facility, and is not subject to the same standards for certification.

Illinois - Backed-up mental health facilities leaves patient behind bars

By Chad Mira, Fox 2 News Now, September 17, 2025

A back up at Illinois mental health facilities is keeping some patients behind bars instead of in treatment.

Susan Potthast has spent the past three years visiting her son in an Illinois state mental health facility. Each trip to Choate Mental Health and Developmental Center ends the same way.

“Every four weeks, I set up a visit. I drive to Choate. I visit him. And every four weeks I cry on the way home that he’s even in there to start with,” Potthast said.

Potthast’s son, whose name is being withheld to protect his privacy, has autism, impulse control disorder and the intellectual capacity of an eight-year-old. In 2022, he was charged with sexual abuse.

“When he got here, we were told that he was roughly a 32-year-old gentleman, but he had the intellect of a child roughly six to eight [years old],” Clinton County Sheriff Dan Travous said. “At that point he was in diapers.”

A judge remanded him to custody of the Illinois Department of Human Services (IDHS) for care at a state mental health facility. But earlier this month, he was returned to the Clinton County Jail for new court proceedings.

“In my 28-year career, this is probably the worst I’ve felt as being an officer, deputy and now as the sheriff,” Travous said.

Sheriff Travous kept the man in solitary confinement for several days due to his special needs. Potthast said keeping her son out of the general jail population is necessary for his safety.

“If he’s just in a regular population of a jail, it’s like his attorney told me, and she’s right, he’d be a victim every day,” she said.

Growing Crisis in Illinois Jails

Sheriff Travous said the case highlights a growing problem across the state. Local jails are increasingly housing mentally ill individuals who have been found unfit for trial.

“We had one who was drinking out of a toilet and thought he was Jesus Christ,” Travous said. “What are we supposed to do? We’re not trained for that.”

FOX 2 News has reviewed court records that show several other examples in Clinton County. One man was declared unfit for trial on July 2 and remains in jail. Earlier this month, a judge ordered the Illinois DHS secretary to appear in court to explain why the department has not complied with a directive to place the man in a treatment facility.

Another inmate booked last September and declared unfit was not released until March, after a judge issued a similar order.

State Response

Clinton County officials have pleaded for help. Sheriff Travous sent a letter to Gov. J.B. Pritzker and state lawmakers outlining the crisis.

“As good as our correctional officers are, they are not trained to handle somebody of that mental capacity being in a jail and frankly, they shouldn’t be in a jail. That’s the last place they should be,” Sheriff Travous said.

State Rep. Charlie Meier said he has been trying to address the issue for years.

“This is a free pass for the state of Illinois,” Meier said. “They’re sitting in a jail here. They’re not having to pay the cost of taking care of them in a facility where they’re supposed to be. We’re spending that money on other things when we should’ve been spending it on taking care of our most vulnerable.”

IDHS said in a written statement that it “takes its responsibility to restore individuals to fitness seriously.”

The agency cited limited bed availability and an increase in referrals, noting referrals rose from 640 in 2020 to 1,154 in 2024. The statement says that it places referrals as soon as beds become available.

A state audit from December highlights another potential problem. It found that 70% of state-operated facility employees had overtime, largely due to short-staffing. The report warns that excessive amount of overtime can have a detrimental effect on the care provided to residents and patients.

Continued

Note: VOR has been working with the Link Center, the National Association of State Directors of Developmental Disability Services (NASDDDS), and state and local officials to bring attention to the lack of appropriate services for people with co-occurring intellectual disabilities and mental illnesses. If your family member falls into this category, please email us at: hdwyervor@gmail.com

Is Massachusetts trying to close last two facilities for developmentally disabled adults?

By Marilyn Schairer, WGBH News, September 17, 2025

No new residents have been accepted to Massachusetts’ two remaining intermediate care facilities that provide long-term care to adults with intellectual and developmental disabilities since 2023, according to state records obtained by GBH News.

The Massachusetts Department of Developmental Services says it has accepted “zero” new admissions at the Wrentham Developmental Center since the end of 2023 and no new patients at the Hogan Regional Center in Danvers since the end of 2020, a representative for the department wrote in response to a public records request filed by GBH News.

State officials first told GBH News that it was still accepting people at the two residences that altogether house about 225 adults with developmental disabilities and autism.

When presented with the department’s public records that show no new admissions in years, Jonathan Tapper, director of communications for the state agency, suggested that’s not because of a change in policy — but that no new patients had met the criteria to be accepted.

“Within the time period requested, individuals who were assessed by [the department] needing residential services were able to be placed in community-based settings with expertise and capacity that met their needs,’’ he wrote.

The new admissions numbers add to growing concerns from some family members who worry that Massachusetts is denying entrance to people in need and harboring longer-term plans to shut down the properties altogether.

Colleen Lutkevich and Kim Meehan

The facilities house a fraction of the population they once held before Massachusetts joined a national trend of closing state-run facilities and housing more people in communities starting in the 1970s — a move that many members of the disability community had long advocated for.

Colleen Lutkevich, president of the Wrentham Family Association, views the care differently. She and other family advocates for people with intellectual and severe developmental disabilities that are low-functioning said residents need around-the-clock care that is not available through other state programs.

Lutkevich says her 72-year-old sister Jean Sullivan has lived at the Wrentham center for the last 65 years. She says her sister has her own room in a cottage on the grounds and benefits from the institutional environment the 120-year-old center provides in residences located on 400 acres of state-owned land.

Lutkevich’s sister, she says, is diagnosed with profound autism, severe intellectual disability and is nonverbal. She says she enjoys the company of long-time housemates and staff.

“There’s a large enough population that does need special care,” Lutkevich said. “If this closes, the expertise and the resources are gone forever.”

The state told GBH News it has no intention of shutting either center down. “Every individual who is entering [the department] for support and services is evaluated so they receive the appropriate care for their needs in the appropriate setting,” Tapper said.

But some families told GBH News they have struggled to get their loved ones accepted. Kim Meehan of Norfolk spent a year trying to get her 52-year-old sister, Kristen Robinson, admitted to the Hogan Center after her caretaker — their mother — unexpectedly died in 2023. She says Robinson is a quadriplegic, legally blind and has a medical diagnosis of dysphasia and a seizure disorder.

“Our family asked over 26 to 30 times to high-up people [in the state], ‘Why can’t she be admitted to the Wrentham Development Center or the Hogan Center?’ And we were always told by the state that she was not eligible,” Meehan said.

Her sister eventually did get admitted to Hogan last year, transferred in from a hospital after being ill and stuck for weeks, and Meehan says she’s now doing well. But Meehan is still angry about how long it took to get her help.

“It’s hard and there needs to be more support — and there need to be places like this that people can have access to,’’ she said. “The state is ceasing access to these places.”

Meehan says she’s not sure why the state doesn’t include her sister in admission numbers released in a response to a public records request. The state declined to comment.

Irene Tanzman, who is a member of a group called the Saving Wrentham and Hogan Alliance, says she unsuccessfully attempted to have her son accepted at the Wrentham Development Center. Instead, she says her son — who has severe autism and other physical and intellectual disabilities — receives Home and Community-Based Services, a program the state offers to eligible individuals in their own homes and communities.

Tanzman says past problems with institutions were more to do with flawed oversight and lack of funding than the actual hospitals. Her group has the support of many local organizations, including the Massachusetts Nurses Association and the National Council on Severe Autism.

“The same problems exist today in community-based services,’’ Tanzman said. “The problem was never congregate care. It was very bad congregate care in a corrupt environment.”

The state has closed most of its state-run facilities for people with intellectual and developmental disabilities. Among them, Massachusetts officials in 2014 closed down the Walter E. Fernald State School in Waltham, the first public institution of its kind in the United States to care for people with disabilities.

Earlier this year, the Healey administration announced that it would be closing two other state facilities — one for severely disabled children and young adults, the other a mental health center on Cape Cod. That announcement was met with sharp pushback by disability advocates and prompted the state to put its plans on pause.

What comes next

Meehan and Lutkevich have reached out to lawmakers in their districts to garner support for the two facilities. Among supporters, Rep. Marcus Vaughn, a Republican from Wrentham, told GBH News that having more options for people with disabilities is ideal.

“At a time when our state faces a growing demand for specialized care and appropriate placements, reopening admissions and thoughtfully expanding that capacity at the center is not only practical, but it’s the right thing to do,” Vaughn said.

Even some leaders at community residential programs say that state-run facilities play an important role.

“It’s interesting because people’s impressions of institutions are dated,” said Brian Carbone, senior vice president of adult services at May Institute, a nonprofit based in Randolph.

The May Institute provides individuals with community living. Carbone said the homes are within neighborhoods and offer smaller congregate living that are less restrictive. But he said not all residents can live in community-based homes because they need more services.

“I think there is a place for the [two facilities], I think there is for those ones that are very difficult to serve, as I said before, in a community residence that can’t really support the number of staff needed to support that person,” he said.

But over the years, some groups have pushed for the closure of the facilities. In 2010, the Massachusetts Taxpayer Foundation recommended shutting down the Wrentham and Hogan centers, funneling residents to community-based homes to save money.

Lutkevich doesn’t believe the state plans to keep the facilities open. She’s no longer worried about her sister, who likely will live out her life in Wrentham. But she’s still worried about the future — and sees parallels with the Fernald school that shut down after its population dropped.

“They’re going to be yelling at you to close it, just like they did at Fernald,” Lutkevich said. “I am afraid for all the young families coming along.”

The Department of Developmental Services declined to make anyone available for an interview.

Read the full story here

For more in-depth reporting on this article, see the story on the COFAR Blog here

Parents Fear Losing Disability Protections as Trump Slashes Civil Rights Office

By Fred Casen-Kelly, KFF Health News, September 15, 2025

Devon Price, a 15-year-old boy with autism, has attended the largest school district in North Carolina for 10 years, but he cannot read or write. His twin sister, Danielle, who is also autistic, was bullied by classmates and became suicidal.

Under federal law, public schools must provide children with disabilities a “free appropriate public education,” to give them the same opportunity to learn as other kids.

The twins’ mother, Emma Miller, and tens of thousands of other parents in the U.S. have elevated complaints to the Education Department alleging that schools and states have ignored mistreatment of their children. Those complaints are in limbo as President Donald Trump’s administration has set about dismantling the federal agency.

Trump once mocked a reporter with a disability. Earlier this year, Health and Human Services Secretary Robert F. Kennedy Jr.’s inaccurate remarks about people with autism were criticized as perpetuating offensive stereotypes.

Now people like Miller are worried their children will be left behind.

“I want justice for my twins, and to sound the alarm so other special needs children are not suffering or being deprived,” said Miller, 53, who lives with her twins in Wake Forest, North Carolina.

The Education Department, which was created in 1979 and helps oversee schools and colleges in the U.S., has the authority to protect students from discrimination based on race, sex, religion, or disability. Its Office for Civil Rights investigates allegations at schools and negotiates corrective actions.

As the school year begins, families throughout the country are unsure what authority will be left to intervene on their behalf if the office is shuttered, said Hannah Russell, an advocate who works with parents in North Carolina trying to obtain educational services for their children with disabilities.

“Without the Department of Education there is no accountability,” said Russell, a former special education teacher. “Everybody is scared.”

Miller described her twins as her “miracle babies” who survived despite each weighing 1 pound at birth. Danielle Price spent the first five months of her life in a neonatal intensive care unit, and her brother, Devon, the first seven months.

She has spent years fighting for them, repeatedly taking on local and state school officials. But even when she notched victories, she said, her children did not get the help they were promised.

Miller said her children are high-functioning and verbal. She said they could have thrived academically if the school system had given them proper services.

“My children have suffered,” Miller wrote in a complaint she filed in September 2024. “The most vulnerable group of children [is] being denied a basic education.”

Continued

Why Voters Will Feel the Impact of GOP Health Cuts Before the Midterms

By Joanne Kenen, Politico, September 18, 2025

The conventional wisdom in Washington is that by pushing off big changes to Medicaid until after the 2026 midterms, Republicans shielded themselves from voter backlash.

Don’t be so sure.

A full year before anyone casts their vote in November 2026 — meaning now, in the fall of 2025 — the American health care system will begin transitioning from an era of unprecedented expansion of coverage to an era of unprecedented cutbacks. And President Donald Trump and the GOP-controlled Congress will be easy to blame.

Unless Congress reaches a deal fast on some expiring Obamacare provisions, insurance premiums are set to rise, often by double-digit percentages, in and out of Affordable Care Act exchanges. Hospitals are retrenching ahead of the massive cuts imposed by Trump’s “big, beautiful bill.” Altogether, around 14 million people will lose coverage in the coming decade, the Congressional Budget Office projected in August, with the first wave of losses beginning in months.

And even if some of the changes in Trump’s sprawling law kick in after the 2026 elections, that doesn’t mean people won’t hear plenty about them beforehand. State legislatures will have to debate what or who to cut to fill gaping holes in their health care budgets. Health plans, providers and state Medicaid agencies will have to start educating the public about new rules established by the legislation, like Medicaid copays and work requirements.

Precisely how this all plays out electorally is anyone’s guess, particularly given the escalating fights over redistricting and a news cycle that seems to get upended by the hour. Nor is it a given that people who face a health coverage crunch or lose coverage altogether will see Trump and congressional Republicans as culpable.

“I think the gamble the Republicans are taking is [voters] are not going to associate that with us, right?” Brown added.

But gambles are by definition risky — as North Carolina Sen. Thom Tillis reminded fellow Republicans when he announced he would retire rather than deliver broken promises to voters on their health care.

Here are three key areas where Republicans are rolling the dice.

Obamacare Benefits Take a Hit

Health insurance subsidies that were expanded or “enhanced” under President Joe Biden’s pandemic relief law are set to expire at year’s end unless Congress acts.

The subsidies, first created in the Affordable Care Act, now provide relief to those who make up to four times the federal poverty level, $128,600 for a family of four next year. Conservatives argue against using federal dollars to subsidize insurance for people who are well into the middle class. But without the so-called enhanced subsidies, CBO projects around 5 million people will lose ACA coverage over a decade — and more than 2 million next year — with many deciding they can no longer afford it. We’ll start to see the dip soon: open enrollment for 2026 ACA coverage starts Nov 1.

Furthermore, those who decide to forego insurance tend to be healthier than those who shoulder the whole cost. That means premiums will rise for everyone — more sharply in the ACA than in other markets — but across the board, said Katherine Hempstead, a health policy expert at the Robert Wood Johnson Foundation.

The median proposed premium increases for ACA plans as of mid-August was 18 percent — well over double last year’s 7 percent. Some outliers are far higher; one plan in Florida proposed a whopping 40 percent hike. States are still finalizing 2026 rates.

The political risks are obvious. Polling by the health research organization KFF has found the enhanced subsidies are popular across party lines — and get a boost in approval even among self-identified MAGA voters when people are told about the magnitude of expected coverage losses. That might be one reason why some vulnerable GOP lawmakers are now bucking their party and joining with Democrats in calls to extend the subsidies — a move the Republicans spurned when they finalized the megabill in July.

Health Providers Get Squeezed

Much of the congressional debate over the megabill focused on rural hospitals — but the entire safety net is increasingly strained. That will be felt sooner than many think.

“There will be impacts before the ’26 midterms,” said Bruce Siegel, president and CEO of America’s Essential Hospitals which represents “safety net” hospitals serving low-income communities. He said he’s spoken to “literally dozens” of hospital chief executives drawing up contingency plans to lay off staff and close services. Maternity care. Trauma centers. Outpatient clinics. Behavioral health.

“If you’re running a health system and you’re looking at millions of dollars of cuts starting next year, assuming these changes go forth… What do you do?” Siegel added. “Do you shut down your most profitable services? No, you shut down things that lose money. And that’s just the sad mathematics of it.” Hospital executives also don’t have the luxury of waiting around to see if some of those cuts will be reversed or if state legislatures can provide relief.

Rollbacks will affect everyone, not just the newly uninsured. And given that hospitals are often the biggest employer in a community and health care overall is an engine of the U.S. economy, both rural areas and big cities will feel it.

Medicaid Gets Transformed

By far the biggest health changes in the new law affect Medicaid, which saw sweeping spending cuts and policy changes, particularly for people covered under the Medicaid expansion in the ACA. Millions are expected to lose coverage in the coming decade. Now, it’s true that the biggest changes begin after the November elections — though not much after. But many people are likely to find out that their benefits are at risk before they cast their ballots.

For instance, work requirements start in January 2027 for people covered under the ACA’s Medicaid expansion, but notifications go out by September 2026 (and their work status in late 2026 will also factor into the eligibility process). Despite the rhetoric about “waste” and “abuse,” most Medicaid recipients already work or are exempt because they have a disability or are taking care of kids. But now those required to work will have to verify employment, or other qualifying activity such as education. In the two states that have tested work rules — Arkansas, before courts stopped it in 2019, and now Georgia — verification has been glitchy. Many people who were working lost health care anyway.

If, as the industry expects, the regulations come out in mid-2026, and it takes about 90 days to digest and translate them into consumer-friendly language, that would mean a big messaging wave could come just before people go to the polls. Notifications about work rules will also come out around then.

With the federal government sending less Medicaid money to the states, other dominoes could fall. State legislatures could fill budget gaps in all sorts of ways that could re-shape the program, Murray noted. That might mean paying health plans less; paying providers less; and cutting “optional” health care services, which range from adult dental care and physical therapy to home- and community-based services for elderly and disabled people, who might otherwise have to go into nursing homes.

Conservatives like Paragon Institute’s Brian Blase, who served in the first Trump administration and has helped shaped GOP health policies, argue this is all a necessary rightsizing of the federal-state cost-sharing relationship. Why should the federal government pay a bigger share of covering the Medicaid expansion population (90 percent of the costs) than the very poor and disabled in traditional Medicaid (an average of 57 percent of the costs)?

“There’s no policy rationale for that,” Blase said.

The people who lose their health coverage may not care about the distinction.

Read the full article here

‘I don’t know how we would survive’: caregivers speak of fears over upcoming Medicaid cuts

By Bobbi Dempsey, The Guardian, September 12, 2025

Whether taking care of an older parent, a relative with disabilities or a child with a serious medical condition, family caregivers in the US are nervous and afraid of upcoming cuts to Medicaid – including those resulting from the Donald Trump-backed legislation known as the One Big Beautiful Bill Act.

The program, which serves low-income families, pregnant women, children, seniors and people with disabilities, enables more than 70 million people to receive critical services while alleviating some of the financial demands on caregivers. But now the bill could chip away at that support with cuts that include ending the temporary incentive for states to adopt the Medicaid expansion, implementing mandatory work requirements (with some exceptions), more frequent eligibility redeterminations for those covered under the Medicaid expansion, and reducing state funding that could force cuts to state-funded home and community-based services for older adults.

Other safety net programs, such as Snap and Section 8, are also in Republican crosshairs and have been targeted by the legislation, and many low-income families rely on a combination of safety net programs. Some families say they feel as if they are being attacked from all directions.

We spoke to several family caregivers to find out what they fear most about the Medicaid changes looming on the horizon.

Robin Bolduc, 69, Colorado

Caregiver to spouse, Bruce Goguen (72), and daughter Tiffany Zimenoff (42)

Bolduc’s husband is a full quadriplegic and uses a ventilator to breathe due to primary progressive MS. Her daughter has Down’s syndrome with multiple underlying medical conditions. Both Bruce and Tiffany use home health services.

“Bruce lives with me and requires 24/7 line-of-sight care,” Bolduc says, noting that Medicaid pays for her husband’s attendant care, as well as disposable medical supplies and medical equipment such as a wheelchair, ventilator, oxygen and shower chair. “Medicaid allows him to live in our home rather than a nursing home or in a hospital. He can be an important person in the lives of me, his children and his grandchildren.”

Bolduc’s daughter Tiffany lives in her own apartment with a live-in caregiver also paid through Medicaid. In a typical month, she has multiple doctor appointments and several outpatient medical procedures – which are generally primarily paid through Medicare, but the co-pays are paid through Medicaid. (People who have both Medicare and Medicaid coverage are considered “dually eligible” and Medicare acts as the primary insurance.) “Medicaid allows her to work, live independently and be a participating member of her community,” says Bolduc.

“In Colorado, we have more support for family caregivers than many states. Unfortunately, many families do not have access to all the resources available. It is often a maze of bureaucracy to access.”

Bolduc estimates that she spends at least eight to 10 hours a month dealing with insurance and paperwork, sometimes providing the same information to multiple systems. She also sometimes must go through the appeals process as a result of administrative mistakes on the part of one or more agencies, and must get recertified every year.

Medicaid has been a godsend that Bolduc says lets her family enjoy a good quality of life, despite the medical challenges. “We have friends and family. We interact with neighbors. We have our dogs. We have a good life despite our challenges,” she says.

“And we provide employment for five people who work as attendants for Bruce and Tiffany. While I provide the vast majority of Bruce’s care and oversee Tiffany’s care, I simply cannot provide that level of care without help. And all of their attendants would lose their job.”

The potential gutting of Medicaid is terrifying to Bolduc. “Without Medicaid, I honestly don’t know how we would survive. Bruce would die within months,” she says.

Jamie Davis Smith, 40s, Washington DC

Caregiver to her daughter Claire Smith, 19

Davis Smith’s daughter, Claire, was born with a chromosome-related condition that causes multiple disabilities and significant medical conditions.

Claire is non-verbal, uses a wheelchair and needs support for every part of her day, from getting dressed in the morning to eating dinner at night. “Yet, she is very happy,” Davis Smith says. “She loves going for walks, watching movies with her siblings, going in the pool and eating ice-cream.”

Davis Smith says her daughter needs constant support for daily tasks such as brushing her teeth and taking medications, and needs someone to take her to doctor’s appointments and handle any medical emergencies, so she has an aide both at school and at home. She also requires specialized equipment, including a harness, that helps keep her safe in the car.

The work performed by family caregivers is often overlooked, and Davis Smith says it can take a toll: “There is a shortage of caregivers available for home and community support. Since we can never count on someone being available, a parent always needs to be able to drop everything to care for her. I had to leave my career, and it’s hard to plan anything.”

Like many families, Davis Smith’s family relies on a combination of programs and resources – which in their case includes private insurance – to obtain the services they need. Medicaid can help fill in the gaps and cover some of the costs that would otherwise be overwhelming. “Even though Claire has excellent private insurance, it does not cover the home and community supports she needs to stay at home, such as an aide and specialized equipment. Without Medicaid, there is a real chance Claire would wind up in an institution, which has worse outcomes and is more expensive,” Davis Smith says.

“Claire’s needs have shaped my life. I left my career, and meeting Claire’s needs has impacted every part of my family’s life, from where we live to our daily routine. Given that Claire needs constant supervision all day, every day, we could not survive without the services Medicaid helps us access.”

Continued

Congress Pushes Back On Trump’s Wish List For Disability Programs

By Michelle Diament, Disability Scoop, September 19, 2025

As federal lawmakers stare down a deadline to fund the government, they appear poised to reject a Trump administration effort to make big changes to the Individuals with Disabilities Education Act and defund some disability programs — but it’s far from a done deal.

Congress has until the end of this month to pass legislation funding the federal government’s next fiscal year, which begins Oct. 1, or risk a shutdown.

In his budget request, President Donald Trump called for eliminating funding for University Centers for Excellence in Developmental Disabilities, or UCEDDs, as well as a program at protection and advocacy agencies that helps ensure people with disabilities have access to voting. He also sought to alter IDEA in an effort to consolidate funding and give states more control over where dollars go.

So far, however, bills in both the U.S. Senate and House of Representatives have spurned the proposals.

Appropriations committees in both chambers approved legislation continuing funding for UCEDDs, protection and advocacy agencies and many other disability programs. Both bills also maintain funding for IDEA and retain the existing funding structure.

Advocates had pushed back forcefully on the Trump proposals. More than three dozen organizations characterized the idea of ending funding for UCEDDs as “dangerous and misguided” in a letter to lawmakers organized by the Consortium for Constituents with Disabilities over the summer. The centers, which provide early intervention programs, autism evaluations, training for families and more have existed in every state for more than 60 years.

Meanwhile, 14 former Education Department officials who were responsible for overseeing IDEA implementation under Republican and Democratic administrations dating back to President Richard Nixon called on Congress to forgo changes to the way that IDEA funding is handled.

Even as lawmakers have dismissed the proposed changes to IDEA and other disability programs so far, next steps remain uncertain. With time running short, lawmakers are already talking about the possibility of a short-term extension or a government shutdown.

“It’s encouraging that both the House and Senate have rejected some of the deepest proposed cuts to disability programs,” said Kim Musheno, senior director of Medicaid policy at The Arc of the United States. “People with disabilities need Congress to finish the job by passing full-year funding, avoiding another long continuing resolution, and protecting the services families rely on every day.”

Read the full article here

Minnesota - Medicaid changes look like $160 million and mounds of paperwork

By Torey Van Oot, Axios Twin Cities, September 19, 2025

Nearly 300,000 pieces of paper related to applications for Medicaid and other forms of public assistance passed through the government office in rural Stearns County, Minnesota, last year.

That figure will grow exponentially once Republicans' sweeping overhaul of Medicaid takes effect, Melissa Huberty, administrator of the county's human services department, tells Axios.

The office is already drowning in paperwork and about 30,000 phone calls a month, Huberty says.

State of play: Roughly one-third of states, including Minnesota, delegate at least some of the work of vetting and processing Medicaid applications to counties.

Over $160 million a year is what Minnesota's Department of Human Services estimates the additional paperwork related to the work reporting requirements alone will cost its local, state and tribal governments.

Friction point: Without additional state and federal funds, cash-strapped counties may have to raise property taxes to help cover the costs.

"Eventually it's going to come down to a decision of how much do you want to pay in taxpayer dollars to process all the paperwork," Huberty says.
Antiquated technology makes enrolling people in Medicaid a time-consuming task.
When a Minnesotan fills out an online application via the state's MNbenefits site, the system spits out a paper form that a county worker then needs to manually input into their system.

Upgrading those systems statewide would cost hundreds of millions of dollars that counties don't have, Association of Minnesota Counties executive director Julie Ring tells Axios.

And there's no way such an undertaking would be done by the Jan. 1, 2027 start date for the Medicaid changes. Even if county workers can keep up, Huberty fears the new requirements will result in many people who should be eligible losing coverage due to paperwork errors or missed deadlines. She estimates that 75% of the forms submitted now contain outdated or incorrect information.

Read the full article here

Auditor: KY Medicaid wasted $800 million. Health secretary cites ‘significant inaccuracies.’

By Sarah Ladd, The Kentucky Lantern, September 17, 2025

Kentucky Auditor Allison Ball alleges in a report released Wednesday that the state mismanaged about $800 million in taxpayer funds, resulting in payments to Medicaid managed care organizations at the same time other states were paying for the same patients.

Dr. Steven Stack, secretary of the Cabinet for Health and Family Services, called the Wednesday report a “rehash” of what federal investigators found in 2022 — that 47 states made capitation payments for Medicaid recipients who were enrolled in two states. Medicaid is a federal-state program that pays for 1 in 3 Kentuckians’ health care.

“The issue of concurrent enrollment in Medicaid Managed Care was identified by a federal inspector general in 2022 and is happening in nearly all 50 states, making the (auditor’s) ‘special examination’ a rehash,” Stack wrote in a Sept. 10 letter to Ball, which is included in the report.

Kentucky Medicaid contracts with six insurance companies to serve as managed care organizations (MCOs) that offer competing health plans and process claims. Medicaid pays the MCOs a set amount called a capitation payment for each patient.

As “one of Kentucky’s costliest programs,” Ball said in a statement, “it’s essential that we make sure every Medicaid dollar spent is going directly to benefit Kentuckians in need of services, not being wasted due to bureaucratic negligence.”

The audit says Kentucky was one of four states — along with Ohio, Oregon and Washington — that were asked by federal officials during the Biden administration to dig into state-specific issues related to concurrent payments to MCOs from Jan. 1, 2019 to Dec. 31, 2022. An auditor spokesperson said the office examined these dates because the Office of Inspector General “specifically asked us to look at this time period.”

Among other things, the report suggests, as a solution, that managed care organizations carry more responsibility in their contracts to help track members and eliminate waste.

“The issues causing this waste are straightforward problems that can be fixed with relative ease,” the report said.

Continued

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VOR Bill Watch:

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VOR SUPPORTS:

H.R.4849 & S.2556 - Rep. Adam Gray (D-CA) and Sen. Chuck Schumer (D-NY) - Protecting Health Care and Lowering Costs Act of 2025 - To repeal health-related portions of An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (Public Law 119-21, The One Big Beautiful Act)

H.R.4796 - Rep. Laura Friedman (D-CA) - Restoring Essential Healthcare Act -To amend Public Law 119-21 (The One Big Beautiful Bill Act) to repeal the prohibition on making payments under the Medicaid program to certain entities.

H.R.4807 - Rep Greg Landsman (D-OH) - Protect Our Hospitals Act - To amend Public Law 119-21 to repeal certain changes to provider taxes under the Medicaid program.

H.R.1262 & S.932 - Rep. Michael McCaul (R-TX) and Sen. Markwayne Mullin (R-OK) "Give Kids A Chance Act" - To amend the Federal Food, Drug, and Cosmetic Act with respect to molecularly targeted pediatric cancer investigations. This bill would renew research into pediatric cancers and includes increasing funding for rare diseases, some of which cause Intellual and developmental disabilities and autism.

H.R.1509 & S.752 - Rep. Lori Trahan (D-MA) & Sen. Chuck Grassley (R-IA)

Accelerating Kids' Access to Care Act -

This bill would amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP, and streamline enrollment under the Medicaid program of certain providers across State lines.

H.R.2598 & S.1277 - Rep Jared Huffman (D-CA) and Sen Chris Van Hollen (D-MD) The IDEA Full Funding Act

To amend part B of the Individuals with Disabilities Education Act to provide full Federal funding of such part.

S.2279 - Sen. Josh Hawley (R-MO)

A bill to repeal the changes to Medicaid State provider tax authority and State directed payments made by the One Big Beautiful Bill Act and provide increased funding for the rural health transformation program.

H.R.1950 - Rep. Mark Pocan (D-WI) - Protect Social Security and Medicare Act

To protect benefits provided under Social Security, Medicare, and any other program of benefits administered by the Social Security Administration or the Centers for Medicare and Medicaid Services.

S.779 & H.R.1735 - Sen. Alex Padilla (D-CA) & Rep. August Pfluger (R-TX)

To amend title XIX of the Public Health Service Act to provide for prevention and early intervention services under the Block Grants for Community Mental Health Services program

H.R.2491 & S.1227 - Rep Kat Cammack (R-FL) & Sen. Edward Markey (D-MA) - The ABC Act

To require the Administrator of the Centers for Medicare & Medicaid Services and the Commissioner of Social Security to review and simplify the processes, procedures, forms, and communications for family caregivers to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under the Medicare, Medicaid, CHIP, and Social Security programs

VOR OPPOSES:

H.R.2743 & S.1332 - Rep. Bobby Scott (D-VA) & Sen. Bernie Sanders (I-VT) Raise the Wage Act - A bill to provide increases to the Federal minimum wage and for other purposes. VOR opposes the provision in this bill that would phase out section 14(c) and sheltered workshops for indiviiduals with I/DD and autism.

S.2438 - Transformation to Competitive Employment Act (Sen. Chris Van Hollen (D-MD) - A bill to assist employers providing employment under special certificates issued under section 14(c) of the Fair Labor Standards Act of 1938 in transforming their business and program models to models that support people with disabilities through competitive integrated employment, to phase out the use of such special certificates, and for other purposes.

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VOR SUPPORTS:

H.R.4807 - Rep Greg Landsman (D-OH) - Protect Our Hospitals Act - To amend Public Law 119-21 to repeal certain changes to provider taxes under the Medicaid program.

H.R.1509 & S.752 - Rep. Lori Trahan (D-MA) & Sen. Chuck Grassley (R-IA)

Accelerating Kids' Access to Care Act -

H.R.2598 & S.1277 - Rep Jared Huffman (D-CA) and Sen Chris Van Hollen (D-MD) The IDEA Full Funding Act

To amend part B of the Individuals with Disabilities Education Act to provide full Federal funding of such part.

S.2279 - Sen. Josh Hawley (R-MO)

H.R.1950 - Rep. Mark Pocan (D-WI) - Protect Social Security and Medicare Act

To protect benefits provided under Social Security, Medicare, and any other program of benefits administered by the Social Security Administration or the Centers for Medicare and Medicaid Services.

S.779 & H.R.1735 - Sen. Alex Padilla (D-CA) & Rep. August Pfluger (R-TX)

To amend title XIX of the Public Health Service Act to provide for prevention and early intervention services under the Block Grants for Community Mental Health Services program

H.R.2491 & S.1227 - Rep Kat Cammack (R-FL) & Sen. Edward Markey (D-MA) - The ABC Act

VOR OPPOSES:

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