With a smile on his face and his right arm raised in the air, Francis placed his two middle fingers in his palms and signed “I love you.”

As states continue to close large state-run institutions designed to house large numbers of people with cognitive disabilities, the United States faces a new crisis: a shortage of new nonprofit group homes.

“Maybe one day we will live in a world without disabilities. Wouldn’t that be perfect for modern-day Hitlers?”

Karen Gaffney has swum the English Channel, given a TEDx talk and received an honorary doctorate.