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Laura Vegas didn’t set out with a grand plan to build a decades-long career in intellectual and developmental disabilities (I/DD) policy. She graduated from Middle Tennessee State University with a bachelor’s degree in psychology and, like many new graduates, was simply looking for a job in her small hometown of Waynesboro, Tennessee. An ad in the local paper led her to Buffalo River Services, a nonprofit provider organization serving people with intellectual and developmental disabilities.
She got the job, and what began as a position as a direct support professional turned into a career spanning more than 30 years in nearly every corner of the I/DD system: provider services, state government, managed care, national policy and quality measurement.
Today, Vegas serves as Director of Quality Initiatives and Supporting Families at the National Association of State Directors of Developmental Disabilities Services (NASDDDS). Her portfolio is broad. She directs the National Core Indicators (NCI) program on behalf of NASDDDS and leads the Supporting Families Community of Practice in partnership with the University of Missouri–Kansas City.
NASDDDS represents state I/DD agencies nationwide and promotes leadership and policies that strengthen home and community-based services. Through NCI, states use standardized measures to assess outcomes in areas like employment, rights, inclusion and health and safety — allowing them to benchmark performance and drive quality improvement.
Vegas’s path to national leadership was shaped by deep experience at the state level. After nearly eight years with Buffalo River Services, she joined the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), where she spent 17 years in a variety of roles focused largely on quality improvement. Early in her tenure, she conducted monitoring of provider agencies, work she describes as striving to be “quality-focused, not punitive compliance.” Over time, she rose through the ranks and ultimately served as Assistant Commissioner of Policy and Innovation.
During her time at DIDD, Vegas helped lead efforts that made Tennessee the first state system to achieve CQL’s Person-Centered Excellence Network Accreditation. She also previously served as a Quality Enhancement Specialist for CQL, conducting accreditation-related activities. These roles reinforced her commitment to person-centered systems change, not just compliance with rules, but transformation of practice.
At NASDDDS, Vegas says her favorite part of the job is working with states. “I loved being a state employee. I loved being a civil servant,” she explains. Now, she supports state leaders across the country as they examine challenges, explore innovations and strengthen their systems. Through technical assistance engagements, she works with states on waiver development, Medicaid policy changes, quality strategies and implementation of federal requirements such as the HCBS Access Rule.
One major focus at present is NCI’s State of the Workforce survey. States use the survey to collect data from provider organizations about direct support workforce wages, turnover and vacancies. With growing federal emphasis on payment adequacy and workforce stability, Vegas and her colleagues are aligning the I/DD and Aging/Physical Disability versions of the tool into a unified cross-population instrument and refining questions to help states meet new reporting requirements.
Equally central to her work is the Supporting Families Community of Practice, which currently includes 22 states. The initiative helps states examine their systems from the perspective of families supporting a loved one with I/DD. Rather than focusing solely on individual services, the community looks at the entire system experience: the “front door,” eligibility processes, service planning, implementation and quality monitoring.
Families, Vegas explains, need more than services alone. They need information, navigation, peer connections, and responsive systems. The Community of Practice helps states identify friction points and redesign processes to make them more transparent and supportive. “We really look at all those different systems from the lens of the families,” she says, with the goal of strengthening the family’s capacity to support their loved one.
Vegas served on the advisory council of the Rehabilitation 嫩B研究院 and Training Center on Home and Community-based Services (RRTC on HCBS) at Shirley Ryan 嫩B研究院. Her expertise in outcomes measurement was helpful in advising the RRTC on the development of a set of quality measures used to evaluate the person-centeredness of HCBS.
Outside of work, Vegas embraces a quieter pace. An avid reader, she enjoys spending weekends at home with her partner and their two Shih Tzus. But she also has a competitive streak. She and her partner fish in a local club, the Maury County Bass Anglers and compete in tournaments throughout the season.
In 2019, they were named Team of the Year in their club, earning the most points based on the cumulative weight of their catches. Vegas was the only woman in the club at the time. “I was just so excited to get team of the year,” she says.