Project Horizon
PROJECT HORIZON PROPOSAL BY REV. CHRISTINA DANIELLE SMITH
Rev. Christina Danielle Smith
347 Latitude Dr.
Daytona Beach, FL 32124
Email: chrissysmith260@gmail.com
Phone (Text Only): (573) 208-8053
October 2, 2026
The Honorable Robert F. Kennedy Jr.
Secretary, U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201
(CC: Dr. Mehmet Oz, Administrator, Centers for Medicare & Medicaid Services)
Subject: National Policy Proposal: Project Horizon – Integrated Healthcare & Independent Living Community (IHILC)
Dear Secretary Kennedy and Dr. Oz,
I am writing to submit Project Horizon (IHILC), a comprehensive federal policy, economic restructuring, and development blueprint designed to permanently solve the structural silos between healthcare and housing while tackling national economic debt, institutional waste, and long-term trust-fund insolvency.
Current federal programs spend billions of dollars annually managing acute medical crises, emergency room over-utilization, and high-cost institutional care, while ignoring the foundational determinant of health: stable, supportive, and accessible housing. Furthermore, our healthcare system drains astronomical resources keeping vulnerable patients trapped in sterile, high-cost environments.
Project Horizon introduces a scalable framework that reforms federal policy to allow Medicare, Medicare Advantage, and Medicaid capitation streams to officially cover room and board alongside clinical care. This initiative redirects wasteful acute-care spending into self-sustaining, community-based housing infrastructure designed for:
Short-term rehabilitative recovery and post-surgical care.
Permanent, autonomous living for individuals with lifelong disabilities, chronic illnesses, and veterans.
Specialized memory care neighborhoods and dignified end-of-life hospice care.
Key Structural Highlights of the Proposal:
Massive Economic ROI & Waste Reduction: Reallocating funds from exorbitant acute/ICU care ($30,000–$60,000+/month) to supported community models ($4,500–$6,500/month) yields an 87.7% reduction in end-of-life acute waste, directly stabilizing Medicare and Medicaid trust funds ahead of projected 2029/2030 deficits.
The "St. Jude" Financial Standard: Modeled after the philosophy that no family should face financial burdens while receiving care, residencies are fully supported without out-of-pocket room-and-board penalties.
Rigorous Public Safety & Zero-Tolerance Vetting: Establishes unyielding criminal exclusions, automated 24-hour pre-registration visitor portals, and specialized cognitive/emotional training for security and front-gate personnel to ensure complete community safety.
Decentralized Execution: Leverages existing non-profit networks like Habitat for Humanity and certified local custom builders to deploy ADA-compliant modular housing rapidly without a bloated federal construction apparatus.
Comprehensive Care Ecosystem: Integrates 24/7 nursing, active MyChart-style health literacy education, vocational/job training support, on-site mental/spiritual health resources, and direct zero-cost nutritional grocery delivery.
The enclosed comprehensive document outlines the full statutory adjustments, financial projections, architecture, and security frameworks required to implement this vision nationwide.
Thank you for your time, leadership, and dedication to reforming American health and public welfare. I welcome the opportunity to discuss how Project Horizon can support our nation’s most vulnerable populations.
Sincerely,
Rev. Christina Danielle Smith
Project Architect & Visionary, Project Horizon (IHILC)
Project Horizon: The Integrated Healthcare and Independent Living Community (IHILC)
A Comprehensive Federal Policy, Economic Projections, and Development Proposal
Prepared for: The White House & Federal Health Policy Leadership
Focus: National Healthcare Restructuring, Room-and-Board Modernization, Institutional Waste Elimination, Public Safety/Criminal Exclusions, and Macroeconomic ROI.
Executive Summary
American healthcare and housing operate in disconnected, counterproductive silos. Federal programs spend billions of dollars annually managing acute medical crises, emergency room over-utilization, and institutional nursing facility placements, while ignoring the foundational determinant of health: stable, accessible, and supportive housing. Furthermore, the current system drains astronomical public funds keeping dying, chronically ill patients trapped in cold, sterile, high-tech ICU beds.
Project Horizon introduces a scalable, federally backed model that bridges this gap. By reforming federal policy to allow Medicare, Medicare Advantage, and Medicaid capitation streams to officially cover room and board alongside clinical care, this initiative redirects wasteful acute-care spending into self-sustaining, community-based housing infrastructure. These communities support independent living, specialized memory care, rehabilitative transitions, integrated substance abuse recovery, and dignified end-of-life hospice care—strictly protected by absolute public safety standards and zero-tolerance criminal exclusions.
1. Core Structural Framework & Financial Model
Traditional housing markets rely on rigid credit scoring that penalizes low-income, disabled, and chronically ill individuals. Project Horizon replaces traditional credit-based barriers with healthcare-backed structural financing.
Healthcare-Backed Mortgages & Leases: Capital development and ongoing operational costs are secured against long-term federal health savings derived from reduced hospital readmissions, eliminated ICU waste, and avoided institutional placements. Individual residencies function as stable personal or family mortgages/tenancies funded directly through capitated Medicare Advantage and Medicaid streams.
Unified Lifecycle Residency: The community accommodates three distinct residential tiers without forcing displacement or relocation:
Temporary / Rehabilitative: Short-term post-acute recovery following surgery, injury, or acute medical flare-ups.
Permanent Residency: Long-term autonomous living for individuals with chronic illnesses, lifelong disabilities, and veterans.
End-of-Life & Hospice Care: Palliative and end-of-life care delivered directly within the resident's home environment, surrounded by family, pets, and familiar comforts.
2. Architectural Design & Radical Personalization
Every resident deserves dignity, privacy, and control over their living space.
Configurable Residential Units: Homes range in size up to four bedrooms to accommodate single individuals, couples, or multi-generational families caring for a medically complex child.
Complete Personalization at Zero Extra Cost: Homes can be custom-fitted, furnished or unfurnished, to match specific clinical, sensory, or personal preferences, including specialized appliance donations or niche eco-friendly kitchen setups designed to reduce physical strain.
Modern Amenities & Accessibility:
100% ADA-compliant structural engineering (zero-grade entries, wide hallways, automated doors, and accessible bathrooms).
Modern energy-efficient appliances, private vehicle garages, and free high-speed fiber internet.
Pet-friendly policies allowing emotional support and companion animals.
Spacious Grounds: Each property sits on a generous 2–3 acre private yard, fully maintained by a professional on-site groundskeeping, repair and maintenance contracting outreach, and landscaping crew. This provides safe outdoor therapeutic space without imposing physical labor on residents or caregivers.
3. Comprehensive On-Site Care & Support Infrastructure
To eliminate caregiver burnout and institutional isolation, comprehensive clinical and support services are integrated directly into the fabric of the community.
24/7 Professional Support: Round-the-clock nursing staff, specialized medical caretakers, medication management teams, and dedicated cleaning and maintenance crews operate on-site.
Specialized Memory Care Neighborhoods: Dedicated, secure architectural zones featuring intuitive wayfinding and sensory gardens provide compassionate, expert care for residents with Alzheimer's and dementia, keeping families and spouses close.
Integrated Substance Abuse Programs & Substance Governance: Dedicated behavioral health and substance abuse recovery programs are embedded directly into the community framework.
Alcohol Policy: Permitted strictly by patient discretion with appropriate approval of a healthcare professional; must be purchased out-of-pocket and never with healthcare funds.
Smoking & Vaping: No smoking allowed anywhere on premises; vaping is permitted.
Cannabis Policy: Available strictly to registered, valid, card-carrying medicinal marijuana users. Zero tolerance for illicit recreational drugs (immediate confiscation, removal from residency, and a mandatory 3-year bar from the community with verified recovery protocols).
Medication & Supplement Monitoring: All supplements and vitamins must be disclosed to the care team prior to purchase and use. Prescription medications and supplements are actively monitored.
Mandatory Random Drug Testing & False-Positive Screening: Residents in substance recovery or applicable programs are subjected to random mandatory drug screenings. Prior to testing, residents are screened for dietary or lifestyle exposures (such as poppy seeds) that could trigger false-positive readings to ensure absolute fairness and accuracy.
Preservation of Continuity of Care: Residents retain the absolute right to keep their trusted, established Primary Care Provider (PCP). Optional on-site physicians, internal telehealth, and phone-accessed clinical teams supplement personal care to manage urgent needs and prevent unnecessary ER visits, with easy access to nearby major hospital facilities.
Strict Professional Boundaries: Nurses, medical staff, and operational employees do not and cannot cohabitate with residents, preserving professional objectivity, personal privacy, and absolute safety boundaries.
Absolute Equity & Non-Discrimination: Admissions, resource allocation, and care management are governed strictly by medical necessity and clinical guidelines. Favoritism, discrimination, and nepotism are legally and operationally barred.
Interactive Patient Health Education: Integrating micro-learning surveys, condition-management guides, and short interactive quizzes directly into resident health portals (modeled after routine MyChart check-ins) to actively educate residents on their specific conditions, treatment protocols, and self-care strategies. Weekly recommended education tracks involvement; if productivity decreases, the care team reaches out proactively to the resident or family.
Mental Health & Spiritual Support: On-site free mental health services, voluntary personal religious/spiritual services and support.
Nutritional & Grocery Delivery Support: Partnerships with Amazon Fresh, Thrive Market, Misfits Market, Publix, and local farms to deliver healthy meats, produce, bread, and beverages via resident app, voice request to care managers, or physician coordination at zero out-of-pocket cost through benefits or meal incentives (SNAP EBT accessible).
4. Advanced Security, Vetting, and Public Safety Standards
Balancing personal freedom with the rigorous safety of vulnerable populations requires a streamlined, secure operational framework that draws an unyielding line against criminal activity.
Strict Criminal Exclusion & Zero Tolerance: Anyone with a history of violent crimes, sexual offenses, abuse, exploitation, or severe criminal negligence is categorically barred from residency. Federal and healthcare vetting cross-references national criminal databases, violent offender registries, and protective custody flags with zero exceptions.
Immediate Removal for Offenses: If a resident or guest engages in criminal acts, assault, theft, or property destruction while on the premises, healthcare-backed housing funding is instantly revoked, leading to immediate eviction and direct hand-off to law enforcement.
Pre-Registration Visitor Portal: Residents or visiting family members must upload visitor details into a secure community management portal within a 24-hour window prior to arrival. Un-cleared visitors must complete an on-site health and security evaluation or vacate.
Vetted Workforce & Specialized Security Training: All staff, contractors, and care providers undergo rigorous federal background checks and fingerprinting. Security and front-gate personnel undergo weekly/bi-weekly training on safe interactions with non-verbal, elderly, and developmentally disabled individuals, passing rigorous emotional/cognitive functioning exams and protocol intervention tests to prevent harm and eliminate discrimination.
Mandatory Biweekly Staff Cognitive & Psychological Screening & Random Drug Testing: All on-site medical staff, care workers, and operational personnel are subject to rigorous biweekly cognitive and psychological evaluations (modeled after AI onboarding assessment frameworks) with a strict passing threshold of 96–98%, as well as mandatory random drug screenings. Prior to staff drug testing, personnel are screened for dietary or lifestyle exposures (such as poppy seeds) that could trigger false-positive readings to ensure absolute fairness and accuracy. Any worker failing to meet the passing margin or screening standards is immediately placed on probation or relieved of duties until successful treatment, re-evaluation, or reassignment.
Mail Privacy: Mail is never monitored unless suspected interference or terrorism is verified and confirmed. Packages and letters of all forms are fully accepted.
5. The Self-Sustaining Commercial & Service Micro-City Hub
To eliminate transportation and logistical burdens, each community features an integrated central commercial center located within a 5-minute ADA-compliant radius:
Retail & Pharmacy Anchors: A full-scale Publix and a Walmart Neighborhood Market with integrated pharmacies.
Specialized Health & Retail Services: An on-site Medical Supply Store for quick mobility and medical hardware ordering, appliances stores, clothing retail stores, a community donation/thrift store, gas stations, and high-capacity EV/accessible-vehicle charging centers.
Connectivity & Infrastructure: Dedicated retail locations for Verizon and AT&T, an electronics support and supply store, and a UPS shipping/package center.
Rehabilitation Centers: Skilled guided physical therapy (gym equipment, therapists, trainers, and group or public swimming) paid for by SilverSneakers or other discounted/low-cost Medicare-approved gym memberships. Homes can be fitted or requested to come with private or community pools (indoor or outdoor). Home rehabilitation services can include specific streaming apps or services (e.g., DDPYoga partnerships), personalized in-home care with trained physical therapists or personal trainers, and selective physician-ordered equipment paid for by insurance, HFA/HSA, or OTC benefits/fall prevention.
6. Financial Projections, Medicare Profit Margins, and Economic ROI
Reforming federal policy to allow Medicare, Medicare Advantage, and Medicaid capitation streams to cover room and board fundamentally transforms public healthcare economics.
Comparative Cost Analysis (Per Patient / Resident Per Month)
Care Setting / Model
Average Monthly Cost
Funding Mechanism
Clinical & Social Outcome
Traditional ICU / Acute Hospital Stay
$30,000 – $60,000+
Fee-for-Service Medicare / Private Ins.
High mortality stress, sterile environment, extreme financial drain, zero long-term recovery asset.
Traditional Skilled Nursing Facility (SNF)
$8,000 – $12,000
Limited Medicare Part A (Short-term) / Out-of-Pocket
Institutional isolation, strict regulations, high readmission rates.
Project Horizon Integrated Community (IHILC)
$4,500 – $6,500
Realigned Medicare Advantage / Medicaid Capitation (Room, Board, & Care)
Full autonomy, 24/7 nursing/palliative support, stable housing equity, zero avoidable ER visits.
Medicare Advantage & System Margin Projections
Elimination of End-of-Life Acute Waste: Transitioning terminal patients from $45,000/month acute life-support units to home-based palliative/hospice care within the community reduces monthly operating costs to approximately $5,500 (an 87.7% reduction), directly recaptured as operating margin.
Capitated Risk Pool Optimization: Removing housing insecurity and unmanaged chronic conditions drops emergency room utilization by 55–70% under D-SNP/I-SNP frameworks, expanding insurer profit margins and surplus rebates reinvested into community care.
Macroeconomic Reinvestment: Capital savings fund regional infrastructure, construction, groundskeeping crews, and commercial anchors, creating a self-sustaining fiscal loop that secures Medicare solvency without austerity.
7. Implementation Framework & Support Ecosystem
Decentralized Construction: Rapid deployment via partnerships with Habitat for Humanity and certified local custom home builders using regional supply chains and personalized patient design guidelines.
Immediate Housing Placement & Expansion: Rapid or same-day housing turnaround capabilities, with eventual pathways into Section 8 and specialized public housing.
Vocational, Educational, Driving and Job Training Support: Dedicated care-team assistance helping residents in recovery or transition or gaining independence enroll in trade schools, secure job training resources, and build independent career paths as well developing skills to pass a learners and drivers examination and be able to drive a car with the appropriate accommodations.
Personalized Direct Communication: Direct communication between care team, physicians, and residents via the resident app messaging system or monitored personal text messaging via care team.
Conclusion & Call to Action
Project Horizon proves that caring for our most vulnerable populations does not require stripping away their autonomy, locking them in clinical institutions, or wasting billions on sterile hospital rooms. By coupling structural public safety, absolute criminal exclusions, rigorous biweekly 96–98% staff cognitive testing protocols, random staff drug screenings with false-positive protections, and fair substance screening protocols for residents with reformed federal reimbursements that cover room and board, we eliminate systemic waste, restore human dignity, and build a robust economic foundation that honors veterans, the elderly, the disabled, and their families and chart a course for healing for the citizens of the United States.
St. Jude’s has a wonderful care model. No one should worry about financial burdens while receiving care and treatment.