Fundraising has always been part of how the nonprofit survives. This year, with a Medicaid rate cut looming, families say the stakes feel different.

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Every Thursday, Lucas Fortwengler walks into Down Syndrome of Louisville around noon and stays until about six. There are his classes, then Boogie Down Crew, the dance group that has become one of the biggest draws at DSL events.

Lucas is 30. He says he has been coming for about 25 years.

In that time, his family says, DSL has helped him land a job and work toward his Eagle Scout rank. Stacy Atwood, whose mother is married to Lucas's dad, Steve, says he can show up any time he needs something, and someone will help.

"We're a family," Atwood said of her experience with DSL. "They're here for us, all of us."

That is what DSL has been for Louisville-area families for nearly 50 years: a place that meets them at diagnosis, sometimes before a baby is born, and stays with them for life.

Now the money that keeps it running is at risk.