Abstract
Patients requiring chronic mechanical ventilation represent a particularly vul nerable segment of the expanding population of individuals with chronic disabilities Many of these individuals can live successfully at home, but face significant obsta cles. Current policies m health care coverage, durable medical equipment coverage, eligibility for assisted living, and licensing of caregivers all restrict the abilities of these individuals to live in the community. Prolonged home mechanical ventilation was pioneered m France, where a current international "best practice" provides a model for developing comprehensive, cost-effective care for these individuals.