Abstract
People experiencing functional loss related to spinal cord injuries frequently require help with activities of daily living, often referred to as attendant care or personal assistance services. There are several public policy issues related to how those services are developed and structured that impact community living and employment. Nationally and in many states, people with spinal cord injuries are advocating for services that they personally control, known as consumer-directed services. This article discusses problems with the traditional, medically-based services, consumer-directed personal assistance services in Virginia and related research findings on recipient outcomes.
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