For several years, the authors of this column have admonished readers that "victory" in Washington and the various state capitals was predicated on the industry's ability to involve consumers in advocacy efforts. But the question arises, "Who are these people?"

Merriam-Webster's Dictionary, in part, defines a consumer as: one that utilizes the economic goods and services of another. The consumers of HME and rehab goods and services certainly fall under Webster's definition, but this is a case where the dictionary fails to fully capture who the "consumers" are.

This consumer/provider relationship is a quid pro quo arrangement. If the industry is expecting consumers to support its agenda, it has an obligation to incorporate the consumers' agenda into its own legislative priorities.

These consumers are people with disabilities and/or chronic illnesses, and in this world of acronyms, the abbreviation for them is PWD. One would think that the consumers who can help move the issues that are important to providers are limited to the kind of people who are their customers. They would include people with a variety of diagnostic labels such as multiple sclerosis (MS), spinal cord injury (SCI), amyotrophic lateral sclerosis (ALS), cerebral palsy (CP), spina bifida (SB), chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), and similar maladies. But this is old-school thinking.

The advocacy community that has been able to influence Congress, and a number of state legislatures, has been effective because it recognizes the fact that there is strength in numbers. National and state level organizations representing the above-listed disabilities are joining together with people with amputations, various forms of mental illness, mental retardation, autism, and other developmental disabilities (MR/DD) as well as people with sensory disabilities such as deafness and hearing loss, blindness, severe visual impairments, and traumatic brain injuries (now the fastest-growing group in disability demographics).

These cross-disability coalitions have mastered the fine art of compromise and realized that they have much more in common with each other than most people may think. Some of the issues important to people with mental retardation and autism are much different than those facing people with neuromuscular disorders and spinal cord injury. But cross-disability coalitions are successful because they have identified the issues that these diverse constituencies share—issues associated with equal access to every aspect of community life with their non-disabled peers.

The first national cross-disability coalition was ADAPT, known then as "America's Disabled for Accessible Transportation Today," formed in the early 1970s to protest the inaccessibility of public transit systems to people with disabilities. People with mobility impairments, mental retardation, and many sensory disabilities forced Congress to include accessibility provisions for transit providers in the reauthorization of the Rehab Act in 1978.

More recently, ADAPT (now America's Disabled for Attendant Programs Today) has joined with the American Association of People with Disabilities (AAPD)—an AARP-like organization of some 30,000-plus members; the National Council on Independent Living (NCIL); the ARC representing people with mental retardation and other developmental disabilities; and the Alliance for the Mentally Ill (AMI). This coalition of PWD was able to pass major federal legislation such as the Americans with Disabilities Act.

Solidarity/The Disability Network of Ohio and the Colorado Cross Disability Coalition are both 10 years old and have successfully flexed their muscles to pass significant legislation blocking onerous Medicaid rules in their states. Other statewide cross-disability coalitions exist and more are forming.

So whose support is the home care industry supposed to court? The industry must reach out to ADAPT, AAPD, and NCIL and arrange for a meeting where they can present the industry agenda, and why it is important to people with disabilities, and listen to presentations on the agenda of the disability community.

"Our Turn" predicts that the outcome of this meeting will be an understanding that there is much common ground between the two sides and that what is good for consumers will eventually be good for providers—by increasing market size and understanding what kinds of goods, services, and technologies the disability community is in the market for. This, and financial support for consumer organizations, will bring legions of consumers to Capitol Hill carrying industry-generated position papers.

Cara C. Bachenheimer, JD, is VP of government relations for Invacare Corp. David T. Williams is a political and legislative strategy consultant.