Last month's column offered the opinion that the American Association of People with Disabilities (AAPD), ADAPT (a more radical group), the National Council on Independent Living (NCIL), and the National MS Society (NMSS) are the most effective voices of the disability/ consumer community. Further, these groups and others work effectively as a coalition of disability rights advocates.

The column ended with advice that the key to getting a large group of people with disabilities—aka consumers—to advocate for action on industry issues is to merge the AAPD, ADAPT, NCIL, and NMSS agendas with the industry's legislative agendas. The AAPD, NCIL, and ADAPT annual meetings—each of which includes a literal "March on Capitol Hill"—are similar in format to the AAHomecare "Washington Conference on steroids." The difference is that Congress takes them and their issues seriously. Why? Because the "disability community" has been acknowledged by Congress as a large, vocal constituency that votes!

All three major-party presidential candidates have position papers on disability issues (although Sen McCain's support is tepid) in their consumer agendas. And their campaigns each employ a disability outreach coordinator (as do smart candidates for election or reelection to Congress) who remind them regularly that their positions are a call for action.

The disability community is a large, vocal constituency that knows where candidates stand on their issues, and they vote at a rate significantly higher than the general electorate.

AAPD, NCIL, and ADAPT have identical legislative priorities. Their top goal is passage of the Community Choice Act of 2008 (CCA). The CCA includes provisions that enable people with disabilities currently "confined" to nursing homes and other institutional care to move out into the community. CCA is an extension of money follows the person (MFP).

The disability community prevailed over the strong objections of the nursing home industry and got MFP enacted into law in 2006. MFP provided 15 states with grants to fund community services, such as personal care assistants needed to live in their own homes and apartments, to a certain number of people with disabilities. The grants went to state Medicaid programs and were targeted toward those residents covered under the Supreme Court's Olmstead v Georgia case—a case supported by amicus briefs from every major player in the disability community.

Olmstead narrowly rules that it is the right of every person covered by Medicaid who wants to live in the community to be given that option and support necessary to do so. CCA extends this right nationally to all people with disabilities regardless of payor. It stands to reason that more consumers living in community settings expands the markets for the home respiratory, HME, and rehab segments of the industry, so industry support of CCA is a natural fit.

The second item on the NCIL and ADAPT agendas is passage of "in the home" legislation. This would expand Medicare and Medicaid coverage beyond that necessary to perform activities of daily living. This means that high-end rehab wheelchairs and other assistive technology, HME, and portable respiratory systems designed for use in the community, outside the home, would be covered under Medicare and Medicaid. In the home is an issue that has dogged the industry for years.

The third item for AAPD, NCIL, and ADAPT is passage of the reauthorization of the Vocation Rehabilitation Act. This legislation would reinstate certain affirmative responsibilities on public entities—specifically public transit—in addition to restating the federal government's obligation to fully fund state-run vocational rehab programs for people with disabilities.

Some 400 NMSS advocates put legislation establishing a neuromuscular disease registry, similar to cancer's tumor registry, at the top of its legislative agenda. They also included the Community Choice Act and in the home legislation when they were in DC in early May. Guess what? They received pledges from the chairmen of both House Ways and Means and Senate Finance to include the registry in legislation that will move before adjournment this year.

So why did this column suggest last month that a meeting between NCART, AAHomecare, AAPD, NCIL, NMSS, and ADAPT was in order? Imagine the intimidation factor of 500+ advocates with disabilities carrying the "industry" agenda in the halls of Congress and embracing it as part of their own. Would the message break through the din of the 3-day work weeks on Capitol Hill characteristic of a Presidential election year? You bet! Why? Because AAPD, NCIL, ADAPT, and NMSS represent a large (25 million strong), vocal constituency that votes!

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