Estimating the size of the adult population needing personal Assistance services: implications for national disability policy

Legislative initiatives to expand federal funding of personal assis-tance services (PAS) have relied primarily or exclusively on need for assis-tance with activities of daily living (ADLs). Analyses of the U.S. Census Bureau's 1990 and 1991 Survey of Income and Program Participation (SIPP) indicate that roughly 1.4 million Americans report needing assis-tance with three or more ADLs, and that 35 % of these are under age 65. Only a small subset of the population needing assistance with three or more ADLs (22%) also report family incomes at or below the federal poverty level, suggesting that means-testing could significantly reduce the size of the population eligible for a federal benefit. Different ADL, age, and income criteria substantially affect the size and composition of the eligible population. The policy implications and limitations of these findings are discussed. In the aftermath of the collapse of the Clinton administrations Healt