Laura,
You are right on all counts. Another piece of the puzzle is to continuing seeking the end of the institutional bias in Medicaid. As long as states need to pay 50% of community-based services (usually on waivers) and only 10% of institutional care, they will continue to cut community options first when budgets get tight--like they are now. Adding to the problem is the CMS in-home rule on the purchase of wheelchairs: people can't seek employment if their mobility equipment isn't suitable for use in the world outside the house. Mike

Nowadays, air travel can be a challenge for anyone. When you add the complication of a disability to the mix, many more things can go wrong. The alternative is simply staying home, or restricting your adventures to local activities. That's not always an attractive alternative. You can fly, safely, with good advance planning and supports in case something goes wrong enroute. Take along a family member or attendant who is familiar with you, your equipment and hopefully the processes involved in traveling with a wheelchair. Being forearmed with knowledge of th Air Carrier Access Act is a big help, as many of the problematic people you encounter during the trip think they are experts but in reality don't know what the law requires.That information is available in a handy booklet (Rights of Air Travelers with Disabilities) at the website of the Federal aviation administration at the Department of Transportation. Always arrive earlier than you think you need to, and pre-identify vendors in your destination city in case something goes wrong regarding the operation of your wheelchair, breathing equipment, or medical care if you require a specialist of some type. To repeat: plan far ahead, arrive everywhere very early, expect challenges, and stay in control when things go wrong. In the end, those steps can make your travel rewarding and enjoyable--or at least bearable.

Laura,
You have done a nice job of describing scenarios that all of us who use periodic attendant care face on a regular basis. Since I'm fortunate to be able to drive myself, local social gatherings don't usually need to include an attendant. When traveling, I try to get away from needing them during meetings, conferences or awards dinners. That might necessitate my asking a fellow attendee or hotel waitstaff to clip on my nametag, pour me a cup of coffee during the break or cut up my steak, and while I was reluctant to do that at first it's second nature now.
Mike