Abstract
Many people with disabilities who get paid help with daily activities also need help with health maintenance tasks, such as ostomy care, ventilator management, bowel and bladder care, tube feeding, insulin injections, and management of other medications. In many states, laws prohibit paid workers without nursing or other medical licenses from performing such tasks. In others, nurses are permitted to delegate such tasks to these workers. In some instances, such workers can perform health maintenance tasks under the direction of the consumer, without nurse delegation or supervision.