Too much paprework - takes forever to find it all and if a person does not have a relative working with them, it can be very difficult. Correspondence back to the client is steeped in such bureaucratic lingo that the client doesn't know if he is eligible or not - simplify. Medicaid should cover assisted living.
Public transportation is a big issue.
Personal care assistance is the major issue in getting people with disabilties into the workforce. Choice isn't real without reliable, competent aides. People with disabilities should have the right to take risks and fail and not be penalized for it. Have a transition plan for lifelong care for those people who will be in the system their entire lives for people between ages 18-60. Now, kids are lost when they turn 18.