Data were gathered from 154 U.S. programs providing personal assistance services for the disabled. The survey identified approximately 850,000 people receiving community-based, publicly-funded personal maintenance, hygiene, mobility, or household assistance services, with physically disabled individuals being the most often served. The report explores the growth in the need for personal assistance services, explains the World Institute on Disability's rationale for studying this situation, and identifies the potential user population. Background information describes several federal and state programs providing personal assistance services. Survey data includes such information as number of programs per state, year of implementation, goals, state agencies administering the programs, and their funding sources. Analysis of program structure focuses on eligibility, services, hours of service availability, maximum service amounts allowed, direct service providers, determination of services allowed, and medical supervision. Also examined is program conformity to the Independent Living Model, in which the personal services attendant is managed by the user and no medical supervision is required. The study analyzes service recipients and program expenditures, and compares the availability of attendant services across the United States. The report concludes with an analysis of the need versus adequacy of the system to meet that need and makes several recommendations. (JDD)