An increasing number of people with disabilities live in the community in Australia and internationally. Many of these individuals live in the family home, on their own, in hostels or in the traditional "group home" model, and receive varying levels of support and care. There is a growing concern that many of the care and support needs of these individuals are not being adequately met, particularly in the area of health care. This article describes the factors that contribute to this difficulty in meeting the health care needs of people with disabilities living in the community. These factors include: (1) Shortage of nursing professionals in Australia; (2) Issues faced by Australian nurses' professional bodies on the administration of health procedures by community support workers; (3) Lack of written policies and guidelines; (4) Lack of adequate competency-based training for support workers; (5) Tension between industrial legislation and disability legislation; (6) Difficulty accessing community nursing services; and (7) Problems with specialist services. This article suggests several solutions to these problems.