by Cindy McCoy

When New Mobility researched friendly cities, we looked for the things that really count when wheels are your constant companion: affordable and accessible housing, transportation, quality medical care, personal assistance services and strong advocacy. With these assets, crime rates may be negotiable.

We began with the front-runners from other lists, then used telephone interviews and surveys to sound out independent living centers and local residents. Each city was given a numerical rating based on quality of services and environmental factors. Using these ratings, a new order emerges:

First Place:

Though not found on anyone else’s list, Denver (pop. 468,000 plus almost 1 million people living in adjacent counties) is our No. 1 pick as America’s most wheelchair-friendly city. It offers a multitude of services and conveniences, a fully accessible mainline metro transportation system and exceptionally strong advocacy. There are two CILs–Denver CIL and Atlantis Community–and ADAPT is headquartered here.

Denver has history on its side: Years ago, ADAPT made accessible buses their business. The result of its efforts is inclusion. The paratransit door-to-door service runs about 23 hours a day, seven days a week, with no limit on number of rides. There are conflicting reports on the service’s dependability–a recent Denver Post story reports no-shows and customer dissatisfaction, while firsthand reports from Denver denizen Mark Able suggest uncommon reliability. Personal assistance programs are available, medical facilities are plentiful, and Craig Hospital has terrific support services for people with head or spinal cord injuries.

Look to Denver also for a wide range of recreational and cultural activities: peerless adaptive sports, both integrated and disability-specific arts programs, active ballet and theater, a symphony orchestra and two opera companies. Coors Stadium–home of the Rockies–is one of the most accessible in the country and, like the Denver Center for the Performing Arts, features universal seating. Denverites do not seem to mind their snow, claiming that 20 degrees quickly reverts to 50 degrees, but people with respiratory problems may have trouble with the dryness and mile-high altitude.

Housing, the most pervasive crisis across the country, is no joy in Denver, either. Rental prices are high, now that the economy is booming again and Californians have re-invaded the city. Offsetting high prices are two creative housing options offered by Atlantis. One features ancillary income sources subsidizing rentals on designated units; the other, developed as a prototype alternative living situation, provides some attendant care opportunities. The brainchildren of Atlantis/ADAPT’s Mike Auberger–and managed by Vikki Gold–these novel solutions float Denver to the top of the A list.

Second Place:
Berkeley, Calif.

Another city left off other lists, Berkeley (pop. 102,000) is the Philadelphia, Boston and Independence Hall of the independent living movement and is still a model of independent living. “You can be yourself here, and that’s a very broad statement,” says Pamela Walker. She adds that people with disabilities have been a public presence here for so long that they’re part of the daily landscape.

Qualifying Berkeley residents get their personal assistance services paid for by California’s IHSS program, in this case managed by Alameda County. The Berkeley CIL–the nation’s first–has two attendant support programs: One maintains a registry matching consumers with potential attendants and the other teaches consumers how to train and manage their attendants. The city offers emergency help for fixing wheelchair breakdowns, filling in for PCA no-shows, or providing last-minute interpreters for medical purposes. Buses are accessible and paratransit is in service seven days a week. And if the elevator on your stop is working, San Francisco lights and nights are only a subway ride away on Bay Area Rapid Transit.

The employment climate is dreary–military bases are closing and the job market is tight–but the city, the University of California, Bayer Labs and the Nature Company have all been disability-aware and friendly. Downside? “Lots of street people,” says Walker. “Lots of weirdness. Lots of politically correct fighting. And it is sometimes called a crip ghetto.”

Third Place:

Seattle (pop. 516,000) seems to be one of those towns everybody assumes is a wonderful place to live. It didn’t make No. 1, but it has lots of qualities that deserve a No. 3 ranking. The weather is mild, services are available, transportation is great, cultural events are plentiful and companies are hiring. The King County metro bus system has been accessible for 20 years, thanks in large part to the Washington Coalition for Citizens with Disabilities, which operates as the area CIL. A highly visible disability community translates to positive attitudes and high employability at Boeing and Microsoft and in the tourism industry. The University of Washington and Harborview both offer spinal cord injury programs and support.

Seattle’s paratransit system doesn’t get the rave reviews of mainline transit, but it’s headed in the right direction. Although curbcuts abound, hilly neighborhoods create their own access barriers and accessible housing is elusive. Private service agencies such as the Easter Seal Society have strong consumer-directed advocacy programs, but the independent living network isn’t as strong as in other cities. Attendant services aren’t administered through independent living centers, so finding a good provider takes investigative skills. The weather is mostly mild, if often cloudy, in this beautiful, safe, internationally flavored city on Puget Sound.

Fourth Place:
Sioux Falls, S.D.

For exuberant citizen loyalty, no place ranks higher than Sioux Falls (pop. 110,000). Although the older sections of the city are not very accessible, the new areas are. The mainline transit system is 100 percent accessible, and the paratransit system is sufficient. As usual, accessible, affordable housing is scarce. Some help with personal assistance exists; Medicaid’s waiver program serves about 40 people statewide. There are two major hospitals with full support services.

Recreation opportunities include such outdoorsy activities as fishing and camping, the fully accessible state parks, fairgrounds and convention center, and South Dakota’s largest shopping mall for competitive shoppers. Minor league sports teams–the Sioux Falls Canaries, Skyforce and the Mustangs–all play in accessible stadiums. And as the largest city in the state, Sioux Falls offers many metropolitan advantages within a rural setting, says Joel Niemeyer of the Prairie Freedom Center for Independent Living.

It’s a quality-of-life thing. This is a clean city with high employment, minimal crime and strong advocacy. The weather is cold with lots of snow, but the city does have a snow removal law. Temperatures range from minus 10 to 90 degrees, with high humidity. Major employers are Citibank and Gateway 2000.

Fifth Place:
Raleigh, N.C.

Raleigh (pop. 212,000) is part of North Carolina’s cultural and intellectual hub known as “The Triangle,” which includes Durham and Chapel Hill. Raleigh’s Capitol Area Transit’s mainline transportation is fully accessible, while Accessible Raleigh Transportation System operates a two-tiered paratransit service.

The ADA-compliant part of the service offers rides at the prescribed 150 percent of mainline fares, but hours are restricted as are pickup and drop-off locations. The CAT Connector is the less compliant shuttle from outlying areas to the mainline stations.

Raleigh has no independent living center, but the State Vocational Rehabilitation Department dispenses independent living services through programs that assist with home and transportation modifications, skills training and limited PCA.

The Department of Administration operates many of the state’s human services resources, including Protection and Advocacy and the North Carolina Office on the ADA, Women, Indian and Black Affairs. According to ADA Director Ken Franklin, the state takes its responsibility seriously and is progressive in many ways. Finding a place to live presents the usual problems, but architect Ron Mace and his Center for Accessible Housing have made a significant difference in Raleigh.

Look to Raleigh for leisure activities such as semi-professional theater, a symphony orchestra, the Hartford Whalers, the Durham Bulls and top college sports. There are eight good-weather months, residents say; the short winters get icy, the short summers get hot and sticky. Employment is most readily available through government and universities, since that’s what so much of Raleigh is about.

Sixth Place:
San Jose, Calif.

San Jose (pop. 780,000), the Santa Clara Valley’s largest and most accessible city, reports good attitudes resulting from government and business taking active roles in disability issues. Mainline transportation is accessible except for a few express commuter routes lacking voice announcement systems. The light rail–running north-to-south through Silicon Valley–is completely accessible, and the paratransit system Outreach offers unlimited rides with its share of headaches. BART, San Francisco’s subway system, is scheduled to extend services to San Jose by the turn of the century, and area parks are all accessible to recreation-minded wheelers.

Valley Medical has a well-known spinal cord injury program, including community and school education and advocacy. Personal assistance services are available through California’s mammoth–but usually workable–IHSS program.

Sun Microsystems and Hewlett Packard, both named by Mother Jones as top-20 workplaces, are aware and accommodating employers. The high cost of living, inadequate housing and poor air quality are major deterrents, but the easy climate can offset a lot of negatives.

Seventh Place:
Salt Lake City

Salt Lake City’s (pop. 160,000) blend of Judeo/Christian/Mormon traditions nourishes individuality and independence, residents say. Both the mainline transit system (70 percent accessible) and Flex Trans, the paratransit service, run six days a week. Housing is difficult, since inflated costs have made Section 8 and other HUD certificates virtually useless. Salt Lake City is the home of the Utah Independent Living Center–which offers a strong advocacy program and helps consumers live in their own homes through its Community Action Program– and of the Disabled Rights Action Committee, aggressive litigants in ADA and fair housing cases. A small, subsidized PCA program serves about 75 people.

There’s a lot to do here–the Delta Center meets ADA standards, you can take in professional rodeo, hockey and basketball, or check out adaptive skiing and whitewater programs. If you move here, try to stick to “The Avenue” if you need accessible bus lines, though a roof over your head may be pricey. Employment opportunities exist with American Express, Micron Technology and Word Perfect, a few of the employers rushing to move their operations to business-friendly Utah. There are 250 days of sun, 100 overcast with precipitation. Expect dry air, some snow and hot summers.

Eighth Place:
Rochester, Minn.

Rochester (pop. 71,000) puts in 300 curbcuts every year; its mass transit system, the Skyway, is 100 percent accessible; and ZIPS, the paratransit service, offers six-day service. The Mayo clinic is a major presence, occupying one-third of the entire downtown area. Enlightened attitudes, strong employers (IBM, the university and the government) and 65 totally accessible HUD units earn Rochester the No. 8 spot.

You’ll find parks and cultural attractions, along with nearby Twins baseball, Vikings football, and a strong university sports program. The Southeastern Minnesota Center for Independent Living (SEMCIL) has been around for 15 years as a force in raising the quality of life for people with disabilities. But there are no subsidized personal assistance services, and the weather can be lousy. Snow piled in front of driveways and curbcuts makes rolling slippery, inconvenient and dangerous.

Dave Schwartzkopf, executive director of SEMCIL and an IBM retiree, keeps returning to Rochester after living in many other places. He loves the Midwestern people and their strong work ethic. “You can get to know everyone in town in a few weeks,” he says. The Land of Lakes offers lots of good living.

Ninth Place:
Madison, Wis.

Answer: Weather, weather and weather. Question: What are three reasons not to live in Madison (pop. 191,000)? But once you get past that, this city is pretty nice. Money magazine’s No. 1 pick for 1996, Madison appears here because Wisconsin has relatively generous personal assistance Medicaid waiver programs. It would be even better but for financial strings running from the nursing home lobby to the Governor’s mansion. The result: Medicaid waiver programs exist, but so do waiting lists. Access to Independence is the area’s center for independent living.

Jesse Kaysen, loyal Madisonian, offers these thoughts: “Madison has been investing heavily in good mass transit for 25 years, and its ridership per capita almost rivals big cities like New York and Chicago. All the fixed-route buses are 100 percent accessible on weekends and holidays, and mostly accessible during the week, depending on what routes you use. Paratransit was better-than-ADA before the ADA. We’ve been routinely installing curbcuts since the mid-’70s, and they retrofit on demand with a yearlong waiting list.”

Kaysen notes that all of Madison’s numerous parks have accessible parking and paved pathways. Looking for a job? Oscar Mayer is here and has an open hiring policy.

Tenth Place:
Albuquerque, N.M.

Named for a Spanish Duke, Albuquerque (pop. 500,000) is attractive for its easy terrain and weather. The mainline transit system, Sun Tran, is newly accessible–at least about 30 percent of it–so there hasn’t been opportunity yet for the proper education of drivers and users. The paratransit service, Sun Van, gets mixed reviews, but its ratings have improved since the system was computerized. The entire system suffers from growing pains fueled by a quickly expanding and transforming population, and waiting lists are long.

Kathy Petrella, program manager for Albuquerque’s Independent Living Resource Center, marvels at the city’s accessibility. “It has good curbcuts, an easy, flat layout, good parking, and an easy grid of streets.” Limited attendant care programs are available. Although winter brings some snow, it usually melts by noon. The elevation is 5,000 to 5,500 feet, so even summer temperatures are cool at night. There’s minor league baseball and UNM college play for sports fans, and the rodeo, circus and musical events are all accessible. In 10 or 15 years, this royal city could be No. 1 on the list.

Not Quite Top 10
There were other top contenders. Topeka, Kan., is another pick for a great place to live in 10 years. It’s got all the beginnings of great housing, personal assistance services, and a strong CIL and advocacy network And it has a laudable track record for moving people out of nursing homes and into the community.

Florida cities Gainesville, St. Petersburg and Sarasota–all candidates for this list–share the very positive qualities of good weather, low cost of living and a strict statewide building code. But the common denominators of inadequate public transportation, housing shortages and scarce personal assistance services keep these cities out of the Top 10.

Minneapolis was the National Organization on Disability’s winner, and both it and its twin city, St. Paul, get high marks for accessibility, medical care and creative housing alternatives. Ithaca, N.Y., Utne Reader’s No. 1 pick, offers personal assistance programs, limited transportation, housing and CIL/advocacy networks. They have lots of weather, though, much of it cold.

Philadelphia–with good PCA services, 60 percent mainline accessibility, unlimited paratransit, strong advocacy and a dynamic CIL–just might have made this list, were it located someplace else.

Housing–the kind spelled with a capital “A” for Accessible and Affordable–is a common sore spot in every city surveyed. Some, such as Seattle and San Francisco, claim shortages caused by the lay of the land. In others, inflated prices make HUD certificates useless. Strong advocacy, such as that in Topeka and Denver, is the only cure on the horizon.

The National Accessible Apartment Clearinghouse maintains a database of more than 20,000 accessible units in about 140 metro areas, and the service is free. (You’ll find contact information below.)

People with developmental disabilities have an ally in the National Home of Your Own Alliance. A demonstration project originating in New Hampshire, it helps consumers locate lenders, find ways to meet down payments and arrange support services. At press time, it was offered in 28 states.

Fannie Mae, a.k.a. the Federal National Mortgage Association, offers the Home Choice Program. Home Choice is a single-family mortgage loan designed to meet the underwriting needs of low- and moderate-income people with disabilities or families with a disabled member. At this time, 11 states offer this program.

Oregon has many assisted living homes, after long-term care reforms in the 1980s. Most of them, however, are designed for seniors. The same is true for other areas offering favorable retirement conditions–low cost of living and reasonable weather.

Massachusetts stands alone in its commitment to providing affordable, accessible housing. Statewide reforms in the 1980s sponsored many housing projects with strict access codes. The state also lends support to housing projects created and administered by nonprofits. Its computerized databases listing all available accessible units make finding an apartment easy.

Personal Assistance Services
The State of California administers, through county offices, a subsidized attendant care program. In-Home Support Services gives consumers $5 an hour for a fixed number of hours based on a caseworker’s assessment of need, and attendants may be family members. Eligibility depends on income; all SSI recipients may use the service and SSDI recipients are eligible depending on assets. The program, for all its faults and funding shortages, still serves as the model for PCA delivery systems.

Yet Mike Auberger–of ADAPT and Atlantis in Denver–says Pennsylvania, New York and Wisconsin offer the most generous personal assistance programs in the nation. As a rule, the farther south you go, the more difficult it is to find subsidized attendant care.

Private home health care agencies offer services ranging from chores to nursing care in virtually all locations. The problem is paying for it at $12 to $20 an hour. Insurers are more likely to pay a part of the expense if there’s a need for skilled nursing, but that costs even more and most health care policies impose sharp limits on how many days of care they will pay for. It helps to be wealthy.

The best hope for most people with disabilities who need personal assistance services is budding federal legislation in the presently unreconciled forms of H.R. 2020 (a.k.a. CASA or MiCASA) and S. 879 (a.k.a. the Long-Term Care Reform and Deficit Reduction Act of 1997). Your congressional delegation needs your encouragement and input on these promising bills.

Personal and Political

What’s your ideal environment? The truth is that no place is ideal and no place is totally rotten. You can get most of what you need in most areas, and your own efforts might convert any town from Hell’s Kitchen to Paradise Cove.

This life with disability is defined by change. When we refuse to allow that change to fuel inertia and withdrawal, the rewards are creativity, involvement and even results. The key to the city, any city, is cut with the tools of advocacy. Write your legislators to let them know what is wrong and what is right. Find out what works and why.

We’re rolling on the shifting ground of social and political currency, and the changes facing disabled people are a litmus test for community, state, national and global change. When we earn change that benefits our lives and the lives of our disabled children, we improve life for all.

Writer Cindy McCoy has recently exchanged “hula, high prices and lush living in Hawaii for neon, cheap meals and desert sands in Las Vegas.”