The story of one Buffalo family reveals the value of consumer directed personal assistance programs, both for care receivers and for public health more broadly.

“When you interview people, you have to tell them, you know, the job is $18.60 per hour, but I can't guarantee you'll get paid on time, even though I'll do my best to advocate for you,” says Renee Christian. “How are you going to get anybody to work?”

Spearheaded by the Community Action Organization, the program seeks to address chronic poverty in the city - but as Steve Peraza writes, the prevalence of precarious, low-wage jobs constitutes a formidable barrier.