Years of poor state oversight have allowed companies to skimp on essential care for sick kids and disabled adults

Day after day, Heather Powell lay in bed, in pain, in her small San Antonio apartment. For two years she languished there, staring at the ceiling, watching cop dramas on Netflix, surfing the Internet with a computer mouse tucked under her chin.

She had been almost completely paralyzed from the neck down in a shooting more than a decade earlier. These days she found some joy in the only human relationships she had left, with the helpers who washed her body and cooked her food and laughed at her jokes.

A state program was supposed to give Powell, now 38, enough help so she could live at home, rather than in a nursing home. But the hydraulic lift that moved her to the shower or a wheelchair broke, trapping her in bed.

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