As a young lawyer, I toured Boswell Hall at Cambridge State Hospital one morning in March 1973.

My colleagues and I represented the residents there in a lawsuit challenging both the conditions and the lack of treatment.

We saw men and women lying on mats, with limbs deformed because of years of neglect. Other men and women slumped in ill-fitting wheelchairs.

Their cause cried out for change -- but few of them could speak.

In the decade and a half that followed, change did occur, at Cambridge and at the other state institutions in Minnesota.

Both by court order and by agreement, therapists were employed to meet the physical and communication needs of these men and women.

After they left the institutions, Medical Assistance provided them physical and occupational therapists and speech-language pathologists. These services allowed many of them, for the first time in their lives, to sit up safely, to look out at the world around them, and to tell other people what they were thinking.

A friend of mine with cerebral palsy spent his childhood lying on the floor or in a bed at Faribault State Hospital. He did not sit upright until he was 13. When he was discharged some years later to a nursing home, he still did not have a decent wheelchair.

Now, with support from Medical Assistance, he has a place he can call his own. With the help of rehab therapists, he now can get about with a power wheelchair.

He will, without question, tell you what he wants to do and what he thinks, using a voice-output communication device.

His life and well-being -- and those of hundreds of men and women like him -- are threatened by changes in Medical Assistance included in the Health and Human Services bills the Republican majority is pushing through the Legislature.

The Senate bill eliminates all physical therapy, occupational therapy and speech-language pathology services for anyone over 21.

But children who cannot walk or talk, who cannot use their hands and arms, do not suddenly gain those skills when they turn 21. And adults who suffer a stroke or a brain injury do not regain skills without help.

For good measure, the Senate bill also eliminates eyeglasses, dentures and prosthetic devices for adults. Both the Senate and the House bills severely limit the funding that enabled my friend and hundreds of others to live in what we all would call a home.

The GOP Medical Assistance proposals include a requirement that the commissioner of Human Services apply to the federal government for a global waiver of federal Medicaid standards. They say they know best how to provide Medical Assistance in Minnesota.

Their medical assistance program, they proclaim, would provide "a results-oriented system of coordinated care that focuses on independence and choice" and encourages and rewards "healthy outcomes."

But the Medical Assistance program they would dismantle has given my friend and others like him healthy outcomes, by providing the assistance he and others need to be independent and to express their choices.

Sen. David Hann said of his bill that "we're doing what all families do" and "doing the best we can with what we have."

We can and should do better.

Luther Granquist is a retired legal aid attorney in St. Paul.