Multiple sclerosis(MS) provides a paradigm of the problems of management in many forms of chronic neurologic disability. Many problems stem from the fragmentation and difficulty of access to the medical and psychosocial support systems, lack of coordination among the mix of services, and economic instability. The evolving role of voluntary agencies is to coordinate services for the complex problem-solving required by patients and families. The achievement of this role requires greater attention from physicians and other professionals who must interface in these complicated situations. Increasing governmental cost containment and regulation could erode the capability to provide personal, flexible, and timely responses to complex human predicaments, many of which can become costly, long-term, and catastrophic situations.