American health care is undergoing a period of rapid and profound change that will probably result in a decreased availability of health care, including physical therapy services. Simultaneously, an international movement to empower children and adults with disabilities suggests that the top-down rehabilitation paradigm where professionals are in charge needs to be rethought. A solution to meet the demands of these two trends, providing cost-effective and meaningful rehabilitation services, may lie in an international model called community-based rehabilitation (CBR). The purpose of this article is to explore CBR as a model of care and to consider how CBR could help to meet the needs of Americans, especially children with physical disabilities.