Independence Plus

Is your program challenged by effective methods to meaningful consumer involvement in the redesign of long-term services and support systems? This report reviews the history and effectiveness of the consumer involvement strategy used from the consumer, state partner, and grant staff perspectives. The report informs future consumer involvement methods in grant activities and other policy decision-making activities and also identifies lessons learned and creates recommendations.

This paper focuses on the experiences and perceptions of community liaisons and the managers of Consumer-Directed Agencies (managers) who participated in the Massachusetts Real Choice Pilot. The experiences of the Real Choice community liaisons and managers provide insight relevant for the larger implementation of the support brokerage component for an Independence Plus option that will be available within the Massachusetts Community First waiver.

The new consumer-directed Medicaid program in Montana, Big Sky Bonanza (BSB) program has created the following products provided to new enrollees. The Waiver Orientation manual contains a program overview, roles and responsibilities and training process. My Support Services Plan is an 18 page worksheet to help consumers develop goal statements, capture personal, health, and spending plan, create an emergency back-up plan and list medical information.

This brochure was created using feedback from consumer focus groups, peer trainers, and other stakeholders. The brochure provides safety & prevention strategies, planning for backup care, preparing for attendant support during a community-wide disaster, how to minimize risk of theft, and health care emergency instructions and form. The strategies address emergency backup and incident management for consumers directing their own care or who have an authorized representative directing their care.

The Arkansas IndependentChoices program developed two new tools. The Consumer-Directed training manual will provide users with ideas and suggestions on hiring, training, and managing a personal care attendant. The Personal Care Attendant handbook will provide users with training material that will help trainees do their job as a personal care attendant. Both manuals contain information about hiring, communication and management issues.

The Missouri Independence Plus Grantees have developed a number of tools during the implementation of their consumer-directed program aimed at helping people with disabilities. Review the 7 participant workbooks titles include Designing Supports, Financial Management, Individual Budget, Orientation & Overview, Person Centered Planning, Support Broker, Self-Determination. Visit their website and view the program brochure for additional information.

In the past decade consumer-directed (CD) services have proliferated in public programs. AARP has developed a two page Fact Sheet that offers an short overview of consumer preferences, program characteristics, the role of fiscal agents, and the ways consumer direction is expanding.

This paper discusses the activities of 11 grantees and the program and policy issues they have encountered. The paper’s primary purpose is to provide information that states and stakeholders will find useful when planning or implementing consumer-directed initiatives, whether through solely state-funded programs or the Medicaid program. In particular, the report highlights program and state and federal policy challenges and how Grantees are addressing them.

This report focuses on the current system for critical incident reporting and tracking within long-term care waiver programs. It also includes recommendations from stakeholders on a definition of critical incident and emergency backup, policy recommendations for new mechanisms that would more appropriately address the needs of consumers, and outlines an implementation plan for new critical incident management mechanisms and statewide emergency backup infrastructure.

The Colorado Department of Health Care Policy & Financing contracted with an independent consultant to organize and facilitate six focus groups with consumers of Medicaid waiver services, family members or representatives, and consumer-directed program participants. The focus groups discussed consumer experiences with existing emergency backup and critical incident management systems and identified strengths and potential weaknesses. This report provides results from the focus groups.