Individualized Budget

Looking for a way to gauge consumer satisfaction in self-direction programs? The state of Virginia Department of Medical Assistance Services (DMAS) conducts an annual Consumer-Directed Recipient Satisfaction Survey, to monitor the performance of the fiscal agent and to provide DMAS with feedback to assist in the development and implementation of quality improvement strategies. The first and second year statewide survey and findings from 2007 and 2008, are available below.

Developed by an FMS provider, this handout offers guidance to participants on becoming employers, through fiscal intermediary services, as determined in their Person Centered Plan.

What are some of the highlights and milestones of the CLP programs? Review the presentations given at the The Gerontological Society of America Annual Meeting on November 19-22, 2009. Officials from the Administration on Aging and representatives from Connecticut, Georgia, Massachusetts and New York on presented.

Guidance is offered on the implementation of section 6087 of the Deficit Reduction Act of 2005 (DRA) Public Law Number 109-171. Section 6087, the “Optional Choice of Self-Directed Personal Assistance Services (PAS) (Cash and Counseling)” amended section 1915 of the Social Security Act by adding subsection (j). Guidance also applies to section 1915(c) HCBS waiver programs when states offer the self-direction opportunity and permit participants to purchase “individual directed goods and services.”

This biennial workshop was held in Baltimore, November 16 & 17. The conference offered two workshop tracks: a Strategic Track dedicated to big picture FMS issues facing state and program administrators and a Tactical Track dedicated to technical and operational issues. The IRS unveiled updated guidance specifically for participant direction Fiscal/Employer Agents and will even offered an informal, face-to-face question and answer booth. Review the presentations for further guidance.

Do you have questions about the different models of fiscal services in consumer-directed care? The first fact sheet compares the Fiscal/Employer Agent (either government or vendor), Agency with Choice, and Fiscal Conduit models. The second illustrates the factors that influence the costs of these different models.

A central part of consumer direction is ability of the consumer to manage the budget and decide what to purchase. Evaluation data and anecdotes are given to show how this ability influences the outcomes of program participants.

How do finance institutions and HCBS influence asset building among persons with disabilities? This article explores patterns of and barriers to utilization of banking services using a case study of an Iowa credit union that has enrolled persons with disabilities under a HCBS waiver. Although not widely used by program participants, the credit union model provides savings opportunities to purchase goods and services that facilitate independent living.

Learn from 10 years of experience in administering the consumer-directed Cash & Counseling program in Arkansas. The report provides a candid history of the development, implementation, and lessons learned from the program. The author gives details on partnership development and use, changes in agency culture and operations, and data on outcomes, cost neutrality, and participant demographics. Also included are the 2003 and 2008 program budgets.

Find answers to your questions about FMS. The Cash & Counseling National Program Office originally presented this overview during a technical assistance call. It defines self-direction and reviews the duties of FMS agencies and issues in the field. Among these are definitions of services and employee categories, types of FMS, tax and labor laws, costs, and funding models.