Individualized Budget

In this collection of informational materials, Ohio outlines what its Medicaid Buy-In for Workers with Disabilities (MBIWD) program is. Documents include an explanatory booklet, flyer and fact sheets. A website link with the government site that houses these documents, application forms and additional information is also included. While this material was intended for consumer use, it could serve as a guide to other states contemplating or running a similar MIG program.

This article explores the benefits and challenges people who have disabilities experience when managing their personal care programs. It also examines how LIFE Accounts would complement social participation opportunities for persons with disabilities.

This paper is an expansion of the NCD’s livable community framework (LCF): a set of public policy recommendations for ensuring that people with disabilities have all the opportunities and choices available to people without disabilities. It links key elements of the LCF to specific needs of people with psychiatric disabilities, and discusses stigma and discrimination.

This report focuses on adults with severe mental illness served by the public mental health system. It aims to identify and describe the range of self-directed care programs for this group being pursued by states and bring together existing evidence relating to the impact of these programs on individuals and on state resources. In doing so, it attempts to contribute to the ongoing debate about effective strategies for improving the quality and outcomes of the public mental health system.

This group of presentations were offered around the state of Colorado in regional training sessions. The day focused on various aspects of consumer direction, including case managers, Medicaid options, and working with personal-care attendants. Other presentations include transitioning a child to consumer-directed health care and a presentation on the benefits, rights, and responsibilities of consumer direction.

The Consumer-Directed Supports Toolbox is a set of materials developed under the Community-Integrated Personal Assistance Services and Supports (CPASS) grant awarded to North Carolina in 2002. It was developed to support the implementation of consumer-directed options in North Carolina. The “toolbox” consists of 3 powerpoint presentations, a set of exercises to be used in conjunction with the powerpoints, a consumer-directed supports manual, brochures and other visual aids.

MA grantees hired an independent evaluator to conduct qualitative assessments of consumers’ experiences at two and nine months of participation. At two months, the successes included connections to community supports and services. Identified challenges included developing and managing an individual budget. Successes at 9 months include increased independence, self-determination, and availability of workers and supports. Challenges included community liaison training and out-of-pocket spending.

Part of the Massachusetts Real Choice grants included community and consumer collaboration and input. The presentations work to introduce how the Real Choice grant aims to work on collaboration, integration collaboration into the pilot project, and review how consumer perspectives were used in the grant. Review the work and ideas on consumer involvement, the pilot evaluation and the consumer experience project.

As part of the Massachusetts Independence Plus grant, the workgroup recognized there was a certain amount of risk associated with individualized budgeting. They devised a “Incident Reporting” System that would document any incidents (such as fall, funding problems, injuries) that would compromise the health of an individual with disabilities being served under the program. The forms were created to assist a future Massachusetts IP waiver and have not yet been adopted

Launched in 2004, Flexible Services and Supports (the Pilot) gave participants control in calculating an individual budget where they then purchased services and goods to meet their community living needs. What were the experiences that provide lessons for the design and implementation of this model on a larger scale? This report reviews: design issues and implementation barriers, makes recommendations for future work, and describes any financial impacts of the Pilot on Medicaid utilization.