Personal Assistant

This brief describes currently available opportunities for consumer direction of care in public programs and private insurance plans, including opportunities for family caregivers to take on roles as representative decision-makers and paid caregivers. Includes recent findings from “Cash and Counseling” demonstrations and assesses prospects for expansion of consumer-directed alternatives to traditional modes of financing and service delivery.

The New Hampshire CPASS project identified system “gaps” that impact a consumer-directed long-term care (LTC) service model. Focus groups identified gaps in the personal care services system, services that are at the heart and origin of consumer direction in the State. This analysis begins with an overview of consumer-directed personal care (CDPC), followed by a discussion of the gaps identified by focus groups and initial recommendations to address the gaps.

This report describes the results from a survey of adults with developmental disabilities in Florida. The survey was conducted prior to implementing the Cash and Counseling program in the state. The research process and results are presented and discussed.

This brief addresses personal assistance services which are the hands-on support that people with disabilities use to participate more fully in community living. These services are related to personal care that people would do for themselves if not for a disability, e.g. bathing, eating, dressing, getting in or out of bed or a chair, using the toilet, housekeeping, these personal care services are known as Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs).

Medicaid beneficiaries who have disabilities and receive personal care services (PCS) from home care agencies have little control over their care. As a result, some are dissatisfied, have unmet needs, and experience diminished quality of life. This study of Arkansas’s Cash and Counseling demonstration program, IndependentChoices, examines how consumer direction affects these aspects of care quality relative to agency-directed services

The State of Colorado plans to initiate a five-year research and demonstration program in 2002. Participants will be able to use money that otherwise would be spent on Medicaid home health agency and personal care services to purchase in-home services from attendants they personally select, hire, and train. The model is expected to improve the quality of attendant support and decrease the state's costs of providing care.

This document describes seven grants in the state of Colorado, they are: The Nursing Facilities Transitions Grant, Systems Change for Real Choices Grant, Colorado Community Personal Assistance Services and Supports Grant, Medicaid “Buy-In” Grant (NEII), Consumer-Directed Care for Elderly (CDCE), In-Home Support Services (IHSS), and Consumer Directed Attendant Support (CDAS).

This webcast focused on forms of abuse/violence/sexual assault against women and men with disabilities, barriers that get in the way of reporting abuse, and strategies that women and men with disabilities believe are important for enhancing their safety. Survey information, gathered directly from individuals with physical and cognitive disabilities as well as victims of domestic violence, disability organizations and criminal justice agencies, was shared with participants.

This paper presents findings from the Cash & Counseling demonstration in Arkansas. The report shows results from a survey of 1,739 elderly and nonelderly adults. The results include that relative to agency-directed services, Cash and Counseling greatly improved satisfaction and reduced most unmet needs. Additional results and presented and discussed.

This summary was prepared by Robert Mollica based on a site visit to the state of Washington in April 2003 organized by the Rutgers Center for State Health Policy/National Academy for State Health Policy Technical Assistance Exchange Collaborative. Thirteen representatives from Nursing Home Transition Grantees from Alaska, California, Delaware, Indiana, Maryland, Massachusetts and New Jersey participated in the site visit.