Cash and Counseling

Unsure about how to best design and implement HCBS programs? This site provides technical assistance to states that may need assistance in determining which Home & Community Service authority best meet their needs, as well as assisting them in developing, evaluating and maintaing HCBS waiver programs. HCBSselfdirection.org is intended to assist state HCBS program administrators, their staff and contractors, and other state agencies involved with developing HCBS programs.

Idaho’s, My Voice, My Choice training program, is an online resource for those wishing to be Support Brokers. The site’s main categories include a section for Computer Instructions, Meeting the Trainers, Readings and Activities. The course itself stresses several key concepts: Self-Determination, the Philosophical Shift that is occurring from traditional supports to a self-directed model, Person-Centered Planning, and the Ethics and Professionalism required as a successful Support Broker.

States increasingly require criminal background checks for home care workers to protect vulnerable adults from harm. While 46 states mandate some type of background check for Medicaid-funded workers, there is no uniform protocol for screening and disqualifying candidates. Developing sound policies and practices is challenging due to costs, database problems & time constraints. The paper offers an up-to-date assessment of practices, policy considerations & research and guidance on moving forward.

This handbook will help participants in the IRIS Program organize and catalog the information they need to self-direct. The handbook includes information on resources, support and services plan, arranging for services, supports and goods, a glossary and FAQ section. The handbook can be downloaded in English (Large Print and Audio), Spanish, Russian, Hmong, and ASL (movie).

IRIS is a self-directed, long-term care option for elderly people and adults with disabilities. This Medicaid waiver program sponsored by the Wisconsin Department of Health Services is available in the 47 counties where Family Care operates. Their website provides information about the program, forms, FAQs, enrollment information and FSA and Participant Handbook.

Planning documents show how Connecticut will use a Cash & Counseling model to provide flexible service choices to keep people out of institutions. The narrative gives details such as the state’s current rebalancing status, goals and objectives, approach, challenges, service options, training and eligibility. The work plan details “Choices at Home” key tasks, lead person and time frame associated with each major objective.

CA’s In-Home Supportive Services (IHSS) aims to keep people in their homes by paying for personal care services approved by social workers. SB 1104 was introduced in 2004 to ensure and measure delivery of services and program integrity. The report examines whether the elements of the bill were enacted. It also describes alternative models for in-home service delivery, including the Cash & Counseling model and one wherein private companies provide IHSS. Sample timecards and handbooks are given.

Here are resources used to educate consumers about MN’s Consumer Directed Community Supports, Personal Care Assistance, and Road to Independence programs. The first handbook gives guidance on the processes and protections of consumer direction and also provides sample care plans and assessments. The handbook on personal care assistance is available in English, Somali and Vietnamese and reviews eligibility, management, and use of services. The last guide assists in moving out of an institution.

Twelve states received Cash & Counseling Replication grants in October 2004. Here, the Replication States’ experiences in developing and implementing their new programs are documented in three stages: planning; design/development; and implementation/enrollment. The appendix includes summaries of the states' grant initiatives.

The three-year study examined relevant policy, program design, and cultural implications that may have an impact on enabling self-directed Medicaid beneficiaries to save money without losing benefits. Using extensive stakeholder engagement, six elements were studied: savings models; costs and benefits of self-direction; Federal tax policy; state policy context; participant needs; and an implementation plan.