Cash and Counseling

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 manual is intended to address two identified training needs for consultants/support brokers working with participants in self-directed care. MODULE ONE: Facilitating the Paradigm Shift for Consultants and MODULE TWO: The Dynamics of Choice and Decision-Making for Participants. The program identifies training needs by addressing the philosophical framework necessary for successful implementation of a participant-directed service and was designed to be delivered in two half-day sessions.

The statehealthfacts.org had recently added a data on states who offer Individual Budget programs. Use this interactive guide to compare and review activities related to participant-directed care. Data includes the program type, program name, CMS waiver authority, includes elderly, and a status update. Current as of January 2006.

This study describes the experiences of workers hired under consumer direction. The Cash and Counseling model does not appear to cause adverse consequences for the hired workers. Directly hired workers report high levels of job satisfaction and do not suffer physical or emotional hardship beyond what might be expected for individuals providing care to relatives. This report offers other information implications about consumers, their families and workers’ well-being.

This paper assesses the effect of consumer-directed care on the emotional, physical, and financial well-being of the primary informal caregivers of the Medicaid beneficiaries who voluntarily joined Arkansas's Cash and Counseling demonstration. The implications of the demonstration find that permitting interested Medicaid beneficiaries to direct their own in-home supportive services reduces burden on informal caregivers, which may help reduce beneficiaries' nursing home use.

This Congressional briefing examined the \"Cash and Counseling\" program, which provides an individualized allowance that Medicaid beneficiaries can use to hire a personal care assistant of their choice - often a family caregiver - or purchase items that help them live independently, such as chair lifts. As policymakers look to the future, what are the lessons learned from the first phase of the cash and counseling program?

The main aims of this paper are to categorize and analyze different types of arrangements allowing home-care users choice and map the prevalence, to review outcomes in terms of flexibility, care quality, satisfaction and conditions for care givers, and to analyze the implications for employment and fiscal sustainability. This paper covers services in 12 OECD countries (Australia, Austria, Canada, Germany, Ireland, Japan, Luxembourg, Netherlands, Norway, Sweden, United Kingdom and United States).

The 2005 Annual Research Meeting is AcademyHealth's premier forum for health services research. More than 2,300 leading health services researchers and policymakers attended the meeting to hear the latest findings on critical health care delivery topics such as, Medicare, coverage & access, disparities, health information technology, long-term care, health care quality, and patient safety. Review the agenda and over 130 presentations covering 17 major areas of health services research & policy.

The 2004 Consumer Direction Initiative Summit convened 79 recipients of mental health, addiction services, families, policymakers, and providers to develop recommendations for SAMHSA’s next steps towards fostering consumer-directed approaches in behavioral health care services for people with substance use disorders, mental illnesses and children with serious emotional disturbances. The report from the summit reviews issues raised in working papers and at the meeting.

Informal family assistance is often a key factor in determining whether a person with a disability can live in a community setting. However, the practice of paying relatives as caregivers remains controversial. This article reports findings from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, in which consumers receive a cash allowance to purchase personal assistance services. The article appeared in Marriage and Family Review, Vol. 1, No. 1/2