Cash and Counseling

Recent health policy shifts and practice changes have explored consumer-directed health care. The National Council on Disability decided to research & evaluate the evidence base in order to offer a clear picture of the initiatives strengths and weaknesses. This study includes a systematic review of the literature (both print & Web-based) on consumer-directed and -oriented care. The study also addresses questions and researches the variety of models, preferences, outcomes and cost-effectiveness.

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.

On 10/7/2004 eleven new states were awarded three-year Cash & Counseling grants, allowing them to replicate and expand on the Cash & Counseling model. Funded by the Robert Wood Johnson Foundation, the Assistant Secretary of Planning and Evaluation and the Administration on Aging, the following states will receive approximately $250,000 to implement Cash & Counseling programs: AL, IA, KY, MI, PA, RI, VT, WA, and WV. MN and NM will receive an additional $100,000 to enhance their programs.

On Tuesday, September 28, 2004, Susan Flanagan presented her recent report: Accessing Workers' Compensation Insurance For Consumer-Employed PAS Workers. This study focused on workers’ compensation (WC) laws and systems as they pertain to domestic service workers, and in particular, personal assistance workers, in 50 states, the District of Columbia, five U.S. territories and the tribal government of the Navajo Nation.

This Impact Newsletter was printed in the Spring of 2004 and the feature is \"Issue on Consumer-Controlled Budgets and Persons with Disabilities\". This issue of focuses on various aspects of and experiences with supporting personal freedom through self-directed supports and individually managed budgets. It includes articles from policy, service, and individual/ family perspectives illustrating what is possible when self-determination guides service provision.

This paper explores the role of older participants in planning, developing and overseeing home and community based service (HCBS) programs. It seeks to help State Units on Aging and others in the aging network identify concrete steps they can take to support the role of these older individuals as public policy advocates. The report addresses the extent of older HCBS participants' current involvement, the barriers to success, and the strategies being used to attain participation.

The Cash & Counseling approach provides consumers with a flexible monthly allowance that is based on an individualized budget, which allows them to direct and manage their own personal assistance services and address their own specific needs. This website hosts a library, offers information the original demonstrations, news & events.

Included here is the call for proposals for the 2004 demonstration of Cash & Counseling and three supporting teleconferences. These teleconferences discuss the requirements for the grant, as well as present past lessons and answer applicant's questions.

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 report describes the results from a telephone survey 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.