Cash and Counseling

The Cash & Counseling Demonstration gives Medicaid beneficiaries who are eligible for personal care services a consumer-directed allowance in lieu of traditional agency services. This report discusses the effects of this program on both the medicaid costs and personal care services recieved in Arkansas.

This report presents twenty-five case stories about the experience of adults with disabilities who receive the cash option in the Personal Preference Program in New Jersey. The report focuses on how “care units,” composed of consumers and/or representatives, paid workers, and counselors interacted around issues of consumer directed care.

This report focuses on workers’ compensation laws and systems as they pertain to domestic service workers. Workers’ compensation laws and regulations are reviewed, as well as promising practices in the states. Tables can be downloaded as one document or individually by topic.

This guide is designed to provide states and programs involved in consumer-directed services with a practical handbook on ensuring and improving the quality of services. This guide is based on a philosophy that the views of the major program stakeholders – consumers, families, program staff, regulators, funders – are the necessary starting point for the design of a quality system.

This report addresses the liability issues that may arise in government-sponsored consumer-directed personal assistance programs. The report focuses on Cash & Counseling Demonstration programs in AR, FL & NJ, In-Home Supportive Services Program in CA & Consumer-Directed Personal Assistance Program in NY. The reports purpose: first, identify circumstances where negligence could result in liability and what persons are likely to be liable; second, identify steps to reduce exposure to liability.

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 report describes the design & implementation of Arkansas’ model of Cash & Counseling—IndependentChoices—and draws lessons from the state’s experience. The report is based on in-person interviews conducted with Arkansas state officials, IndependentChoices’ program staff, staff providing counseling and fiscal services under IndependentChoices, staff providing traditional PAS in Arkansas, and staff of advocate organizations. The summary also draw lessons for future Cash & Counseling programs.

This report describes the design and implementation of Personal Preference, New Jersey’s model of Cash and Counseling. It also draws lessons from the state’s experience. The report is based primarily on in-person interviews conducted in April 01, about 18 months after the program began enrolling beneficiaries (Nov 99).

The report presents twenty-seven case stories about the experience of adults with disabilities who receive the cash option in the IndependentChoices Program. The report focuses on how "care units," composed of consumers and/or representatives, paid workers, & counselors interacted around issues of consumer directed care. Stories were analyzed for cross-cutting topics & themes such as family context of care, the meaning of independence, & the community context of care emerged in the interviews.

Oregon's Independent Choices Program allows Medicaid-eligible individuals to pay cash directly to providers for personal care and related services. Under this five-year project, participants receive a monthly cash payment and are fully responsible for the mechanics of payroll and budgeting for needed services.