Cash and Counseling

Find resources to help in the development of VDHCBS programs including Readiness Review contacts and a FAQ sheet discussing issues of coordination, funding, participant direction program parameters, SUA and AAA roles, services, target groups, standards, fiscal management services and stakeholder participation.

This 15-page slide presentation, summarizes the need for the Medicaid Buy-In Program in Hawaii, called “Hire Abilities”. This presentation outlines the program’s goals, recent successes, need for the MIG option, enrollment, cost and more. It also looks at the national MIG picture and could be a helpful resource for other states.

The Vermont Offset Pilot Demonstration is one of four state pilots initiated as a first step in preparing for the BOND demonstration. It's purpose is to test whether changing SSDI rules to provide a glide ramp off SSDI cash benefits would encourage more beneficiaries to work at a high enough level to reduce or eliminate cash benefit payments. The findings provide invaluable information on the issues of implementing such a complex federal project within widely variable state systems.

An alternative to the traditional care delivery system, Arkansas’ IndependentChoices was the first program nationally that offered participant directed care as an option to its’ Medicaid population. Arkansas serves as a model for other states interested in implementing similar programs. This in depth procedures manual outlines the history, philosophy and detailed procedures for the program. Review examples of these enrollment and operating policies.

Part of the Cash & Counseling effort, IndependentChoices is a Medicaid program that allows the consumer to direct their own personal assistant services. Because Arkansas was the first state to have a program like this, their experiences and materials are a good resource for other states looking to implement similar programs. This handbook was created as an introduction for new enrollees. Also see samples of their marketing materials: Brochure, Appointment Card template and Decal.

States’ efforts to expand consumer-directed long-term care service programs, are often hindered by challenges related to costs, staffing and organizational issues, infrastructure requirements, and resistance from stakeholders. Yet states have developed a number of successful strategies for overcoming these challenges. Their experiences offer valuable insights, guidance, and encouragement to other states considering CDS. The abstract (free) and full report (subscription required) are available.

This presentation was part of the 2007 Government and Vendor Fiscal/Employer Agent Workshop. This presentation provided an update on policies regarding self-direction, with an emphasis on those related to fiscal management activities. The session also answered some of the more frequently asked questions and explored some of the differences between section 1915(c) waiver programs and the new State Plan options for self-directed services.

This report describes the design and implementation of the Consumer-Directed Care Research Project (CDC) and draws lessons from the state's experience. The report is based primarily on in-person interviews conducted in January 2002, about 18 months after the project began enrolling beneficiaries.

The results of a survey on the interest of managed care organizations in developing a Cash & Counseling option for delivering long-term personal assistance services.

This table helps compare traditional case managers, support brokers and FMS entities and outlines them by duties and responsibilities, funding and activities for support services. This matrix was composed for a February 14, 2006 technical assistance call for Cash & Counseling grantees.