All States/Territories

This document identifies assessment instruments being used and reviews some of the variation across instruments and in the processes for using them. It includes an overview of the major components of the assessment instruments and of their role in a state’s eligibility determination, assessment, or care planning processes.

This brief addresses personal assistance services which are the hands-on support that people with disabilities use to participate more fully in community living. These services are related to personal care that people would do for themselves if not for a disability, e.g. bathing, eating, dressing, getting in or out of bed or a chair, using the toilet, housekeeping, these personal care services are known as Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs).

The TTW was designed to remove many of the barriers that previously influenced people’s decisions about going to work because of concerns over losing health care coverage. The goal is increase opportunities & choices for beneficiaries to obtain employment, vocational rehabilitation, & other support services. The attached regional updates offers statistics, newly-approved provider listings, & upcoming events. More information: visit website or fill out fax form on the newsletter backside.

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.

This report describes South Carolina’s programs for older people and people with physical disabilities to gain access institutional and community Medicaid supports through a single access point, and have increasing opportunities to direct their own services. The report also describes how the state has been particularly innovative in using information technology to improve the quality of community supports and participants’ access to services.

This report describes the Commonwealth of Pennsylvania’s Office of Mental Retardation's efforts to implement a system-wide reform of its supports for people with mental retardation. The objective of this Transformation Project is to improve the quality of life of people who use publicly funded supports by providing them with more choices and greater control over these supports.