Consumer/Participant Direction

How do finance institutions and HCBS influence asset building among persons with disabilities? This article explores patterns of and barriers to utilization of banking services using a case study of an Iowa credit union that has enrolled persons with disabilities under a HCBS waiver. Although not widely used by program participants, the credit union model provides savings opportunities to purchase goods and services that facilitate independent living.

The trends in state Medicaid HCBS programs, target groups, participants, and expenditures are summarized and policy recommendations are made. The paper shows the progress in providing Medicaid HCBS but also identifies many current problems and policies. Inequities in access to services and limited funds result in unmet needs. Cost issues have been a primary focus of policy makers and quality problems are largely not addressed.

The Handbook was developed to provide state staff, policymakers, service providers, program participants, and other stakeholders with a comprehensive source of information about participant direction programs and policies. Its primary purpose is to explain how States can increase program participants’ choice of and control over their services and supports. In addition to providing detailed information, the Handbook also provides links to additional web resources on the selected topics.

This curriculum, "Choices for Long-Term Care" was developed by the New York State Office for the Aging in partnership with Albany area institutions. These materials serve as a tool for NY Connects professionals to better understand the philosophy and definition of information and assistance, enhance their communication skills, and become familiar with the call map to better assist callers.

Learn from 10 years of experience in administering the consumer-directed Cash & Counseling program in Arkansas. The report provides a candid history of the development, implementation, and lessons learned from the program. The author gives details on partnership development and use, changes in agency culture and operations, and data on outcomes, cost neutrality, and participant demographics. Also included are the 2003 and 2008 program budgets.

March 2-4, 2009 state program staff, CMS staff, and technical assistance providers met in Baltimore to discuss Money Follows the Person and other strategies for helping people move out of nursing homes. Speakers presented on topics ranging from service integration, housing finance strategies, mentoring, quality, and many others.

Program administrators, advocates, and researchers advise the Senate on ways to improve wellbeing and cost outcomes of long-term care by increasing access to HCBS. They speak on national demographics, successful HCBS programs of the past and present, state programs in Wisconsin and Florida, integrating acute and long-term care for dual eligibles, and program finance models. See “Video Contents Index” for time stamps and information on each testimony.

View the forum session presentations to learn how Arkansas, Texas, and Virginia have created consumer-directed options. They discuss demographics, program details and histories, costs, challenges, and the future. The final presentation goes over Money Follows the Person and Cash and Counseling from the federal level, examining policy, demographics, and outcomes.

The Veterans Health Administration plans to partner with the Aging Network in order to be serving over 109,000 veterans using HCBS by 2011. February 25 and 26, 2009, these organizations met in Boston to develop the partnership, work out next steps, and identify challenges. Presentations provide details on existing infrastructure, Nursing Home Diversion, financial management services, and existing research on HCBS and self-direction.

The experience of the Cobb and Douglas Counties Community Services Boards in Georgia in shifting from a segregated traditional service system to an innovative system focusing on economic development for persons with disabilities illustrates some common aspects of system change. The 7-year organizational evolution is analyzed here. The main points that emerged are: staff development; partnerships and funding; sustainability; management and HR practices; and expanding coverage to new populations.