Consumer/Participant Direction

An advisory committee of consumers, providers, practitioners, advocates and experts worked collaboratively to identify the major challenges preventing people with mental illness from discharging out of nursing facilities and into less restrictive communities. This report is a result of their work and aims to make available a framework for successful transition programs. The best practices described are offered as a guide for service providers, advocates, and mental health clients themselves.

Explore the impact of consumer-directed support on the economic, health, and social outcomes between families enrolled in the program and those on a waiting list. Caregivers reported fewer out-of-pocket disability expenses, greater access to health care, engagement in more social activities, and greater leisure satisfaction. There also appeared to be greater impacts on lower income families; these caregivers reported better mental health and access to health care than did the waiting list group.

The Nurse Delegation Invitational Forum brought together 28 participants from seven states to discuss the involvement of unlicensed assistive personnel (UAP) in the provision of health care tasks to long-term care consumers through nurse delegation and consumer direction. The Oregon long-term care system served as the forum centerpiece, with presentations by staff from state programs, the board of nursing, practicing nurses who delegate and visits to several sites in the Portland area.

Rutgers Center for State Health Policy convened national and state thought leaders in nursing practice and regulation to develop consensus principles to guide the profession's collaboration with people who want to live in their homes and communities. The 2004 draft principles were revised and endorsed by the American Academy of Nursing's Expert Panel on Aging in November 2005. They are offered as a foundation for further dialogue within and across states.

This report describes the implementation of consumer directed care by synthesizing information from in-person discussions with program staff, a mail survey of program consultants, telephone interviews with consumers in the treatment group, and program records. It discusses the program’s goals and features, the ways beneficiaries managed their program responsibilities and took advantage of increased flexibility, and the degree to which beneficiaries were satisfied with the program.

Vermont is changing their long-term care systems and in a shift from nursing homes, the state has family members care for elderly relatives. A recent Wall Street Journal cover story details the changes. Some of the new home and community based services include the development of the Choices for Care program.

West Virginia has chosen to modify the PES E/D to capture both the experiences of participants in the Personal Options waiver (who are able to self-direct a portion of their services), as well as those in the traditional waiver program. WV added an additional domain for Personal Options participants that addresses the adequacy of support staff, resource consultants and financial management services. The survey and training manual are attached.

As part of the 2004 Real Choice grants, New Hampshire and Wisconsin proposed to complete a feasibility study and then develop LIFE Account programs. With no federal legislation creating a savings program, grantees are restricted to modified program that works under existing law. This paper considers six options: Section 1115 Demonstrations, Waivers under Section 1915(c) & 1915(b), Section 1915(i) & 1915(j) State Plan programs, and Section 1937 Benchmark programs and suggests some next steps.

The Montana Choice program created this booklet for individuals receiving personal assistance services in their home or would like to begin receiving services. The handout provides users with the resources needed to manage their care under the self-directed personal assistance program.

This booklet can assist individuals when they need help to remain in their own homes as a result of an accident, prolonged illness, disability or frailty that comes with age. It also provides individuals with the basic tips designed to walk through the many facets of hiring in-home help or what many consider a \"consumer-buying guide\" for a certain type of care.