Consumer/Participant Direction

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.

In an effort to enhance marketing efforts and increase enrollment in the Cash & Counseling Demonstration and Evaluation (CCDE), the Robert Wood Johnson Foundation provided funding to conduct qualitative research (focus groups). Participants included staff members whose agencies have contracts with the Florida Dept. of Elder Affairs & Florida Dept. of Children and Families to provide case management and personal care services to eligible elders and adults under age 65 with physical disabilities.

This report describes a Florida cash payment program, Consumer Directed Care, which is testing the effectiveness of increased participant control for people with disabilities, including children and older persons. Florida is part of a demonstration project to measure the impact of substituting a cash allowance for Medicaid services from provider agencies. This document provides information on the program implementation and impact.

This document provides information on VNS Choice, the New York long-term care program for older people with disabilities. Case managers work with healthcare and long-term care providers to coordinate participants’ Medicare and Medicaid services. The document discusses the intervention and implementation of this program. According to program staff, VNS CHOICE has reduced hospital and nursing home use among participants and has low disenrollment.

This document focuses on Sunrise Towers, a public housing complex for older people in Laconia, New Hampshire. This form of public housing is modeled after assisted living and provides meals and personal assistance to keep residents in the community. The document describes the program, the services the program offers, and funding sources.

This document highlights the Village Integrated Service Agency, a program of the Mental Health Association in Los Angeles County. The program provides coordinated, comprehensive services for people with mental illness. Available services are determined by the needs and goals of the participants. This report describes the program and its effectiveness in helping people with mental illness live independently.

This document describes the State of Washington’s many resources specifically designed to facilitate the transition of nursing facility residents to less restrictive, community settings. The state also offers four funding sources for transitional services people may need when leaving a nursing facility. The document notes the specific programs, their implementation and impact.

In 1996, Vermont began to shift resources from nursing facilities to home and community-based services. To implement the legislation, several programs, new services, and policy changes were created that offered individuals more choices for long-term services. This report describes how Vermont changed its long-term care system to reduce institutional reliance by supporting people with physical disabilities and older people in the most appropriate and least restrictive environment possible.

This document describes Utah’s efforts to educate nursing home residents about community-based long-term care options. Group and individual educational sessions and assessments are conducted through organizations knowledgeable about community services. The document provides further information on the implementation of this program.

This document describes Community Choice, New Jersey’s permanent, state-operated nursing facility transition program. The program provides information about nursing home alternatives and assistance moving from nursing facilities. This program’s implementation and impact are illustrated in this document.