Reports

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.

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.

Families USA has released Medicaid: Good Medicine for State Economies predicting the impact state Medicaid spending will have on business activity, jobs, & wages in 2005. The report argues that extending the $10 billion in fiscal relief provided by Congress to the states last year, through enhanced Federal participation in Medicaid, through the end of fiscal year 2005 would help strengthen state economies by generating even more business activity, jobs,& wages. Includes data for every state.

Millions of Americans with disabilities or long-term illnesses need assistance with daily activities. Family members and friends fill much of that need, but paid workers are a critical source of care and services. The need for assistance is increasing yet the number of people available is growing slowly. CMS funded this paper to summarize literature and research on the home care, home health, and personal assistance services workforce, highlighting issues raised and lessons learned.

The Formative Evaluation of the Real Choice Systems Change Grants evaluates how the Systems Change grantees are progressing towards meeting their goals. The Formative Evaluation identifies problems faced by the grantees and ways that they deal with the problems. This document provides summary information about each of the FY2003 Grantees.

This report provides a summary of the partnership development activities undertaken by the 52 Grantees that were awarded a Systems Change Grant in 2001. It describes the ways that Grantees involved consumers and public and private partners in the development of Grant applications and their plans for involving them in implementation activities. In addition, the report includes a more in-depth description of partnership involvement for nine Grantees (three from each Grant type).

The purpose of this report is to compare and contrast the fiscal year (FY) 2001 Systems Change Grantees’ goals and planned activities as identified in their Grant applications submitted to CMS. This report provides a summary of the goals of the 52 FY 2001 Grantees and representative examples of the various activities they plan to implement to help them achieve these goals. The report also includes a summary of States’ views of the strengths, challenges and barriers of their LTC systems.