An Overview of the Independence Plus Initiative to Promote Consumer-Direction of Services in Medicaid

The Independence Plus Initiative was established to give states expanded opportunities within Medicaid to allow for consumer direction of long-term services and supports. The consumer direction movement continues to evolve rapidly, and this calls for federal and state resources to evaluate new and changing programs. This issue paper explores the difference between IP and Cash and Counseling, the 1115 demonstration, IP and HCBS Waivers, and outlines policy implications.