To address the needs of Medicaid beneficiaries who are elderly or disabled and desire greater control over their personal care, the federal government has encouraged states to offer consumer-directed options.
A growing number of Medicaid beneficiaries receiving disability-related assistance in their homes hire workers and manage the services themselves under consumer-directed care.
States considering a Cash and Counseling program are likely to be interested in the number and types of eligible beneficiaries it might attract, factors that could deter interested beneficiaries from participating, and possible increases it might create in the total number of beneficiaries receiving...
This report estimates the effects of Cash and Counseling on caregivers who were providing the most unpaid assistance to adult beneficiaries at the time beneficiaries volunteered for the demonstration.
This report details implementation, goals and features, and consumer satisfaction with New Jersey’s Cash and Counseling program, called Personal Preference. The model proved administratively feasible and politically tenable during the evaluation period.
Cash and Counseling had sizable effects on the proportion of people receiving paid care in Arkansas and New Jersey. It also had sizable effects among the nonelderly—but not the elderly—in Florida, where a higher percentage of enrollees were already receiving this type of care before enrollment.
This report examines how Cash and Counseling affected Medicaid and Medicare service use and cost. In all three states, costs incurred by the treatment group were higher than those incurred by the control group. However, the reasons were different across states, and the patterns differed over time.
Promoting the well-being of parents and other relatives who serve as informal caregivers to provide vital, unpaid personal care to children with developmental disabilities is an important policy objective.
Provides design and implementation lessons for states thinking about adopting a Cash and Counseling program. The lessons are based on the experiences of the Arkansas, Florida, and New Jersey programs.
Describes the design and implementation of the Personal Preferences program in New Jersey, which provides consumer-directed supportive services for some Medicaid beneficiaries with disabilities.
This report presents the first impact analysis results from a three-state demonstration in which disabled Medicaid enrollees eligible for personal assistance services get a cash allowance so they can hire whom they please or use the money to buy equipment or supplies, instead of obtaining services through...
Describes the experiences of 240 early clients in Personal Preference, the state's cash and counseling demonstration. Notes that 76 percent were still enrolled at the time of the nine-month interview, 17 percent had dropped out, and 7 percent had died.
Describes the experiences of the first clients to participate in Florida's Cash and Counseling Demonstration, the Consumer-Directed Care program. Notes that most clients are children (47 percent) and nonelderly adults (36 percent).
Finds that many in the early treatment group cohort were in relatively poor health and had high levels of functional impairment. Still, one-third lived alone, and one-quarter had no unpaid informal caregivers.