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Foster, L., Brown, R., Phillips, B., Schore, J. & Carlson, B.L. (2003, March). Improving the quality of Medicaid personal assistance through consumer direction. Health Affairs, Supplemental Web Exclusives: W3-162-175.
Abstract
As states seek to improve home and community-based services for people with disabilities, many are incorporating consumer-directed supportive services into their Medicaid programs. The national Cash and Counseling Demonstration uses a randomized design to compare an innovative model of consumer direction with the traditional agency-directed approach. This paper presents findings from the first demonstration program to be implemented, in Arkansas. Our survey of 1,739 elderly and nonelderly adults showed that relative to agency-directed services, Cash and Counseling greatly improved satisfaction and reduced most unmet needs. Moreover, contrary to some concerns, it did not adversely affect participants' health and safety.
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