Lessons from the Arkansas cash and counseling program: how the experiences of diverse older consumers and their caregivers address family policy concerns

Authors:
SAN ANTONIO Patricia, et al
Journal article citation:
Journal of Aging and Social Policy, 22(1), January 2010, pp.1-17.
Publisher:
Routledge
Place of publication:
Philadelphia, USA

The Cash and Counseling Demonstration and Evaluation (CCDE) program was a trial of an unfettered consumer directed service offering Medicaid recipients in three states a cash allowance and information services in lieu of agency delivered care. Based on this experience the concerns of policy makers were drawn together into four family policy questions often asked about consumer-directed services and examining issues such as quality, suitability, and fraud and abuse. The data reported are drawn from in-home interviews with 19 adults with diverse disabilities over 50 years of age and their care unit members who participated in IndependentChoices, the Arkansas implementation of CCDE. Building on other CCDE evaluation survey data, this analysis discusses recipient and care givers’ experiences of receiving, giving, and managing care. It demonstrates how the program allows consumers choice, so that they receive the services they want, but at the same time the programme’s flexibility allows policy makers to safeguard both consumers and programme resources through the use of representatives, state consultants, and fiscal intermediaries. The authors conclude that overall the experience with Arkansas CCDE has been quite positive and that it might act as a model to help address the needs of both consumers with diverse disabilities and policy makers in other states.

Subject terms:
older people, policy formulation, self-directed support;
Content type:
research
Location(s):
United States
Link:
Journal home page
ISSN online:
1545-0821
ISSN print:
0895-9420

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