,,,,,,,Lessons from the Implementation of Cash and Counseling in Arkansas, Florida and New Jersey

Lessons from the Implementation of Cash and Counseling in Arkansas, Florida and New Jersey


 

Publication Date:

Publisher: Center on Aging, University of Maryland

Author(s): B. Phillips; K. Mahoney; L. Simon-Rusinowitz; J. Schore; S. Barrett; W. Ditto; T. Reimers; P. Doty

Research Area: Health

Type: Report

Abstract:

Medicaid traditionally restricted its coverage for supportive services at home to human assistance with personal care and homemaking provided by licensed agencies. Increasingly, however, states are offering Medicaid beneficiaries the opportunity to obtain supportive services from individual providers through "consumer-directed" care programs. Cash and Counseling is one such program, offering a flexible monthly allowance to beneficiaries to purchase goods and services related to care.



The Cash and Counseling program ran demonstration projects in Arkansas, Florida and New Jersey, and this evaluation report summarizes the lessons learned from these projects. Because agencies that provide traditional home care services tend not to support cash programs, the authors suggest that outreach be conducted directly to eligible beneficiaries, and that family and friends who may serve as workers or representatives of a beneficiary's interest be present at home visits during the enrollment process. Counselors tasked with developing consumer spending plans should employ advance preparation to minimize visits and time, and states should ensure that counselors are aware that they will not be held responsible for poor outcomes arising from consumer decisions. The authors conclude that Cash and Counseling programs can be implemented successfully to serve populations with various disabilities and in various age groups, increasing beneficiary satisfaction and disability-related health outcomes.