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...

The Cash and Counseling Demonstration gives Medicaid beneficiaries who are eligible for personal care services a consumer-directed allowance in lieu of traditional agency services. Using survey and Medicaid claims data on 2,008 adult applicants randomly assigned to treatment or control groups,...

A growing number of Medicaid beneficiaries receiving disability-related assistance in their homes hire workers and manage the services themselves under consumer-directed care. Although consumer direction clearly benefits beneficiaries, it is sustainable only if workers are satisfied with their...

Examines how a new model of consumer-directed care changes the way that consumers with disabilities meet their personal care needs and, in turn, affects their well-being. The analysis yielded estimated program effects that were large, compelling, consistent across numerous types of measures, and...

Although providing personal care to a family member with disabilities often is rewarding, it can also be emotionally, physically, and financially burdensome. Caregiver burden may be exacerbated if paid personal care services (PCS), such as those provided by Medicaid-certified personal care...