| 8054.2 Enabling Personal Preference: The Implementation of the Cash and Counseling Demonstration in New Jersey |
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| About 1.2 million people receive disability-related supportive services in their homes through state Medicaid plans or home- and community-based waiver programs. Under state plans, services traditionally have been restricted to human assistance with personal care and homemaking provided by licensed agencies. However, coverage of additional services is often limited, and a case manager decides whether they are needed. In contrast to traditional service models, states are offering Medicaid beneficiaries the opportunity to obtain personal care from an alternative known as "consumer-directed" care, or "Cash and Counseling". It's an expanded model of consumer-directed supportive services that provides a flexible monthly allowance for consumers to use to hire their choice of workers, services, and other goods. This report describes the design and implementation of Personal Preference, New Jersey's model of Cash and Counseling. It also draws lessons from the state's experience. This report is based primarily on in-person interviews conducted in April 2001, and were conducted with New Jersey state officials, Personal Preference program staff members, and officials of organizations representing the personal care industry in New Jersey. Under its state Medicaid plan, New Jersey chose to "cash out" Personal Care Assistance. It did not cash out an of its seven Medicaid home- and community-based waiver programs. To identify eligible beneficiaries, New Jersey required that a personal care agency send the Personal Preference program a form with contact information for each beneficiary assessed or reassessed for PCA. The form included information on care plan hours, which was used in determining the amount of the cash allowance for demonstration participants assigned to the treatment group. | |
| Project Officer: | Doty, Pamela |
| Office of Disability, Aging, and Long-Term Care Policy | |
| 202-690-6443 | |
| Link to report: http://aspe.hhs.gov/daltcp/Reports/enablepp.htm | |
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