To remain in their homes, older adults may need help with daily activities (called activities of daily living or ADLs). Consumer direction means giving people more choices and more control over both the type of care they receive and the caregivers who provide it.
From 2001 to 2005, staff from the National Association of State Units on Aging and the National Council on Aging worked to build knowledge for, and support of, consumer direction through:
Surveys and interviews with state administrators in 2004 established a baseline from which to assess growth in consumer-directed programs for older people. Survey findings included the following:
Project staff developed the Consumer Direction Tool to help citizens, policy-makers, providers and legislators determine whether long-term-care programs and policies help people to make their own choices about the services they need and the people who provide them. People can also use the tool to identify and surmount barriers to consumer direction.
The 13 states receiving technical assistance:
Five states—Illinois, Iowa, Pennsylvania, Washington and West Virginia—used their reform agendas to develop successful proposals for RWJF's Cash and Counseling demonstration grants in 2004, according to the project director. Cash and Counseling provides Medicaid enrollees who are frail or have disabilities with a monthly cash allowance to purchase their own personal care and homemaker services. Participants also receive counseling to help plan their service purchases.