Giving Clients Freedom to Choose Services Helps People with Severe Mental Disabilities

Evaluation of a self-determination project

The Monadnock Developmental Services, in Keene, N.H., developed a project that enabled persons with chronic developmental disabilities to exercise greater self-determination in the care they receive and make their own decisions about how their needs are met, with the help of a planning team composed of relatives or friends of their choosing.

The project was part of the Robert Wood Johnson Foundation (RWJF) Building Health Systems for People with Chronic Illnesses national program.

Key Results: Monadnock Developmental Services, which originally set out to allow 45 clients to control their Medicaid and state funds, soon granted the same freedom and control to all the clients it served (approximately 500).

Evaluation Findings: Conroy's independent evaluation of the project showed increased levels of satisfaction among clients and cost savings of as much as 15 percent.

Afterward: The project has been expanded across the state of New Hampshire (see Program Results on ID# 027576) and has fostered a separate RWJF national program, Self-Determination for People with Developmental Disabilities, co-directed by Tom Nerney, the original principal investigator, and Don Shumway.