Independent Choices: Enhancing Consumer Direction for People with Disabilities

An RWJF National Program

Dates of Program: July 1995 through June 1999

Field of Work: Fostering the development of consumer-directed home and community-based services for people with chronic disabilities.

Problem Synopsis: In 1995, approximately 17 percent of Americans had a disability, and 30 percent of these people needed some type of supportive services, such as assistance with bathing or walking, according to the National Council on the Aging, Washington. As society ages and advances in medical technology continue, people are living longer and are requiring more help with a range of personal needs. At the same time, expenditures for long-term care services have risen dramatically, with 40 percent of state Medicaid budgets spent on long-term care services in the mid-1990s, according to the National Council on the Aging.

Synopsis of the Work: Independent Choices: Enhancing Consumer Direction for People with Disabilities was a $3.4 million program of the Robert Wood Johnson Foundation (RWJF) designed to foster the development of consumer-directed home and community-based services for people of all ages with chronic disabilities. Authorized by the Board of Trustees in July 1995, the program ran until June 1999. Independent Choices, managed by the National Council on the Aging, Washington, supported four research and nine demonstration projects.

Key Findings

  • Overall, the assessment team led by A.E. Benjamin, PhD, at the University of California, Los Angeles found that:

    • Independent Choices was generally successful in meeting its goals. The program stimulated some innovative activity in the field and attempted to tackle some important issues in a serious and focused way.
    • Independent Choices partially contributed to the "mainstreaming" of consumer direction in the field of aging. The program broadened the number of actors and sites where consumer-directed projects are being planned and implemented.
    • Independent Choices played a modest role in shifting attention from the ideology of consumer direction to the technical challenges of designing programs.

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