Pennsylvania Confronts Challenges to Create Stronger Self-Directed Personal Assistance Services

Cash & Counseling Sidebar

Dates of Project: October 2004 to February 2009

Field of Work: Fostering the development of participant-directed home and community-based services for people with chronic disabilities in Pennsylvania

Synopsis of the Work: The Cash & Counseling national program introduced or expanded participant-directed personal assistance services for frail older adults and other people with disabilities in Pennsylvania and 14 other states. Cash and counseling, now called participant direction, is an approach to long-term care personal assistance services in which the government gives people cash allowances to pay for the services and goods they feel would best meet their personal care needs and counseling about managing their services.

The program was a joint venture between the Robert Wood Johnson Foundation and the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation.

Pennsylvania launched Services My Way, which let frail older adults with disabilities and other adults with disabilities design a service plan and choose the goods and personal assistance services they need to continue living at home based on a flexible spending plan. The state faced significant challenges in implementing Services My Way, which are covered in the sidebar.

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