New State Strategies to Meet Long-Term Care Needs

Year in Research Nominee for 2010

Consumer-directed long-term care service programs give participants the flexibility they want, while reducing unmet need for home and community-based services and supports. States’ efforts to expand such programs under Medicaid, including those supported by federal Cash and Counseling demonstration and evaluation grants, are often hindered by challenges related to costs, staffing and organizational issues, new infrastructure requirements, and resistance from stakeholders. Yet states have developed a number of successful strategies for overcoming these challenges, even in financially trying times. Their experiences offer valuable insights, guidance, and encouragement to other states contemplating consumer-directed service expansions.

The Robert Wood Johnson Foundation funded Cash & Counseling demonstration sites and an evaluation of the initiative between 1995 and 2009.