People Who Direct Personal Care Services Are More Satisfied,
By Dave Reynolds, Inclusion Daily Express
April 15, 2003
WASHINGTON, DC--People who are able to direct their own in-home supports are much more satisfied -- and receive better care -- than those whose supports are directed by others, a new report reveals.
The report, published Tuesday on the Internet by the journal Health Affairs, surveyed 1,739 people who received Medicaid services through a program called "Cash and Counseling" in Arkansas. Participants received an average of $320 per month to hire in-home care staff to help with bathing, eating or housekeeping; to buy assistive devices or supplies; or modify their homes.
Those who receive in-home services were randomly assigned to an experimental group that could chose their services and providers, while the others received the traditional supports.
Researchers found that those who could control their services were "much less likely" than the traditional group to report that paid caregivers performed poorly, and more likely to say that they performed "exceptionally well."
They were nearly 20 percentage points more likely than the others to say they were "very satisfied" with the way they were spending their lives and were less likely to report unmet needs.
Those in the experimental group were no more likely to have health problems or accidents related to their care than those in the traditional group.
"This approach gives people with disabilities more freedom and responsibility, in the same way that all of us want to be in charge of our lives and our choices," said U.S. Health and Human Services Secretary Tommy G. Thompson in an HHS press release. "The study confirms that these Medicaid recipients make good choices that maintain their health and safety, even as they improve their convenience, satisfaction and quality of life."
Future research will look at other aspects of the Arkansas program and how "Cash and Counseling" is being implemented in New Jersey and Florida.
"Medicaid Recipients With Disabilities Benefit From Directing Their Own Personal Care Services, Study Finds" (HHS Press Release)