Leading Edge Resources: Individual and Family Support

ggPayments to Parents for Extra Caregiving. The Centers for Medicaid and Medicare Services (CMS) has re-evaluated its prohibition on payments to parents who provide the extra caregiving needed by their children with developmental disabilities. The new HCBS waiver application will permit states to compensate parents as paid caregivers as long as they develop, subject to CMS approval, written criteria for determining the circumstances under which such payments are justified. Minnesota's Department of Human Services adopted a long-term care assessment tool to distinguish between services that are a normal part of parental responsibility and those that exceed normal duties and warrant compensation. This is part of the MN Consumer Directed Community Supports Services (CDCS) waiver program. (http://edocs.dhs.state.mn.us/lfserver/Legacy/DHS-4270-ENG)  The Deficit Reduction Act of 2005 provides for payment of parents of minor children with disabilities through Section 6087 4(B)(i) At the election of the State —

(i) a participant may choose to use any individual capable of providing the assigned tasks including legally liable relatives as paid providers of service

Direct Payments for Support. An increasing number of countries are implementing direct payment programs. In England Local Authorities have been allowed to make cash payments to certain adults with disabilities for almost a decade. In 2000, Local Authorities could offer Direct Payments to parents of children with disabilities and adults with disabilities aged sixteen or over, as well as careers aged sixteen or over. In 2002, Direct Payments became mandatory — Local Authorities required to offer them to anyone receiving a community care package. Direct Payments are made to meet individuals' community care needs instead of using traditional services, thus allowing greater choice and control by individuals and families over their lives. In 2005, 872 families have been receiving direct payments for such services as personal assistance, domiciliary care, respite, and out of school activities.

In Canada a number of provinces have had direct payment programs for decades now. For instance, Special Services at Home in Ontario has provided individualized funding to thousands of adults and children. In some areas, the funding is managed by service agencies or government offices, while in others, the funding goes directly to the family.  Individualized funding arrangements have been a part of the system in British Columbia, Manitoba and Alberta for a number of years. In British Columbia, funding for attendant care services is paid directly to the individual.

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