title: New state strategies to meet long-term care needs.
abstract: 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.
authors.affiliation: Office of the Assistant Secretary for Planning andEvaluation, US Department of Health andHuman Services inWashington, DC, USA. Pamela.Doty@hhs.gov
authors.forename: Pamela
authors.initials: P
authors.lastname: Doty
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Mahoney
authors.forename: Mark
authors.initials: M
authors.lastname: Sciegaj
mesh_terms: D000368:Aged; D018672:Community Health Planning / Q000379:methods*; D003256:Community Participation; D005380:Financing, Government; D006078:Government Programs; D006287:Health Planning Guidelines; D006301:Health Services Needs and Demand; D006801:Humans; D007353:Insurance, Long-Term Care / Q000331:legislation & jurisprudence; D008134:Long-Term Care / Q000379:methods*; D006278:Medicare / Q000191:economics; D016730:Program Development; D012052:Reimbursement, Incentive; D013219:State Government; D014481:United States