Where are they now? Cash and Counseling successes and challenges over time.
The positive results of the Cash & Counseling Demonstration and Evaluation (CCDE) led to the funding of a replication project that included 12 more states in 2008. Since then, the political and economic environments have changed. The authors sought to investigate how well the three original and 12 replication CCDE programs are coping with current challenges, and how their experiences may inform the growth and sustainability of emerging participant-directed programs. Semistructured telephone interviews were conducted with the 15 Cash & Counseling state program administrators. Key topics addressed included: successful aspects of state programs, biggest challenges for each program, and information program administrators would like to learn from state colleagues. Themes related to budget issues (e.g., staff shortages and program funding cuts) and non-budget related issues (e.g., understanding of program operations) emerged from the interviews. State program administrators also discussed program successes. To promote the sustainability and growth of participant-directed programs, existing participant-directed programs should be tied to national policy trends as well as review whether or not the programs address participant-directed principles. The development of new participant-directed programs should be based on other states' experiences as discussed in this paper.
University of Maryland, College Park.
Lori
L
Simon-Rusinowitz
Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina.
Abby J
AJ
Schwartz
University of Maryland Center on Aging, College Park.
Dawn
D
Loughlin
The Pennsylvania State University, University Park.
Mark
M
Sciegaj
Boston College Graduate School of Social Work, Chestnut Hill, MA.
Kevin J
KJ
Mahoney
Open Text, Rockville, Maryland.
Yaw
Y
Donkoh
D003376:Counseling; D003657:Decision Making; D006233:Persons with Disabilities; D006699:Home Care Services; D007407:Interviews as Topic; D008484:Medicaid / Q000191:economics*; D057240:Patient Preference; D015397:Program Evaluation; D014481:United States; D014483:United States Dept. of Health and Human Services
budget authority; employer authority; long-term services and supports; participant direction