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Tritz, Karen. (2005). Long-Term Care: Consumer-Directed Services Under Medicaid. Congressional Research Service, Order Code RL 32219. Retrieved June 29, 2005, from http://www.law.umaryland.edu/marshall/crsreports/index.asp?AlphaStart=L
Abstract
Legislation to expand consumer-directed Medicaid long-term care services has been introduced in each of the last three Congresses. The legislation would have required states to cover personal care attendant services under the Medicaid state plan for certain Medicaid-eligible individuals. The legislation also specified that the consumer (or his or her representative) must be allowed to select, manage and dismiss his or her personal care attendant(s). Similar legislation is expected to be introduced in the 109th Congress.
The Centers for Medicare and Medicaid Services (CMS) and others have undertaken initiatives to facilitate states operating consumer-directed programs. One of the more well known of these programs is the Cash and Counseling Demonstration. As Congress considers proposals to encourage development in this direction, it faces such questions as: What beneficiary protections need to be built into these programs? How does one ensure the quality of consumer-directed services, and under what circumstances should states be required to seek a federal waiver?
This report discusses options for consumer-directed services under Medicaid; factors states need to take into account in developing consumer-directed programs; and considerations for future policy development. This report will be updated as necessary to reflect any substantive program or policy changes. (From the abstract at http://www.law.umaryland.edu/marshall/crsreports/crsdocuments/RL322191212005.pdf)
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