Effects of Cash and Counseling on Personal Care and Well-Being

Medicaid beneficiaries who have disabilities and receive traditional support services from Medicaid agencies often have little control over their care. Cash and Counseling is a flexible, consumer-driven program that gives Medicaid beneficiaries a monthly allowance. With this allowance they can purchase goods and services that facilitate independence, and they can hire whomever they like as caregivers, including family members and friends. This paper examines the effects of Cash and Counseling on the types and amount of personal assistance services Medicaid beneficiaries received, on the beneficiaries’ satisfaction with their care, and on their overall well-being.