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New Center Helps States, Others Implement, Expand, Improve Participant-Directed Long-Term Care Programs

Resource type: News

Boston College Graduate School of Social Work |

BOSTON, MA (April 6, 2009) The Boston College Graduate School of Social Work today launched a new technical assistance center that offers states the tools they need to implement a wide variety of participant-directed long-term care programs. The National Resource Center for Participant-Directed Services is the only national center of its kind and is available to assist states and other entities that want to offer, or already offer, participant-directed services to people with disabilities. Participant-directed (also called consumer-directed and self-directed) long-term care programs help people of all ages across all types of disabilities maintain their independence and determine for themselves what mix of personal care services and supports work best for them. The mission of the National Resource Center is to give every person eligible to receive publicly funded long-term care services and supports the option to manage those services for themselves at home, said Kevin J. Mahoney, PhD, director of the new Center and a professor at Boston College. The National Resource Center for Participant-Directed Services will provide technical assistance, training, research, and policy analysis to states and other organizations with the goal of improving the lives of people of all ages with all types of disabilities who want to maintain their independence and freedom to direct their own services and supports. The Center is funded by a $4.75 million grant from the Robert Wood Johnson Foundation, a $3.5 million grant from The Atlantic Philanthropies, and additional support from the U.S. Administration on Aging and the Office for the Assistant Secretary for Planning and Evaluation, and the Veterans Health Administration. The National Resource Center builds on the lessons learned from the successful Cash & Counseling program (, which has been implemented in 15 states. That program allows its participants to choose the type of services they receive, who provides those services and when, and to manage their own budgets to pay for the mix of goods and services that best meet their needs. Specifically, the Center can provide technical assistance to Area Agencies on Aging, Centers for Independent Living, and other organizations that are instrumental in implementing participant-directed programs. The Center will work closely with the National Participant Network, which brings together participants from different Cash & Counseling states to build involvement at the state level and provide feedback for program development and successful implementation of participant-directed services. The new Center will be a tremendous resource for states and others that want to successfully introduce or sustain a participant-directed long-term care program, said William Ditto, Director, New Jersey Division of Disability Services. Kevin Mahoney and his team helped New Jersey successfully transition our Personal Preference program from a small Cash & Counseling demonstration program to a fully integrated, state-supported option with more than 750 participants and more people enrolling every month. The National Resource Center for Participant-Directed Services, which officially launched this month, will offer a wide variety of services, including: Individual Consulting: The Center is staffed by a team of experts in participant-directed services. They are available to help states and other organizations design and implement participant-direction programs, evaluate existing programs, and/or recommend improvements in all aspects of participant-directed services, including: policy development, quality assurance, financial management support services, and program oversight. Membership Program: Member benefits include updates on the latest developments in participant-direction, opportunities for peer-to-peer networking and support, and direct help with troubleshooting program problems and improving program operations. Research: The Center will manage a broad research agenda, including conducting research on promising practices in participant-direction and the impact of participant-directed programs. Research in the first year of operation will include an inventory of participant-direction programs nationwide. Training: The Center will offer several training modules in different program areas, including helping states train the consultants who will help to administer their participant-direction programs. Additional modules are in development. Public Policy: The Center will implement a public policy strategy that furthers research, knowledge, and understanding of self-direction for current and potential stakeholders. Participant Involvement: The Center is committed to engaging and sustaining the involvement of participants with disabilities and their caregivers in the design, implementation, evaluation, improvement, and sustainability of participant-directed services. This includes developing plans and processes for helping both state programs and the Center involve participants at all programmatic levels. Internet-Based Resources: The National Resource Center’s web site ( will house a number of tools, including an online handbook written and edited by experts involved with the Cash & Counseling program. Developing and ImplementingSelf-Direction Programs and Policies: A Handbook will be a useful tool for all those working to develop or expand participant-direction programs. Chapters cover topics such as: legal authority, financial management services, individual budgeting, quality management, and involving program participants in design and implementation. The Handbook is now available for download online at Extensive research has shown that participants are overwhelmingly satisfied with self-directed programs, and demand for these services has grown.Beginning in 2007, the federal Deficit Reduction Act provided every state with new, expanded opportunities to implement participant-directed care programs as part of their regular Medicaid State Plans. That, coupled with changes in the Older Americans Act, has paved the way for participant-directed programs to reach every state and every major disability group, from the elderly to children-including persons with all types of physical and intellectual disabilities. Our vision is that, one day, high-quality, participant-directed care programs, based on the hallmarks of the very successful Cash & Counseling program, will be the primary way that all states make personal care services available to eligible residents with disabilities-with a traditional direct-care plan available as an option rather than as a default plan, said Mahoney. For more information about the National Resource Center for Participant-Directed Services, please visit our website at:

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