From State Health Watch (v14,n1)...HSR: Health Servies Research is publishing a special issue (February 2007 - Vol. 42 Issue 1,pt2, pp.353-586--the link may only connect for individual or institutional subscribers) devoted to the Cash & Counseling Medicaid demonstration program. The demonstration started in FL, NJ, and AR, and it has since expanded to 12 other states.
Targeted primarily at long-term care (i.e., nursing facilities) and home and community based services (HCBS) available through Medicaid, the program awards funds to Medicaid recipients to be used to purchase personal care or assistive services, instead of relying upon direct funding to home care agencies. Briefly, the program led to somewhat increased program costs because consumers randomly assigned to the demonstration connected themselves to more support services and these additional services identified greater health care needs than had been addressed, whereas individuals in the usual care condition were less likely to receive care at all. The demonstration also helped individuals in areas with a labor shortage to obtain support services more easily than those in usual care.
HCBS is a Medicaid funding option in other states that may allow substitution of outpatient services for residential substance abuse treatment or enhancement of residential treatment with community support services. What opportunities might there be for adolescents and their families to use this model? What capacity is there for Tennessee to implement such a model? What are the costs and benefits of such a change?
Update: For those interested in obtaining copies of the HSR articles, email me and I will try to connect you to them.
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