Consumer and surrogate preferences for a cash option versus traditional services: Florida adults with developmental disabilities.

As long-term service expenditures have risen, policymakers have sought ways to control costs while maintaining consumer satisfaction. Concurrently, there is increasing interest in the disability community in consumer direction. The Cash and Counseling Demonstration and Evaluation (CCDE) seeks to increase consumer direction and control costs by offering a cash allowance and information services to persons with disabilities, enabling them to purchase needed assistance. Because the disability community is composed of diverse subgroups, needs of these consumer communities must be assessed individually. Results from a telephone survey conducted to assess the interest in a cash option for Florida adults with developmental disabilities is presented, the three-state CCDE described, how survey findings can inform consumer information efforts discussed, and policy issues highlighted.

Cash and counseling demonstration and evaluation. Start-up activities.

One possible approach for making long-term-care systems more consumer-directed is to provide the consumer with a cash alternative. Advocates have touted the possible advantages of this approach, while nay-sayers have worried about the potential for abuse and questioned the claims of cost savings. This article describes the Cash and Counseling Project, a large-scale demonstration project with a rigorous, policy-driven evaluation built into it. Written prior to the project's actual implementation, this article specifically reviews the major evaluation questions, and the state selection process.

Determining consumer preferences for a cash option: Arkansas survey results.

As long-term care (LTC) expenditures have risen, policymakers have sought ways to control costs while maintaining consumer satisfaction. Concurrently, there is increasing interest within the aging and disability communities in consumer-directed care. The Cash and Counseling Demonstration and Evaluation (CCDE) seeks to increase consumer direction and control costs by offering a cash allowance and information services to persons with disabilities, enabling them to purchase needed assistance. The authors present results from a telephone survey conducted to assess consumer preferences for a cash option in Arkansas and describe how findings from the four-State CCDE can inform consumer information efforts and policymakers.

Adopting a disability approach to home care services for older adults.

The disability and aging communities differ significantly in their perceptions, definitions, and values about the independence and autonomy of disabled individuals. These viewpoints are reflected in the different services and goals of personal assistance provided to older and younger disabled persons. We explore the applicability of the disability approach to personal assistance for older persons and offer ethical, practice-oriented, and political arguments for the aging community to adopt this approach. We also review past efforts toward achieving a "unified agenda" between the aging and disability communities and outline possible future initiatives.

Paid family caregiving and the market view of home care: agency perspectives.

Home care agency administrators were surveyed to explore their views on hiring kin to care for their own relatives. The results suggest that formal systems may tend to view paid family caregiving in ways similar to policy makers who express concern about substitution for unpaid care and runaway costs. Many administrators expected that families may abuse the program and accept pay for work not performed. A major implication of the study is that implementation of family compensation through agencies could result in attempts to focus on controlling informal care.

Community agency support of family caregiving.

Agencies that provided home care services for the elderly were surveyed to identify the services that they provided to support family caregivers. More than one-third of the responding agencies provided various family supports, including referral information, training and support groups, counseling, and hiring of family members as caregivers. Agencies favored expanding concrete and psychosocial services rather than financial supports.

A marketing strategy for the dental public health profession: what is it? Why is it needed?

A personnel management problem exists within dental public health that interferes with its mission of improving the nation's oral health. A major cause of this problem may be that many administrators who write position descriptions and hire professional staff are unaware of differences between clinical and public health dental practitioners. A marketing plan has been developed to address this lack of awareness about proper use of dental public health professionals. Its main goal is to establish more appropriate personnel and employment practices within dental public health. The expected outcomes of this plan could assist both recipients of dental public health services and members of the profession. The purpose of this article is to introduce the marketing strategy to dental public health professionals.