Forum Session

Long-Term Services and Supports: Consumers in Charge—Consumer Direction and Money Follows the Person
November 7, 2008


Carol V. O'Shaughnessy, MA


Many Medicaid beneficiaries with disabilities have limited choices about their living arrangements and services they need to live independently. They access personal care services primarily from Medicaid-approved agency providers; if consumers are eligible for a broader array of home and community-based services (HCBS), a professional case manager authorizes a care plan and arranges services from approved providers. For some, institutions are the only choice. In recent years, federal policy efforts, including a series of grants to states and two major demonstrations—Cash and Counseling and Money Follows the Person (MFP)—have focused attention on offering Medicaid consumers more choice in arranging supportive long-term care services and helping them transition from institutions to community settings. This Forum session highlighted state efforts to promote consumer-directed long-term care services and state observations about activities under MFP demonstration grants.


Joshua M. Wiener, PhD, Senior Fellow and Program Director, Aging, Disability, and Long-Term Care, RTI International; Herb Sanderson, Associate State Director for Advocacy, AARP Arkansas; Marc Gold, Director, Promoting Independence Initiative, Texas Department of Aging and Disability Services; Maureen Hollowell, Director, Advocacy and Services, Endependence Center, Norfolk, Virginia

Slides from the presentations by Dr. Wiener , Mr. Sanderson , Mr. Gold , and Ms. Hollowell are available for download. Speakers’ biographies are also available.

Related Materials

See also two documents handed out at the meeting: a fact sheet on CMS Programs for Self-Directed Care ; and Mathematica's Research Design Report for the Evaluation of the Money Follows the Person (MFP) Grant Program, Final Report" (October 3, 2008).

For more information on the Cash and Counseling demonstration funded by the Robert Wood Johnson Foundation and the Department of Health and Human Services, see "Choosing Independence: An Overview of the Cash and Counseling Model of Self-Directed Personal Assistance Services" (2006). See also the Robert Wood Johnson Foundation Web site for information on the Cash and Counseling National Program Office at Boston College Graduate School of Social Work.

For an overview of long-term care spending, see "National Spending for Long-Term Services and Supports (LTSS), 2012," (The Basics, March 27, 2014). See also the entry a related Forum session held September 2007.

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