1. Utilizing Cash & Counseling Lessons Learned to Inform Participant Direction: A Closer Look at Controversial Topics The National Resource Center for Participant-Directed Services (NRCPDS) February 16, 2011 National Grantee Meeting

2. Session Overview Session Goal: An opportunity for open dialogue based on research and practice to support the continued growth and success of participant direction. Introductions Brief overview of participant direction and relevant public policy topics Multi-perspective panel discussion on controversial topics Open discussion

3. Presenter Introductions Erin McGaffigan (Moderator) Public Policy Lead, NRCPDS Lori Simon-Rusinowitz Director of Research, NRCPDS Dianne Kayala Director of New Initiatives, NRCPDS Lynn Griffin New Mexico Family Member and Advisory Group Member Merle Edwards-Orr State Unit on Aging at the Vermont Department of Disabilities, Aging and Independent Living

4. A Note About Our Session It will be “participant-driven” Diversity of the panelists and their opinions is intentional Active involvement of the audience is critical

5. What is your area of focus? 1.Aging Services 2.Disability Services 3.Veterans Services 4.Aging & Disability Services 5.A Mix of the Above

6. How knowledgeable of participant direction would you say you are? 1.Extremely knowledgeable 2.Knowledgeable 3.Somewhat knowledgeable 4.This is new to me

7. What are Participant-Directed Services? Long-term care services that 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 Sometimes referred to as “consumer-directed” or “self-directed” services

8. Cash & Counseling Elements Person-driven assessment Representative option Transparent and equitable individual budget Support broker/ Consultant services Financial management services Design of a spending plan Ability to hire workers and purchase goods and services Participant-driven quality management system Emergency back-up planning

9. Our History Cash & Counseling enrollment began in 1998 as a three-state demonstration program in Arkansas, Florida and New Jersey. Replication of Cash & Counseling included 12 additional states. Funded by The Robert Wood Johnson Foundation, HHS Office of the Assistant Secretary for Planning and Evaluation, and the Administration on Aging. Collaboration between Boston College Graduate School of Social and University of Maryland.

10. The National Resource Center for Participant-Directed Services (NRCPDS) Center was launched in April 2009 and funded by:  The Robert Wood Johnson Foundation  The Atlantic Philanthropies  Additional project-based support from: U.S. Administration on Aging Office for the Assistant Secretary for Planning and Evaluation Veterans Health Administration Housed at Boston College Graduate School of Social Work

11. Employer Authority (Participant Employer of Record) Employer Authority (Agency Employer of Record) State Programs with Employer Authority 11

12. 15 Cash & Counseling States 20 Additional States with Budget Authority Programs Growth of Budget Authority Programs 12

13. Do you currently work with participants who hire their own workers and/or manage an individual budget? 1.Yes- Hiring workers only 2.Yes- Individual budgets 3.No, not yet

14. Panelists 14 Lori Simon-Rusinowitz Director of Research, NRCPDS Dianne Kayala Director of New Initiatives, NRCPDS Lynn Griffin Participant Family Member and Advisory Group Member Merle Edwards-Orr State Unit on Aging at the Vermont Department of Disabilities, Aging and Independent Living

15. Panel Process Panelists will have an opportunity to provide insights on 3 important topics (from a larger list of 6) chosen by the audience Each topic will receive a total of 15 minutes Moderator will ensure diverse points are made within time allotted

16. Which topic would you like the panel to address first?  Hiring Relatives  Worker Training  Innovative Purchasing of Goods and Services  Addressing Quality and Monitoring Fraud & Abuse  Implementation Operational Issues  Cost Containment

18. Which topic would you like the panel to address next? 1.Hiring Relatives 2.Worker Training 3.Innovative Purchasing of Goods and Services 4.Addressing Quality and Monitoring Fraud & Abuse 5.Implementation Operational Issues 6.Cost Containment

20. Which topic would you like the panel to address last? 1.Hiring Relatives 2.Worker Training 3.Innovative Purchasing of Goods and Services 4.Addressing Quality and Monitoring Fraud & Abuse 5.Implementation Operational Issues 6.Cost Containment

22. Closing Remarks & Open Discussion

23. Thank you & Follow-up To reach presenters… Erin McGaffigan erin.mcgaffigan@bc.edu erin.mcgaffigan@bc.edu 781-944-1853 ParticipantDirection.org