| March 30, 2007
Consumer-Directed Care
The basic premise of consumer-directed care is that individuals receiving the service are able to determine what they require and can use good judgment in purchasing and overseeing service delivery.
5 factors influencing policy development
Advocacy - Adults, primarily those who are under 65 and disabled, have been strong advocates of increasing their ability to manage and direct their own services.
Olmstead decision - This 1999 Supreme Court case determined that states have a legal obligation to serve individuals disabilities in a setting that reflects the individual’s preferences.
Cost - Both federal and state governments face increasing Medicaid long-term care costs, which have increased their willingness to test service alternative approaches.
Workforce shortages - Many states are facing critical shortages in the direct long-term care workforce, which results in some consumers-- especially those in rural areas -- not receiving needed services. Consumer-directed models of service delivery may expand the labor pool by allowing consumers to hire a friend, family member or neighbor to provide direct care services.
Changing perceptions - Many believe that the philosophy of care should move from a medical to a social model. Consumer-directed models can create a flexible array of services that can be responsive to factors such as a person's involvement in the community or their interest in entering the workforce.
Source: Health Affair
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 The move to
consumer-directed models of service
As more people choose to age in their own homes, the concept of consumer-directed care has received a degree of acceptance in the field of aging, as well as among policymakers.
States have been developing options for disabled Medicaid beneficiaries to manage and direct their home- and community-based services, including hiring their own providers as an alternative to the traditional professional management model of using agency-based providers.
Characteristics of consumer-directed care:
- Employee/employer relationship between consumer and service provider
- Definition of “provider” is deliberately loose and may include anyone passing a criminal background check, including friends or family members
- No required licensing or government oversight for personal care attendants, as is required by the professional management model of care delivery
A 1999 U.S. Department of Health and Human Services report, In-Home Supportive Services for the Elderly and Disabled: A Comparison of Client-Directed and Professional Management Models of Service Delivery, included review of a 1995
UCLA study. In the study, two models of care were compared -- consumer-directed and case-management models:
- The consumer-directed model had more desirable outcomes than clients in the case-management model within three broadly defined areas: satisfaction with services, empowerment, and quality of life.
- No significant differences were found in outcomes between the two models in two other areas: client safety and unmet needs.
- The study also compared outcomes for people using the consumer-directed model who hired family members as paid workers with those of consumers who employed non-family members. No differences were found with respect to the frequency of reported unmet needs or on quality of life measures for consumers who hired family members as paid workers as compared with those who employed non-family members.
- Consumers who hired family members had more desirable outcomes on some measures in the areas of safety, satisfaction with services and empowerment.
- Clients whose aides were family members reported a greater sense of security, having more choice about how their aides performed various tasks, a stronger preference for directing their aides and a closer rapport with their aides.
In Indiana, the consumer has the ability to hire private care through the CHOICE (Community and Home Options to Institutional Care for the Elderly and Disabled) program. For more on Indiana’s efforts to expand consumer-directed services, see pages 32 and 33 of the Indiana State Plan for Aging and In-Home Services. |
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University of Indianapolis Center for Aging & Community presents
an IN Place series event:
"Empowering Indiana Families to Meet the Challenges of Population Aging:
Taking Charge and Taking Action"
Speaker: JoAnn Burke, PhD
Coordinator, Elderhood Institute, St. Mary's College
Wednesday, April 18, 2007
INDIANAPOLIS
co-hosted by Elder Source & Elder Friendly Communities
Jewish Community Center - Laikin Auditorium
6905 Hoover Road
8:00-8:30am Continental breakfast
8:30-9:30 Presentation
9:30-10:00am Q&A
MUNCIE*
co-hosted by LifeStream Services, Inc.
Maring Hunt Library
2005 S. High Street, Muncie, IN
1:30-2:30pm Presentation
2:30-3:00pm Q&A
There is no charge to attend either presentation, but RSVPs are requested. RSVP to Lidia Dubicki at (317) 791-5930 or via e-mail by Friday, April 13.
*Note: This is a change of location from what was previously published.
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Aging network updates
St.Vincent Institute on Aging has a new name:
St.Vincent Center for Healthy Aging. The new moniker better reflects the organization's long-standing mission "to help adults successfully age by providing a proactive and holistic view of their health, looking at their physical, cognitive, emotional, social, spiritual and nutritional wellness needs," said a letter from Dr. Diane Healey, CHA's medical director.
Go tropical at the Indiana Health Care Association annual conference, April 10-12 in Indianapolis. Open to healthcare organizations and adult day and adult foster care providers, the two-day event will have a tropical flair. Casual wear -- Hawaiian shirts included -- is encouraged. For more information or to register, visit the
IHCA website.
"What Are Old People For? How Elders Will Save the World" is the topic of a free presentation by Dr. William H. Thomas, scheduled for Wednesday, April 18 from 5:30-6:30pm. The event is part of the 2007 Kirkpatrick Lecture Series sponsored by Ball State University Fisher Institute for Wellness and Gerontology and will be held at the Alumni Center at Ball State University in Muncie. Call the Community Center for Vital Aging at (765) 289-4541 for more information.
4th Annual Indiana Conference on Aging Well will be held Thursday, May 17 at the Ball State University Alumni Center. The keynote speaker will be Jean Deeds, author of There Are Mountains to Climb. Click here for more information.
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Training available for nonprofits
The United Way of Central Indiana's Nonprofit Training Center will host a morning of training for people who work in nonprofit organizations on Wednesday, April 25 from 8am to noon. The keynote speaker will be award-winning marketing professional Lorraine Ball, who will address the "Dos and Don’ts of Nonprofit Marketing." Participants can also choose to attend two additional breakout sessions. For more information or to register, visit the
UWCI website.
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 Grants to go for
Community Health Projects Call for Proposals
The Local Initiative Funding Partners Program, in partnership with the Robert Wood Johnson Foundation, supports community-based projects that focus on the health or health care problems of people who are not reached by traditional health and social services or for whom existing systems are fragmented and insufficient.
The program provides grants of $200,000 to $500,000 per project, which must be matched dollar for dollar by local grantmakers. Application due date is July 10, 2007.
Community College Encore Career Project
Grants will be awarded to community colleges that help attract, prepare, or place adults age 50 or older in new careers in education, health care, and social services. Grants will not support cultural, personal, or recreational activities.
Ten grants of up to $25,000 each will be awarded. Application due date is May 1, 2007. For more information: http://www.civicventures.org/communitycolleges/
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Have news to share?
If you have an idea or suggestion for the IANA e-news, or if your organization has an announcement you would like published, please contact Amy Magan at amagan@uindy.edu or (317) 791-5933. Announcements should be no more than 200 words and should be applicable to aging service providers. All submissions are subject to editing for length and clarity.
The IANA e-news is published monthly by the University of Indianapolis Center for Aging & Community. | |
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University of Indianapolis Center for Aging & Community
901 S. Shelby Street Indianapolis, IN 46203
(317) 791-5930 PHONE (317) 791-5945 FAX http://cac.uindy.edu
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