During the pandemic, most states allowed some form of payment to family caregivers whose loved ones were receiving Medicaid home and community-based services (HCBS). As those payments dry up, workforce shortages could be exacerbated. Twelve... read more
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"The Elizabeth Dole Home Care Act" would expand access to home and community-based services for aging Veterans, including an expansion of the Veteran Directed Care program.... read more
A disability-rights advocate pleaded with Missouri mental health officials not to implement a policy change for at-home caregivers. At issue is a decision by the Missouri Department of Mental Health to change how it calculates rates for... read more
Missouri’s Department of Mental Health announced in July that the Self-Directed Supports program could be excluded from a rate increase for caregivers. Complicating matters even more, state regulators have proposed a change in how it calculates... read more
If all goes as planned, a recent state proposal will help In Home Supportive Services caregivers in California, which could increase compensation for family members who are putting in long hard hours, many without pay. At the state level, recent... read more
For people with developmental disabilities, the state of New York offers two forms of support—traditional and self-directing. But self-directed services, which provide more flexibility and independence, are significantly underused by people of... read more
The Arizona Health Care Cost Containment System (AHCCCS) is in the process of requesting an amendment to the state’s active 1115 demonstration that would provide permanent payments to parents who act as paid caregivers for their minor children.... read more
End of the COVID-19 public health emergency has many states revisiting waivers that allowed payments to disabled Americans’ parents and relatives.... read more
Medicaid funds are distributed to these families primarily through two vehicles, the Supports Program and the Community Care Program. Because the Community Care Program generally provides richer benefits than the Support Program, there is a... read more
You probably don’t associate dressing up as Taylor Swift or Barbie with getting the vital health care treatment you need. But Minneapolis resident Jen Onsum has taken it upon herself to stand out from the crowd with fun clothes and funny posts on... read more
Arizona may pay parents who are caregivers of minor children with disabilities. Arizona parents who are caregivers for children with disabilities have been getting paid for their caregiving since the COVID-19 pandemic, and that temporary payment... read more
In the last 20 years, several new authorities have been created, allowing states to also offer Home and Community-Based Services (HCBS) through the Medicaid state plan. Review the list of authorities that allow benefits including section 1915(j)... read more
The Centers for Medicare & Medicaid Services (CMS) released updated guidance that will extend COVID-19 public health emergency (PHE) flexibilities approved in the states' section 1915(c) home- and community-based services (HCBS) waiver... read more
Home and community-based services allow veterans to “age in place” while receiving the care and support they need. They also cost less than institutional care facilities. As these U.S. Department of Veterans Affairs (VA) programs expand, it will... read more
The Louisiana Department of Health received federal approval on July 22 to begin issuing bonus payments to direct support workers who served waiver participants during the pandemic. Direct Support/Service Worker/Professionals (DSWs) and Self-... read more
The Appendix K waiver allowed home and community-based service (HCBS) providers more wiggle room during emergencies, such as the COVID-19 pandemic. Centers for Medicare & Medicaid Services (CMS) introduced the waiver to support states in... read more
A new State Medicaid Director Letter offers policy guidance on the extension. CMS is now indicating through this guidance that COVID-19 Appendix K flexibilities currently approved to end six months after the expiration of the PHE may be extended... read more
A key takeaway for readers of Self-Direction: A Revolution in Human Services is that self-direction is a philosophy, not a single model. Self-direction has been used to support many different populations with a wide range of needs in a wide... read more
“‘Essential workers’ has always had a certain meaning to those of us receiving in-home services. But essential is not synonymous with stead.” Keith Williams (a member of Applied Self-Direction’s Participant Council) is the manager of independent... read more
Data from the state shows that the hours allocated for community attendant services are not being filled, and it could be costing the state billions of dollars. While many Texans do without the care they need, those with nearby family often have... read more
State Rep. Al Cutrona of Ohio has introduced legislation to give further choices and support for Medicaid self-direction services. According to Cutrona, self-directed Medicaid services give participants the authority over certain services and... read more
The Virginia Department of Medical Assistance Services recently released revised guidelines for state Medicaid disability waiver programs which would allow certain family members who provide caregiving services for their child or spouse with... read more
State officials will soon create a registry of direct support professionals — or DSPs — who provide in-home care to people with mental and developmental disabilities. The goal is to track abuse and neglect. Advocates say the registry only partly... read more
The state’s Choices for Independence waiver program through Medicaid, known as CFI, allows friends and family caregivers, and now legal guardians and legally responsible adults, to be paid for providing care for loved ones, as long as the... read more
90 awardees for Medicaid home and community-based services (HCBS) grants that will improve services for people who are older or have a disability, helping them remain in their home or community. Projects will benefit members of Wisconsin Medicaid... read more
Jay Steinhardt, 67, lives with a number of health-related challenges, including epilepsy. But he’s managed to live on his own for most of his adult life. “I have a lot of doctors appointments,” Steinhardt said. “I also have a lot of community... read more
The Rhode Island Self-Direct Coalition (RISDC), is excited to announce that they have officially begun to recruit, train and refer Direct Support Professionals (DSPs) who will provide practical daily assistance to individuals with intellectual... read more
Roughly one quarter of Coloradans are living with some form of intellectual or developmental disability. In the most serious cases, medical advances have increased life spans, but that newfound longevity has created a host of challenges for... read more
Nathan Hill started receiving $12.75 an hour from a state Medicaid program to help care for his severely disabled son during the pandemic, money he said allowed his family to stop using food stamps. The program was designed to provide a... read more
The New York State Independent Living Council (NYSILC) inducted two veteran advocates for individuals with disabilities, Debra (Debbie) Bonomo and Kathy Lynch, into the New York State Disability Rights Hall of Fame. Ms. Lynch has dedicated... read more
Ryan Donnelly, advocacy coordinator at Granite State Independent Living (an Applied Self-Direction member) told state lawmakers that shortages of direct care workers are forcing our consumers to make difficult choices. Some have made or are... read more
With elder care in the spotlight this legislative session, lawmakers adopted key reforms aimed at boosting transparency in how nursing home managers spend taxpayer money and increasing oversight of the state’s more than 900 homemaker companion... read more
In a continued effort to support veterans across rural America, Chairman Jon Tester led a Senate Veterans’ Affairs Committee hearing where he pushed officials from the Department of Veterans Affairs (VA) and Centers for Medicare and Medicaid... read more
A bipartisan House bill to expand resources and support services for residents with intellectual or developmental disabilities won unanimous passage in the Senate. It now heads to the governor’s desk for final signature. The bill addresses the... read more
Executive Director Carl Blake testified before the Senate Committee on Veterans' Affairs (VA) on the importance of Veterans' access to long-term care. He urged Congress to eliminate the cap on Home and Community-Based Services, allow VA to cover... read more
Andrew Strelczyk lost his vision and both legs before he was 60, in a string of accidents that could befall anyone. Now 70, he’s eligible for a nursing home but is determined to continue living in his Nashua apartment, listening to classical... read more
Dennis Heaphy, lead researcher at the Disability Policy Consortium, lives in Back Bay and has used personal care attendants (PCAs) since the mid-1980s. Heaphy said the program allows him to live a meaningful life with opportunities he might not... read more
The growing demand for waivers makes it challenging for families to get immediate help. At the end of 2021, 11Alive found 7,047 people were on a waiting list. As of May 1, 2023, the Georgia Department of Behavioral Health and Developmental... read more
The budget amends Section 3614-f of the Public Health Law by adding a new subsection permitting the Department of Health to address an inquiry requesting records and information concerning wages, compensation, and other benefits to home care... read more
Johnston with support from former Onondaga County Executive Nick Pirro launched an experimental Medicaid program in Onondaga County in 1992 that allowed chronically ill or physically disabled people to hire caregivers to help them at home so they... read more
Governor Maura Healey lamented the “crisis-level” shortages in MassHealth’s Personal Care Attendant Program earlier this year. Fixing it, she pledged, would crown “the top of the list.” A tweak in policy would help. MassHealth allows consumers to... read more
New York State is attempting to eliminate hundreds of agencies, including those that specialize in helping diverse cultural populations and serving those in poverty-stricken areas. Under current law, New York State will be closing hundreds of... read more
More than half a million Americans with intellectual and developmental disabilities are currently waiting for government funding for long-term care in their homes. Many states are working to clear their waitlists for IDD services by investing in... read more
After outcry from hundreds of families and letters from state Democrats, Virginia plans to study whether a Maryland program allowing certain family members to be paid for caregiving services for people with disabilities can be adopted in the... read more
Not all third-party payroll service providers are created equal. A trusted, qualified company can help keep businesses secure and tax compliant. This IRS Tax Tip provides a quick overview of the various types of third-party payroll service... read more
Since the start of the COVID-19 pandemic, Virginia has directly paid parents and spouses to provide personal care services for disabled children under 18, as well as disabled husbands or wives, through certain Medicaid waivers. This emergency... read more
This New York-based provider has recently made a major shift and doubled down on its consumer-directed care program. The program gives seniors and children who need at-home care an alternative caregiver model in an industry where employees are... read more
Review an updated analysis of states’ American Rescue Plan Act (ARPA) spending plans. The data is based on the most recent spending plan submissions required by the Centers for Medicare and Medicaid Services (CMS). The table includes an indicator... read more
The Outsider Collective started helping artistically-minded people follow their muses. The artists are people with developmental disabilities who’ve elected to access “Self-Directed Supports” instead of traditional services a person would receive... read more
How did states support Medicaid home- and community-based services (HCBS) during the public health emergency (PHE)? States used several types of authorities when responding to the COVID-19 PHE, including disaster-relief state plan amendments,... read more
President Biden announced the most comprehensive set of executive actions any President has ever taken to improve care for hard-working families while supporting care workers and family caregivers. The Executive Order includes more than 50... read more
Colorado U.S. Senator Michael Bennet led sixteen Senate colleagues to reintroduce the Latonya Reeves Freedom Act. The bill would strengthen the civil right of Americans with disabilities to receive long-term services and supports (LTSS) in the... read more
eVero Corporation has released the results of a survey on challenges faced by intellectual and developmental disabilities (I/DD) providers in implementing and managing self-direction programs in New York. Prominent areas covered in this survey... read more
Self-direction increased in prevalence during the public health emergency. One of the White House’s directives would expand access to it for veterans as well. “That’s a big deal for self-direction, to start, to share the national spotlight with... read more
New York State approved a raise of $2.50 an hour for home healthcare workers but the state, the healthcare workers, and the agencies that pay them say some insurance companies are keeping most of it. What agencies typically saw upstate was... read more
The Office for People With Developmental Disabilities (OPWDD) and the Department of Health (DOH) are in the process of making changes to the agreement that OPWDD has with the federal government called the OPWDD 1915(c) Comprehensive Home and... read more
In 2021, about 74% of New Yorkers who need home care workers couldn’t retain them, according to a study authored by the Consumer Directed Personal Assistance Association of New York State. Advocates say New York’s ability to increase wages for... read more
Findings from a new study on Texas Medicaid released last week revealed numerous systemic issues that are having a compounding negative effect on access for beneficiaries, ranging from the state’s workforce shortages to Medicaid policies that... read more
This is the final report in a four-part series about Connecticut’s aging population and the challenges in finding ways to care for people. More people are aging in place. But the state’s home care industry operates with little oversight. Just... read more
Laurie Truesdell of Mesquite is managing her own budget under Medicaid. Truesdell, who from birth has had cerebral palsy, said she waited seven years to get off a state waiting list for Community Living Assistance and Support Services, or CLASS,... read more
Self-directed care (SDC) is a treatment model in which recipients self-manage funds designated for provision of services. The model is designed to cost no more than traditional services while achieving superior participant outcomes. The authors... read more
Policymakers should make finding and providing care easier for family caregivers and better incorporate and recognize family caregivers and their vital role as part of Alaska’s long-term care network. Paid family caregiving through participant-... read more
Thousands of caregivers, still reeling from three years of the pandemic, marched on the New York state capitol to protest the proposed budget. The budget includes cuts of $700 million from safety-net hospitals, raises the pay of home care workers... read more
“We want to get our state to not just be, ‘We're gonna do the bare minimum,’” said Julie Reiskin, one of the heads of the Colorado Cross Disabilities Coalition (and a member of Applied Self-Direction’s Participant Council). Instead, the goal is... read more
Governor Lamont Announces Agreement To Expand Access to Health Coverage for Personal Care Attendants
The Connecticut Personal Care Attendant Workforce Council and SEIU 1199 have come to an agreement to expand the application deadline for personal care attendants to apply for the first round of the new Premium Assistance benefits through their... read more
Disabled people across the state are pleading with lawmakers to block cuts to New York's Medicaid program. Sen. Gustavo Rivera sponsors legislation to prevent the changes to state Medicaid that would reduce eligibility and access to at-home... read more
The Senate Veterans’ Affairs Committee approved this week the Elizabeth Dole Home Care Act, which is meant to expand options for Veterans in need of long-term care. The bill, if ultimately signed into law as written, would expand access to home-... read more
Consumer Directed Choices (an Applied Self-Direction member) a provider of consumer self-direction for seniors and people with disabilities – took to the streets last week to celebrate World Kindness Day. The team handed out $10 Stewart’s Shops... read more
Robbie MacMillan has been on a Medicaid HCBS waiver waitlist for eight years. He is now 19-years-old, but Robby’s not just another number on a waitlist. Robbie’s need for a Medicaid HCBS waiver is vital to the care he needs for the rest of his... read more
Letter responses to the article “Real families need the Real Lives law” (Opinion, Feb 20). One response explains, “We are grateful for the growth opportunities the self-direction movement has afforded supported individuals and their families. We... read more
Cameron Reitan, a second-year Master’s of Public Health is also employed as a personal care attendant – essentially, she’s hired by people with disabilities to help them with whatever tasks they need. In this interview, she talks about why she... read more
We want for our children with intellectual or developmental disabilities what everyone else wants: the best possible life. The path is just a bit steeper and full of assorted obstacles. Unfortunately, state government is turning into one of those... read more
A familiar crowd gathered in New York’s Capitol last week. The purple and gold beanies of 1199SEIU, the turquoise tees of the Consumer Directed Personal Assistance Association, and the custom red face masks of the Caring Majority campaign made... read more
The state’s Aged and Disabled Waiver Program for individuals with developmental disabilities is facing staffing shortages, leading to institutionalization of these individuals into state psychiatric facilities, even though they would be able to... read more
In wake of court setback, Disability Rights North Carolina urges action to ask the state to pay support providers more, serve people on waiver waiting list. Disability Rights estimates that at least 2,000 more slots are needed in the coming... read more
Robert lives in Pennsylvania and uses the Participant Directed Services model. This blog provides his perspective on how he managed to keep my staff during the pandemic. “I tried to think if there’s anything we did different during the pandemic,... read more
In 2011, after a federal investigation, the U.S. Department of Justice declared North Carolina was in violation of the law and the Olmstead ruling. The state ultimately settled with the federal government, but it has continuously dragged its feet... read more
The Missouri House of Representatives approved a preliminary version of a bill that would raise wages for state employees, though some members of the lower chamber argued more needed to be done. The part of the amendment that failed would have... read more
Senate Bill 2276 would reimburse family caregivers who provide “extraordinary care” to dependents who are on 1915(c) Medicaid Waivers. The goal of the bill is to provide at least a bit of financial stability for families that are strained by... read more
A bill introduced in the state House of Representatives is short and technical, but it could have major implications for people with autism, more than a thousand of whom are on a waiting list for state services such as housing and personal care.... read more
Self-directed care undeniably has a place in the future of home-based care. How big that place is, however, is still up in the air. There are many benefits to offering self-directed or consumer-directed care, especially for patients who would... read more
U.S. Senators Jerry Moran (R-Kan.), Jon Tester (D-Mont.), and Maggie Hassan (D-N.H.) – members of the Senate Veterans Affairs Committee (SVAC) – recently introduced the Elizabeth Dole Home Care Act. Once enacted, this legislation would aim to... read more
Many people in need of home care services cannot get them. Staffing also poses a problem due to low wages and reimbursement rates for providers. Sponsored by Rep. Ginny Klevorn (DFL-Plymouth), HF585 would establish care evaluation as a service... read more
New research from the University of Kansas shows that consumers shouldered as many responsibilities as typical home care employers, often with little added resources and many barriers in the way. According to the researchers, policies allowing... read more
Although the primary goal of self-directed programs providing long-term services and supports (LTSS) is to maximize choice and control for service recipients, such programs may also benefit family caregivers by compensating them for providing... read more
A lifespan waiver could ensure people receive consistent care throughout their lives. But more needs to be done to make sure those services are available, advocates say. The state wants to create a “lifespan” approach. The idea is to plan what... read more
The pandemic spurred innovation within Medicare and Medicaid. As the end of the public health emergency (PHE) looms, the timing is right for recommendations to elevate person-centered flexibilities. The purpose of this Roadmap is to serve as an... read more
With self-direction, people who have physical or developmental disabilities choose the supports and staff that work best for them to live independent lifestyles. Hear how it works from two people using the services in New York as they explain how... read more
SEIU Healthcare on Friday announced the deal it reached with the state of Minnesota, which would increase starting wages from $15.25 to $20 per hour by 2025 and offer more pay bumps for veteran workers. Union negotiators hailed the deal as... read more
Fixing the historically fragmented and under-resourced infrastructure supporting this workforce presents urgent challenges that diverse stakeholders must collectively address. California’s In-Home Supportive Services (IHSS) providers have an... read more
Gail Larson lives with her fiancé, with whom she has been partners for 20 years. For years, they did not marry due to a federal law that prohibits most married people from working as Medicaid-funded personal care assistants for their spouses.... read more
Maura Healey said she will “absolutely” work with advocates and labor representatives to strengthen Massachusetts’ Personal Care Attendant Program by addressing a “crisis-level” workforce shortage. The MassHealth program provides funds for... read more
While a well-supported direct care workforce is essential to caring for California’s aging population, experts predict a shortage of 600,000 to 3.2 million workers by 2030. California is currently investing in the direct care workforce in a... read more
Grant funding for Medicaid home and community-based services tops $17 Million The Wisconsin Department of Health Services (DHS) announces the final 26 awardees for the Medicaid home and community-based services (HCBS) grant opportunity. Projects... read more
This framework was created specifically for California’s various Medi-Cal Home and Community-Based Services (HCBS) programs, including the In-Home Support Services (IHSS) program. It is a valuable tool for policymakers, providers, advocates, and... read more
Wry, tenacious and determined, Zukas designed Berkeley’s first curb cuts, brought wheelchair-accessible buttons to BART elevators and engineered accessibility improvements around the globe. In 1970, he effectively lobbied for California’s In-Home... read more
The Request for Information (RFI): Access to Coverage and Care in Medicaid & CHIP was open for a 60 day public comment period from February 17, 2022 through April 18, 2022. This report summarizes the findings and key themes. Respondents noted... read more
There are many benefits to the self-directed care (SDC) model but access to resources is essential to successful outcomes. Considering the autonomy and flexibility associated with SDC, it is important to understand how SDC responded to the COVID-... read more
Saturday marked the International Day of Persons with Disabilities. Melissa Groves, Consumer Directed Choices (an Applied Self-Direction member) discusses how a person can take control of their own care. The Consumer Directed Personal Assistance... read more
This article reviews the peer-reviewed and grey literature published from January 1985 to November 2022 that has quantitatively evaluated the effects of personalized budgets for people with disabilities (PwDs), in terms of a range of benefit and... read more
With Veteran Directed Care, Veterans are literally the boss of their own care. Navy/Army Veteran Caren Scalla is exactly the kind of Veteran for whom the program was designed. Scalla wants to help spread the word. “It makes a difference... read more
Congress and Veterans Affairs (VA) must act to ensure the needs of our heroes and their caregivers are met by increasing access to home and locally-based care, and rapidly expanding programs, like Veteran Directed Care (VDC), to all VA... read more
Almost all states responded to the workforce crisis by increasing home and community-based services (HCBS) provider payment rates. While some of these increases may have been supported through temporary American Rescue Plan Act (ARPA)... read more
When her husband died nearly a decade ago, Rosa worried about how she would pay their bills, since she couldn’t leave her daughter to work. That was when someone told her about the In-Home Supportive Services program. Rosa became a paid caregiver... read more
Some Minnesotans with disabilities enrolled in the personal care assistance (PCA) program are unable to use their professional degrees because their job opportunities pay too much money. Brittanie Wilson of the Minnesota Council on Disability... read more
In the wake of the disproportionate death toll in congregate settings during the COVID-19 pandemic, this report examines weaknesses in the home and community-based services (HCBS) ecosystem and outlines a roadmap to expand community living... read more
Penny Pepper has spent more than 20 years balancing the books, hiring and firing, and eyeing up spreadsheets – like many disabled people, all in the name of ‘Direct Payment’. Direct Payment is a UK program that provides disabled people with funds... read more
This paper discusses the approach to the 2023 edition of the Long-Term Services and Supports (LTSS) State Scorecard. The Scorecard framework will be updated to both retain many of the key characteristics from past editions but will also adapt to... read more
The complex care needs of older adults arising at the intersection of age-related illnesses, military service, and social barriers have presented challenges to the US Department of Veterans Affairs (VA) for decades. In response, the VA has... read more
Contributing writer, T.J. McClellan details the Synergy Conference focused on self-advocacy. Many of the sessions focused on self-direction waivers and how individuals with disabilities and families can ask about waiver options to direct... read more
Most innovations take a long time to diffuse, or simply may fail to do so. For example, in health care, the average time it takes for an evidence-based practice to make its way into general practice is 17 years, and half of all new practices... read more
During National Disability Employment Awareness Month, Consumer Directed Choices (an Applied Self-Direction member) is honoring the contributions made to this country by dedicated American workers with disabilities. Advancing disability inclusion... read more
The organization provides a service to people that are intellectually and/or developmentally disabled. Every individual that is a part of the Person Centered Services gets a Care Coordinator, who helps people to create goals, learn new skills,... read more
“I joke that I live with 10 different roommates” said advocate Alma Silver. “Even though an agency is the official employer of my caregivers right now, I still shoulder the hours of unpaid labor that it takes to coordinate my team. I do so... read more
For decades, Mark Laing and Luanne McGregor have needed home health care aides. If someone doesn’t show up for them, that means they don’t get out of bed. The couple said their hope is to have better pay for their caregivers. They believe it... read more
The grant money will be funneled through the In-Home Supportive Services Career Pathways Program which includes a large number of the state’s direct care workforce and serves more than 650,000 residents statewide. All IHSS and Waiver Personal... read more
This Austin couple assumed that their son's Medicaid services -- which he has been self-directing for five years because of his autism -- would continue while they disputed his yearly budget with Texas Health and Human Services Commission. They... read more
Spooner advocated for health care, transportation and housing on behalf of disabled people for 40 years. Spooner's “crowning achievement,” according to Bill Henning, executive director of the Boston Center for Independent Living, was his work... read more
San Diego home care workers are demanding higher pay. The county’s In-Home Support Services (IHSS) program provides long-term care to the elderly or those who are disabled throughout San Diego. Workers say they are helping these community members... read more
A study commissioned by the Montana Department of Public Health and Human Services (an Applied Self-Direction member) recommends increases in Medicaid reimbursement rates. “These services should be prioritized for reimbursement to... read more
RFI Response: Disability Policies in the 21st Century: Building Opportunities for Work and Inclusion
The House Energy and Commerce Committee Republicans issued a request for information (RFI) to solicit public comments on specific problems and solutions that Congress should address to improve the lives of those with disabilities. Applied Self-... read more
“We know how important our community outreach is so our aging population can continue to thrive. It can be challenging to navigate all the different programs and services for older adults, so we’re there to walk alongside the people we serve,”... read more
At 16 years old, Lizzie started working as her mother’s legal care worker to earn money from the work she was already doing at home. She describes the hiring process as complicated and cumbersome with plenty of paperwork, detailed requirements,... read more
Home care firms looking to change their payer mix increasingly are considering public programs such as Medicaid and Veterans Affairs (VA) programs. The VA is planning to expand its Veteran-Directed care program to 70 more veteran health centers... read more
Nancy Crowther worries every time her personal care attendant leaves the house. She worries that her attendant will see the Dairy Queen banner boasting $16 an hour flapping in the wind and be tempted to apply. Hiring an attendant used to be easy... read more
Self-directed personal assistants, assistants in which the client directs, pays and manages the worker themselves, would need a 60.1% rate increase to meet the benchmark recommendation set to identify adequate direct care wages.... read more
Veteran Directed Care (VDC) aims to keep Veterans at risk for nursing home placement in their communities. VA medical centers (VAMCs) purchase VDC from third-party organizational providers who then partner with them during implementation.... read more
When it comes to their care, Veteran Affairs’ Veteran Directed Care program puts Veterans at the top of the chain of command. It’s more than just having someone to help with his care, Thomas Ellington said. “The flexibility takes a lot of stress... read more
Of the two new programs - one will increase access to home health and self-direction for consumers and the other will address the unique needs of individuals with disabilities and senior citizens that arose during the pandemic.... read more
Biotechnology company Genentech and Open Style Lab (OSL) came together with the spinal muscular atrophy (SMA) community to create Double Take, a first-of-its-kind fashion show featuring members of the community modeling adaptive clothing designs... read more
Family caregivers, long the backbone of the country’s long-term care system, are increasingly tapping public and private resources to get paid for caring for loved ones. While many caregivers don’t know they can be paid, there are also those who... read more
In this article, Jessica Swanson makes the case to her state legislature to support a historic investment in the Medicaid home and community-based system to create more direct care jobs to meet the growing need and increase wages for the... read more
With Veteran Directed Care, Veterans are literally the boss of their own care. “Veterans are in control,” says Lori Cox, Veteran Directed Care manager. “They can hire their own caregivers, purchase approved goods and services…there... read more
Maintaining independence has become increasingly challenging for Keith Williams (a member of Applied Self-Direction’s Participant Council) and others who rely on at-home care because of a critical workforce shortage facing the home health care... read more
Two coverage areas that experienced large growth were services supporting self-direction and community transition. In 1998, only one state provided either service type, compared with 19 states providing self-direction services and 34... read more
More councils are planning to end in-home help for older Australians, with concerns growing that ceasing such services could put severe strain on the state’s aged care system. Some predict 80% of councils to get out of home aged care services... read more
American Rescue Plan Act funds to help improve services for people in Wisconsin's long-term care programs. Providers whose work supports people in Wisconsin’s HCBS programs can apply, including the Include, Respect, I Self-direct (IRIS) program... read more
Personal budgets (PBs) may improve the lives of people with mental health conditions and people with intellectual disability (ID). However, a clear definition of PB, benefits, and challenges is still faded. This work aims to systematically review... read more
Anna Nahlupin is considered a “sandwich caregiver,” someone who is responsible for family members a generation above and below her. According to the Pew Research Center, 12% of parents fall into this category. Nahlupin gets paid through Consumer... read more
A local Florida columnist highlights the Consumer-Directed Care option as one pathway for family caregivers to receive compensation for their efforts. Read the full article... read more
The Pennsylvania Department of Human Services is proposing a new option called “agency with choice,” which it says combines the best aspects of the two existing models in place. However, many in the home care space feel like the proposal could be... read more
The low pay and stressful job requirements discourage people from considering employment in In-Home Support Services IHSS - a form of self-direction in California. Read the full article... read more
According to writer Grace Dow, “People with disabilities may be unable to live in their communities without cases like Olmstead v. L.C. I am grateful that the institutionalization of disabled people was found to be discriminatory. I would have a... read more
According to prominent disability rights activist Charlie Carr, “As EVV continues to go live in the states, an alarming number of problems reported by self-directed PCS consumer employers are arising that undermine their control of their... read more
As of last December, more than 666,000 Californians were authorized recipients of In-Home Supportive Services (IHSS) care (a form of self-direction), according to the state Department of Social Services. In the coming decades,... read more
Pennsylvania offers a “consumer-directed” option. The caregiver is paid by the state, which contracts with a vendor to handle administrative tasks and payroll for people employed under the consumer-directed option. But now the Pennsylvania... read more
The author Alison Holmes shares about the challenges her son JJ faces to receive services at home in Florida. According to Holmes, “We live in Florida. We’ve been on the waiting list for in-home health care assistance since JJ was 3... read more
Agency with Choice has been utilized by home and community service recipients and providers for decades. The concern among advocates stems from a new Agency with Choice model being proposed by Pennsylvania's Department of Human Services. The... read more
During the pandemic, Oregon obtained federal permission to pay parents as caregivers but that will end unless a change is adopted. Read the full article... read more
The Core Standards for Information & Assistance Professionals in Self-Direction resource, developed with the... read more
Mental health experts testified before Congress about their support for expanding opportunities to improve mental health services for older adults through care coordination and policy change. Erin Emery-Tiburcio, Ph.D. held up the self-... read more
This story features one man’s experience struggling to find the direct care workers that he needs to live independently at home. He is enrolled in the Consumer Directed Services Program in Missouri. Read the full article... read more
According to State Senator Diane Savino, “The [Fiscal Intermediary] revisions made to the New York state budget greatly benefit the larger home health care organizations and severely impact the smaller ones. This is a classic “David... read more
Initially viewed as a stopgap measure, paying family members has emerged as a potential solution to the chronic shortage of professional caregivers in Vermont. But while many parents support the idea, advocates say the state should... read more
In December 2019, the New York State Department of Health (DOH) issued a Request for Offers (RFO) from fiscal intermediaries (FIs) to enter into contracts with the DOH to provide FI services in the Consumer Directed Personal Assistance... read more
Members of the Missouri Centers for Independent Living (MOCIL) left hundreds of notes on the door to Gov. Mike Parson’s office, asking for a pay raise. MOCIL has 22 centers throughout the state that serve people of all ages with all... read more
One of the most closely watched proposals in New York state budget negotiations is aimed at addressing low wages for home health aides as providers cope with a worsening staffing crisis. Struggling to recruit employees due to wages typically at... read more
By 2040, the population of American adults aged 65 and older will nearly double, and that of adults aged 85 and older is expected to quadruple over the same period. As our aging population grows, the need for home care is increasing.... read more
New York state has a large population that is growing old. Along with that, the trend has been for people to opt for “aging in place” — in other words, not in a nursing home, but rather in the comfort of their own residence. To do that... read more
This letter, from Applied Self-Direction, NASDDDS, ADvancing States, & the National EVV Consumer Employer... read more
Lawmakers and witnesses focused mainly on ways to beef up Medicaid home care benefits and caregiver pay Wednesday, at a Senate Special Committee on Aging hearing on home care. Sen. Tim Scott, R-South Carolina, talked about another... read more
According to the author Janet Cruz who self-directs in New York, “The future of CDPAP, which is a lifeline for vulnerable New Yorkers keeping us out of potentially dangerous institutional settings, is in limbo due to a potential change... read more
Maribel Slinde, who chairs Iowa CareGivers, makes recommendations to Iowa lawmakers regarding how to spend the state’s ARPA funding in support of workers in HCBS. One recommendation would exempt direct care workers, including those in... read more
Partners Kendra Scalia and Brandon Johnson both have health conditions that require daily care assistance at home in New York. A lack of home care aides since the pandemic has resulted in the pair not being able to hire a single person... read more
As rotting garbage bags pile up in the Del Monte's bedroom, the couple is still waiting for a caregiver from Sacramento County's In-Home Supportive Services program (a self-direction program). According to a program representative, "the IHSS... read more
In an unprecedented move, the New York state Senate and Assembly revealed their one-house budgets over the weekend with provisions to fully fund the Fair Pay for Home Care Act. The bill would raise the minimum wage for home care workers... read more
It has become very difficult to find at-home health care in recent years, for people with disabilities and older people. Nearly 75 percent of New Yorkers lost their home care workers last year, according to a report from the Consumer... read more
From personal protective equipment (PPE) to low numbers of nursing staff, the pandemic has fueled shortages across all sectors. Home health agencies and the patients that they serve have been hit especially hard. According to a report by Consumer... read more
Thanks to a new measure sponsored by State Senator Laura Fine (D-Glenview), people with disabilities in Illinois may soon be able to choose their spouse to serve as their provider of personal care instead of having to hire a personal... read more
The Virginia Senate passed two bills that will expand access to paid sick days across the Commonwealth. Under the current law, employers are only required to provide paid sick leave to home health workers who provide consumer-directed services.... read more
Changes made to the eligibility criteria for home health care (including the Consumer Directed Personal Assistance Program) could force thousands of disabled New Yorkers into institutionalized care or leave them in their homes without... read more
New Hampshire, like the rest of the nation, is facing a home care crisis. Most adults want to age at home. Demand for home health and personal care aides is expected to grow more than demand for any other occupation between 2020 and... read more
States across the country are grappling with workforce shortages and are running out of time to come up with innovative ways to raise wages without leaving providers behind. Bryan O’Malley, the Executive Director of the Consumer... read more
Many direct-care workers are unsure about the COVID-19 vaccines, leaving the people who depend on their labor that much more vulnerable. This article highlights Tim Jin, who according to the article, “now hires and manages his own staff—all of... read more
Leading Veterans service organizations– Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of Foreign Wars – released The Independent Budget Recommendations for the Department of Veterans Affairs FY 2023 and FY 2024.... read more
The California Department of Social Services said it is issuing one‑time $500 bonus payments to roughly 550,000 In-Home Supportive Services (IHSS) providers throughout California. Read the full article... read more
Devin Hamilton was diagnosed with cerebral palsy when he was three years old. While a student at RIT, he enrolled in the self-direction program through New York State. Listen to the full conversation... read more
Thanks to American Rescue Plan funds, more Tennesseans with disabilities will hopefully be getting services they need, aimed at supporting them in their homes and communities. One state program, Enabling Technology, introduces gadgets... read more
The Department of Veterans Affairs (VA) has announced plans to expand three of its home and community-based caregiving services (including Veteran-Directed Care) to its 171 medical centers by the end of 2026. Read the full article... read more
According to opinion writer Agnes McCray, “I am a human rights advocate, community activist, concerned citizen and parent with extraordinary differences who has successfully raised a family here in Syracuse. Given today’s health care crisis and... read more
Author Jessica Adkins, Marketing & Development Director, Access II, Independent Living Center, responds to budgetary changes in Missouri as follows, “In response to Gov. Parson’s veto to additional funding for providers of Consumer Directed... read more
Rural residents face more barriers to healthcare access, including challenges in receiving home and community-based long-term services, compared to urban residents. Self-directed services provide flexibility and choice in care options and may be... read more
This opinion piece is by John Sepulveda, a Queens resident who cares full-time for his 92-year-old mother, Gladys, with the help of New York’s Consumer Directed Personal Assistance Program. He argues against the proposed change to... read more
Before we settle into the new year, we want to reflect on all we accomplished together in 2021. Despite the challenges and uncertainties presented by the ongoing pandemic, our collective community has made tremendous strides to grow the self-... read more
A report on why some in Tennessee who self-direct believe they’re having a hard time finding caregivers. Read the full article... read more
Florida’s top economists could be taking a closer look at the number of people with developmental and intellectual disabilities in Florida who require home and community-based services. Read the full article... read more
With the ongoing shortage of health care workers, families across the country are struggling to access the home care their loved ones need. For people who care for relatives with chronic conditions, the problem is particularly acute.... read more
With the ongoing shortage of health care workers, families across the country are struggling to access the home care their loved ones need. For people who care for relatives with chronic conditions, the problem is particularly acute.... read more
A group of New York fiscal intermediaries has filed a lawsuit against the state’s Department of Health (DOH), claiming the agency improperly withheld access to information regarding why they were not selected for state contracts. You... read more
Almost three quarters—74 percent—of New Yorkers needing home health aides were unable to retain a worker in 2021, according to a report by the Consumer Directed Personal Assistance Association of New York State (Applied Self-Direction member).... read more
Amid a massive home care staffing crisis, Central New York’s State legislative delegation is calling on the Department of Health to save a popular home care program called the Consumer Directed Personal Assistance Program (CDPAP) that is at risk... read more
A new report (from ASD member, Consumer Directed Personal Assistance Association of New York State) indicates a significant percentage of vulnerable people are fighting to maintain their at-home care workers, with many losing the battle... read more
More than 500,000 caregivers in California will each receive a $500 bonus from the state as soon as January, as it tries to retain workers in a sector long hampered by low wages and high turnover rates. Read the full article... read more
Southeast Alaska Independent Living (SAIL) is offering a program in which Veterans can choose their own caretakers. It also allows those seniors to continue living at home, instead of an assisted living facility. Read the full article... read more
The New York State Department of Health is attempting to rein in a program that has grown popular with people with long-term physical and mental disabilities that enables them to choose their own caregivers. Read the full article... read more
When 2020 began, local residents Lynn Weidner and Brandon Kingsmore were just beginning to advocate for better conditions and wages for home care workers; an issue that is near and dear to them. Nearly two years later, their advocacy work has... read more
The Veteran-Directed Care program gives veterans with a high need of care more control over their own affairs. According to one veteran in the program, “Veteran’s disability puts a huge burden on families. This program, by paying my partner, and... read more
After several failed negotiating attempts over the past four years, the county of Lake has finalized a new contract with the In-Home Supportive Services (IHSS) workers’ union. IHSS workers will see their base wages rise by $0.65 an hour... read more
Marissa is a 32-year old woman with Down Syndrome living in Utah who is in a self-direction program. She was able to hire her mom, Kim, to provide her care for the first time during the pandemic. According to Kim, “It was stressful long before... read more
The demand for home health care has been growing in the past few years, and many providers have struggled to find the workers to meet it. Staffing shortages in home health, like many areas across the healthcare industry, have worsened during the... read more
Among the possible items to be included in President Joe Biden's caregiving plan, part of a multi-trillion dollar social spending plan under consideration in Congress, is an expansion of Medicaid eligibility and funding to improve states' in-home... read more
The New York & Michigan Solutions Journalism Collaborative, an endeavor involving a few dozen news organizations including the Detroit Free Press and Rochester Democrat and Chronicle, has vetted some of the solutions and shortcomings in the... read more
Representatives of the home health care industry are worried that the new New York state vaccine mandate will prompt thousands of workers to quit their jobs, curtailing care for patients who are recovering from hospital stays or who rely on long-... read more
Some 250,000 home health care workers must get the coronavirus vaccine by Friday in New York, but tens of thousands of them have yet to receive it (and consumer-directed workers are exempt). Read the full article... read more
U.S. Senator Kirsten Gillibrand (D-NY) gathered with advocates from the Southern Tier Independence Center in Binghamton on Friday to push for further investment in home health care. “Howard Struble, a Johnson City resident, said consumer-directed... read more
Personal care assistant (PCA) workers in Minnesota will see higher wages and other new benefits this month. The statewide minimum wage for PCAs rises from $13.25 to $14.40 per hour effective Oct. 1, then increases again to $15.25 on July 1, 2022... read more
According to Maggie Hoffman, an Applied Self-Direction member and parent advocate, “My adult son, who has disabilities, cannot live the life he deserves because so little support exists for people like him. This legislation signals a commitment... read more
The senator talks about how home-based disability care helped her family and why it is important for seniors and people with disabilities to have a voice. From the article, “Self-directed care is one avenue for family caregivers to be paid for... read more
Home care workers represent 53 percent of the workforce supporting seniors and people with disabilities, but the majority of them (including many self-directed workers) are not impacted by Biden’s vaccine mandates. Read the full article... read more
The state Agency for Persons with Disabilities submitted an ambitious legislative budget request calling for more than $25 million in additional funding to reduce the lengthy waitlist for the Medicaid IBudget program (which includes self-... read more
This article highlights the top legislation under consideration by Congress that, if passed, could significantly impact long-term care delivery, including the proposal to allocate extra funds for states implementing self-direction programs as... read more
Because Tennessee has never increased the reimbursement rate for home care providers since the program began over 11 years ago, the state’s CHOICES program (which includes self-direction) is at great risk. Read the full article... read more
This article looks at home care workforce trends, including the projected size of the Medicaid self-directed workforce. Read the full article... read more
All staff at rest homes, assisted living residences and hospices, as well as workers providing in-home, direct-care services (including consumer-directed care workers), may soon be required to be vaccinated against COVID-19 in Massachusetts, Gov... read more
Nicole LeBlanc, the Self-Advocate Advisor at TASH, argues in this opinion piece for the expansion of home and community-based services. Specifically she states, “When I lived in VT and got HCBS services, I self-directed my waiver and found self-... read more
The passing of the budget bill during Virginia’s special legislative session this month will bring over $3.1 billion in federal American Rescue Plan Act (ARPA) funds to the Commonwealth over the next year (including funding to increase pay for... read more
This case study outlines the unique impact of self-direction in Wyoming and other rural and frontier areas around the country. Read the full case study... read more
For seniors and people with disabilities, living independently comes with its challenges but disability rights advocates are fearful that without improvements to in-home support services (a self-direction program in California), many of San Mateo... read more
This report summarizes findings from the recent audit of the Veteran-Directed Care Program by the VA Office of Inspector General (OIG) and their recommendations for program improvements. Read the full article... read more
As states roll out their electronic visit verification (EVV) apps, patients and home caregivers are facing hurdles. This podcast specifically refers to the challenges of EVV rollout in self-direction programs. Listen to the podcast ... read more
This article explores the stories of multiple families that include children with complex health needs who are encouraging legislators to fully fund the infrastructure bill, a federal package that includes $400 billion to bolster home and... read more
Electronic visit verification systems make homecare more difficult, trap people with disabilities, and cost more than paper timesheets. So why are they rolling out across the country? This article details the unique challenges of implementing EVV... read more
An idea that came out of the COVID-19 pandemic has helped hundreds of families with a loved one who has disabilities, but now is in danger of running out of funding. "Caregiver compensation," which provides a small amount of money for a family... read more
Caregivers and family of those with disabilities are worried the Maryland Department of Health may be about to end a provision early that gives them more flexibility in how services are billed for and delivered during the coronavirus pandemic.... read more
Research shows that fraud occurs in self-direction at about the rate of traditional services, with lower incidences of fraud in programs with mature FMS. A New Bedford man who receives care through MassHealth’s personal care attendant (PCA)... read more
Funding for in-home personal care for aging Coloradans and people with disabilities would jump for three years under American Rescue Plan spending, including funding to launch “new systems allowing caretaking families to directly hire their own... read more
Gov. Ron DeSantis’ administration is asking the federal government for an additional $1.1 billion in federal Medicaid dollars over the next two years to bolster access to home and community-based programs (including self-direction) and... read more
This opinion piece, written by a family member and self-directed worker, argues for increased wages and support for direct care workers. Read the full article... read more
The CEO of Granite State Independent Living in New Hampshire and Applied Self-Direction member, Deb Ritcey, outlines the critical assistance for the disability community included in the state’s newly approved budget. Highlights include and invest... read more
Senate Democrats recently introduced a bill intended to enact President Biden’s promised $400 billion for in-home disability and elder care, known as the Better Care Better Jobs Act. Democratic Senate staff and advocates spent weeks attempting to... read more
Senate Democrats will release legislation as soon as Thursday to meet President Joe Biden‘s promise to expand in-home care for the elderly and disabled while boosting caregivers’ wages and unionizing opportunities, according to a draft bill... read more
The United States Senate Special Committee on Aging recently released a report written by Ranking Member Tim Scott of South Carolina, Expanding Opportunities for Older Americans: Self-Directed Home and Community Based Services. The... read more
Columnist Mike Ervin, aka the ‘Smart Ass Cripple,’ argues that the pandemic has made clear that people in nursing homes are extremely vulnerable and that something needs to be done about it. According to Ervin, “I recruit, hire, train, and... read more
Millions of people in the United States provide essential care for children, aging parents, or loved ones with disabilities. It shouldn’t be this hard to make it work. An ASD Program Member is quoted as follows, ““Paying family members is a huge... read more
Research shows that fraud occurs in self-direction at about the rate of traditional services, with lower incidences of fraud in programs with mature FMS. A Florida woman has been arrested on allegations that she stole $180,000 from Medicaid over... read more
A closer look at the direct care crisis in Michigan, including mention of MI Choice, a self-direction program, that provides home and community-based services for about 15,000 Medicaid beneficiaries each year. The program has a waiting list of 1,... read more
An opinion piece from a local woman who volunteers with Friendly Visitors. One woman she visits has been without a worker for two months in the In-Home Supportive Services (a self-direction program). The author argues that better pay... read more
As a post-pandemic world nears, a new question emerges: What can be done to safeguard long-term care before the next public health emergency? With home and community-based services (HCBS), people can remain in their own homes and hire caregivers... read more
A1 Case Management and reSOARces, a companion nonprofit organization that is built upon the basis of a self-directed model, which involves people with disabilities and special needs choosing their caregivers, have been feeling the impacts of... read more
Written by experts who played a key part in the growth, evaluation, and dissemination of this revolutionary approach, this book describes the development of the self-direction movement through the authors' personal accounts. Also included are... read more
This story takes a closer look at one mother’s struggle to recruit personal care workers to assist her daughter with physical and developmental disabilities in Tennessee. While they would like the option to self-direct via the state’s Katie... read more
The author argues that COVID-19 exposed the profound challenges that long-term care providers face in Ohio and nationwide. One proposed solution is for the state to invest in home and community-based services programs in the state, such as... read more
Having caregivers come and go is a problem for many disabled people, including those who serve as the employer. Recognizing that, the Biden Administration has proposed a $400 billion infusion of federal Medicaid cash to stem a nationwide shortage... read more
This article provides an introduction to self-direction, the opportunity to pay family caregivers, and how to get involved. Read the full article... read more
Covid has pushed state health agencies to use Medicaid in ways that would never have been imagined before. With one in five Americans saying they are unable to afford healthcare, how are state governments using this historic moment to expand... read more
This opinion piece comes from the perspective of a mother who is paid as a family caregiver. She makes the case that home care workers should receive better compensation and benefits. Read the full article... read more
A sibling, who serves as a paid family caregiver for her brother, comments on the inadequacy of personal care worker wages in Pennsylvania and nationwide. The author points to the American Jobs Plan as a potential avenue to invest in increased... read more
New Jersey’s new state budget proposal includes wage increases for workers who provide critical care for individuals with disabilities, older residents, Medicaid beneficiaries and children. $157,000 will support wage increases in the Division of... read more
This article presents the new duties needed to help participants self-direct. Whether states assign these additional tasks to care managers or create a new class of support brokers to do this work, the job of the care manager changes. Examples... read more
The pandemic created new urgency around efforts to improve conditions for New York State’s beleaguered home care workers, including ongoing efforts to increase funding and worker wages for the Consumer-Directed Personal Assistance program. Read... read more
Florida lawmakers have agreed to spend an additional $95 million a year to provide more people with intellectual and developmental disabilities access to services they need to live in their communities and out of institutions via the iBudget... read more
This article provides a comprehensive overview of the consumer directed model, including commentary from Denise DiNoto of Consumer Directed Choices (an Applied Self-Direction member) on her own experience self-directing. According to Denise, “I... read more
We are immensely thrilled to announce the IRS has formally approved the temporary use of electronic signatures on a number of tax forms signed and postmarked on or after August 28, 2020, including Form 2678, Employer/Payer... read more
One family’s story about the transformative impact of self-directing via the Veteran Directed Care program for Veteran Ken. On what it meant to begin self-directing, “It made a great change. It was like someone switching a switch. And we went... read more
An introduction to the various self-direction program options available that allow paying family caregivers via Medicaid. Read the full article... read more
States have the opportunity to use Medicaid to support enrollees with long-term care needs and their families by developing consumer direction programs that allow family members to be hired to provide care. This report explores how Connecticut,... read more
Effective July 1, 2021, Virginia joins the District of Columbia and many other states with paid leave for designated workers (Virginia’s Paid Sick Leave Law), home health workers in this case (including self-directed workers). Read the full... read more
This article highlights MI Choice, a self-directed... read more
The Hill published an op-ed by ASD's Kate Murray, American Rescue Plan can give disabled adults freedom of choice for care. The piece advocates for states to consider using their enhanced HCBS... read more
This article takes a closer look at the potential impact of the proposed $400 billion for HCBS included in Biden’s... read more
The 2021 Self-Direction Virtual Conference Series will include two different sessions on self-direction around the world. (Can you tell we miss traveling??)
On Wednesday, May 5th, Lynn Breedlove, from the Wisconsin Long-Term Care... read more
The author of this opinion piece opposes proposed budget cuts to the Consumer Directed Services personal care program in Missouri. View the full article here.
What is the Self-Direction Conference without every Financial Management Services (FMS) providers’ favorite session, The FUNdamentals of Fiscal/... read more
Under a policy pushed by Gov. Andrew M. Cuomo, the administration of a popular self-direction program that allows Medicaid recipients to receive at-home health care for loved ones was interrupted for more than 100,000 New Yorkers. Now, Democrats... read more
Employees of In-Home Support Services (a self-direction program in California) participated in a day of action calling on President Biden and members of Congress to fulfill the promise of the Build Back Better Plan and commit $450 billion to the... read more
Gabriela Amari, a participant in New York’s Consumer Directed Personal Assistance program, powerfully makes the case that the state should invest in self-direction (rather than pouring more money into nursing homes) in this opinion piece. View... read more
We are excited to announce our first-ever Self-Direction Virtual Conference Series this spring! This past year has underscored the critical importance of... read more
Following the passage of new legislation, veterans enrolled in the Veteran Directed Care program and their spouses are now eligible to receive the COVID-19 vaccine through the VA health system. View the full article... read more
Missouri’s governor has made two recommendations for budget cuts to the state's consumer directed services program. This program currently serves more than 40,000 Missourians. Advocates are fighting back against the proposed cuts. View the full... read more
Further coverage of proposed budget cuts to Missouri’s consumer direction program - and the advocates trying to prevent the cuts. View the full article... read more
Should San Diegans who provide home care services to the elderly and others get at least the minimum wage? So posits an audit of In-Home Supportive Services (a self-direction program) by California State Auditor Elaine Howle, which charges... read more
In the ongoing negotiations over New York's proposed $193 billion budget, several lawmakers in both legislative chambers are rallying behind a measure that would provide $1.3 billion in new funding to substantially raise the pay of home-care... read more
Wisconsin is celebrating a major milestone. On February 28, 2021, a 40-year-old individual with a physical disability from Adams County was referred to IRIS (Include, Respect, I Self-Direct), Wisconsin’s self-directed long-term care program. This... read more
A proposed collective bargaining agreement in Minnesota would raise the minimum wage, increase the number of PTO days, and increase the number of paid holidays for direct care workers. Andre Best of Best Home Care (an FMS member) comments on the... read more
Auburn Pub published a commentary on the direct care workforce... read more
A commentary critiquing New York’s Governor Cuomo on his handling of... read more
New proposed state legislation, sponsored by Republican State Senator James Setteimeyer, in Nevada would make self-directed services more widely available in the state. View the full story... read more
The Virginia Senate narrowly passed a bill mandating paid sick leave for home health care workers, including consumer-directed workers, who care for Medicaid recipients after severely limiting the scope of which essential workers would be... read more
On Jan. 27, 2021, the New York State Department of Health published revised proposed amendments to the regulations governing personal care services and consumer-directed personal assistance services. You can read the full article... read more
John, a 22-year-old with an intellectual and developmental disability and seizure disorder, manages his services through self-direction. When COVID-19 hit, John had the flexibility to adapt his services and supports, including hiring his brother... read more
Open Minds published a... read more
This article details California’s new Spousal Impoverishment Protection Rule which allows more individuals to access self-directed services via the In-Home Supportive Services Program by allowing the ‘well spouse’ to retain income and assets (to... read more
Local news coverage from Massachusetts on the benefits of consumer-directed care, particularly during the pandemic. One woman’s experience is described. Learning that she would be able to choose her personal care attendant including family or... read more
An in-depth look at the Veteran-Directed Care program in Montana and how it has supported Veterans enrolled in the program to successfully direct their own care at home. This article also speaks to the advantages of self-directed care in rural... read more
This article closely examines the impact of the pandemic on paid in-home caregivers, including family members. Bea Rector, a director at the Washington Department of Social & Health Services (an ASD State Program Member), is quoted in the... read more
McKnight's Senior Living published an article on Applied Self-Direction's recent AARP Public Policy Institute report, ... read more
We are pleased to announce that the AARP Public Policy Institute has released our report, Paying Family Caregivers to... read more
The most recent issue of the Journal of Gerontological Social Work, A Tribute to Rosalie Kane: Honoring Her Life and Work as Scholar, Mentor, and Social Worker in Gerontology... read more
The Division of TennCare and the Department of Intellectual and Developmental Disabilities (DIDD) announced that more than 290 children have been enrolled in the Katie Beckett Program since it opened for applications in late November... read more
This guest column authored by an Outreach Specialist in Michigan highlights the MI Choice self-directed... read more
This article details the... read more
The Indiana Family and Social Services Administration plans to overhaul its rules to ensure that elderly residents have access to home- and community-based services. The state also has instituted a “family caregiver program,” which... read more
Consumer-directed workers in New York will be eligible to receive the COVID-19 vaccine beginning the week of January 11th. You can read the full article... read more
As the year draws to a close, we are taking time to reflect on what has been an unusual and challenging year. In the face of unprecedented adversity, our members played a critical role in supporting the over 1.2 million people self-directing in... read more
New York State Congressman Brian Higgins (NY-26) announced the approval of legislation providing multiple improvements to Veteran services, including waiving the in-person application requirement for those seeking enrollment in the Veteran-... read more
The National Association for Home Care & Hospice (NAHC) is urging Congress to fully fund the Lifespan Respite Care Program.... read more
From all of us at Applied Self-Direction, we wish you and your families a joyful holiday season. While this year presented one challenge after another, it has been an honor for us to support stakeholders in self-direction as you rose to the... read more
Applied Self-Direction is joining a dynamic panel of experts for the virtual HCBS Conferences session, Balancing Person-Centeredness and Utilization Management within HCBS.
While the aging and disability network strives to be... read more
A brief story of how self-direction has made a difference for one man living independently in... read more
A recent lawsuit in CA was struck down that would have prevented the state from deducting employee benefits and union dues from IHSS workers’ paychecks. IHSS is one of the largest self-direction programs in the country. You can read the full... read more
A heartwarming story about how one woman in New Jersey is benefiting from self-direction and gaining access to the community through a partnership with a local chef. You can read the full article... read more
Personal care attendants in Virginia who work directly for Medicaid clients faced a deadline to show the hours they worked during the early months of the COVID-19 pandemic to qualify for a $1,500 hazardous duty payment. About two-thirds of the 43... read more
This opinion piece was authored by a CIL Executive Director in Oklahoma... read more
Advocates in Wyoming are seeking to prevent budget cuts to home and community-based services as the state faces a $750 million budget deficit in the upcoming session. The Community Choices Waiver, which includes self-direction, is pointed to as... read more
Advocates in Florida are concerned about proposed rules that would require support coordinators to ‘certify’ that individuals with disabilities have exhausted all other options for care before applying for the iBudget self-direction program. You... read more
A detailed local report out of Idaho considers... read more
One of ASD’s Stakeholder Members, Consumer Directed Choices, was recently featured in their local news. The... read more
Governor Newsom of California has vetoed a proposal that would have allowed family caregivers receiving payment via California’s In-Home Services and Supports self-direction program to be eligible for unemployment benefits. You can read the KQED... read more
This opinion piece in City Limits suggests that the Consumer-Directed Personal Assistance Program in New York... read more
It’s finally here! The fourth National Inventory of Self-Directed Programs for the... read more
A remembrance of Ruth Bader Ginsburg and her contributions to the disability community, most notably providing the majority opinion in the Olmstead v. L.C. decision. This... read more
We are thrilled to announce that the fourth National Inventory of Self-Directed Programs for the 2020 AARP Long-Term Services & Supports State Scorecard Report will be released on Thursday, September 24th, 2020!
Applied Self... read more
The pandemic has strained already short-staffed caregiving services, leaving seniors in southwest Colorado without much of the support they need to survive. This... read more
The executive director of the Home Care Alliance of MA responds to recent criticism in Massachusetts that only unionized workers have received extra support and pay during the pandemic. This rebuttal includes reference to how home care agencies... read more
The Senate did not pass the latest proposed coronavirus stimulus legislation which was widely panned by disability advocates because it did not address key issues such as enhanced funding for HCBS. This latest development increases the likelihood... read more
This Cal Matters opinion piece by a union executive director advocates for... read more
This is a letter to the editor regarding New York’s self-direction program under the Home and Community-Based... read more
This next year will be pivotal for self-direction. We want to help our members advocate for the change they want to see with policymakers and funders.
We hope you will join us for an... read more
Applied Self-Direction is highlighting stories of individuals and families who are self-directing at home during the pandemic. You can read about Kevin's story... read more
The report, National Core Indicators COVID-19 Bulletin #4: Data on Racial Disparities, looks at the racial... read more
In the Post Register, an Idaho news... read more
The Colorado news outlet, The Mountain Mail, wrote a feature on their local Veteran-Directed Care program, Veterans take... read more
The Rooted in Rights blog post, As a disabled person, expanded access to telehealth... read more
The Next Avenue article, Where family caregivers can get financial assistance, provides advice to caregivers on how to get paid, including an in-... read more
Building the LTC system of the future: Will the COVID-19 nursing home tragedies lead to real reform?
The Health Affairs blog post, Building the long-term care system of the future: Will the COVID-19 nursing home tragedies lead to real reform?... read more
In the Disability Scoop article,... read more
The Economist article, The pandemic shows the urgency of reforming care for the elderly, explores... read more
The New York Times article, 'Nothing about us without us': 16 moments in the fight for disability rights, chronicles major advocacy... read more
In collaboration with Granite State Independent Living, Applied Self-Direction created a case study to better... read more
The Home Health Care News article, Biden announces $775B plan to boost the... read more
This Gotham Gazette op-ed, The pandemic further exposed nursing homes; New York needs to invest in better options... read more
This amNewYork op-ed, Disability and dignity in the age of COVID-19, was written by Michele Kaplan, a disability advocate and... read more
Applied Self-Direction is highlighting stories of individuals and families who are self-directing at home during the pandemic. You can read about Tyler's story... read more
New York was one of the first states to be hit by the COVID-19 pandemic with nearly half a million reported cases and over 30,000 deaths. Over 40 percent of those deaths have been in nursing home settings.
The Consumer... read more
The Partnership for Medicaid Home-Based Care is requesting support of legislative proposals that increase federal funding for Medicaid Home and Community-Based Services (HCBS) and enhance... read more
US Democratic Presidential Candidate Joe Biden released a disability plan which includes an aim around self-direction: "Affirming the right of people with disabilities to self-... read more
The Journal of Gerontological Social Work published the article commentary, Self-Direction of Home and Community-Based Services in the Time of COVID-19, written by our colleague Kevin J. Mahoney, Founding Director of the National... read more
The Boston Globe published the opinion piece, After COVID-19, a better way to support the elderly and people with disabilities, written by our colleague Kevin J. Mahoney, Founding Director of the National Resource Center for Participant-... read more
Applied Self-Direction partnered with AARP to publish the blog post, A Solution, with or without Pandemic: Let Individuals Hire Family for Care. The blog discusses the win-win of hiring family members as well as the short- and long-term... read more
"Self-directing participants are equipped to efficiently and effectively improve their wellbeing by addressing the underlying social determinants of health that are unique to that individual. In this way, self-direction breaks the mold of “... read more
Merle Edwards-Orr presented "Self-Direction and Pressing Issues in Aging" for the Health Management for Older Adults: Developing an Interdisciplinary Approach course at the Harvard Medical School. This course is led by a physician, a... read more
Kevin Mahoney, Ellen Mahoney, and Michelle Putnam recently published Self-Direction in Long Term Services and Supports: The Cash and Counseling Demonstration and Evaluation Ten Years On, a book assessing the impact of the original Cash... read more
The Centers for Medicare & Medicaid Services (CMS) has strongly encouraged states to submit electronic visit verification (EVV) good faith effort extension requests by November 30, 2019. Many states have already submitted requests, 11 of... read more
Qualified providers and quality providers are not always synonymous. Managed Care Organizations (MCOs) may be given direction to utilize qualified providers, but guidance on what qualified really means may not be part of the conversation. For... read more
Individual budgets are a key component of self-directed services, and assessment-informed budgets are used in the majority of states to allocate waiver funding for Home and Community-Based Services. The Human Services Research Institute (HSRI)... read more
As the number and variety of self-direction programs across the world continues to increase, it is enlightening to compare definitions and approaches. “Self-Direction Worldwide: Contrasting Beliefs and their Impact on Practice” by Lynn Breedlove... read more
We are excited to share that James Toews has joined Applied Self-Direction to support our members and stakeholders as we advance self-direction. Prior to his work at Applied Self-Direction, James had a distinguished career in federal... read more
We are excited to announce that we will co-host a two-day learning experience ("Match") on International Advances in Self-Direction with the Human Services Research Institute (HSRI). The Match will be held on September 9-10 in Boston,... read more
A new study led by Boston University School of Public Health (BUSPH) and Veterans Affairs Boston Healthcare System researchers finds that a program that gives Veterans flexible budgets for at-home caregivers is at least as effective as other... read more
The Boston College School of Social Work published an article on the Journal of Gerontological Social Work Special Issue on Self-Direction in Long-Term Services and Supports. The article highlights the role Kevin J. Mahoney, Professor Emeritus at... read more
We are excited to announce that the Journal of Gerontological Social Work has released a... read more
We are pleased to announce that we have joined the Collaboration to Promote Self-Determination (CPSD), an advocacy network whose mission is to push for major systemic reform of the nation’s disability laws and programs. The vision of CPSD is a... read more
The Centers for Medicare and Medicaid Services (CMS) will join us “live and in person” at the Self-Direction Conference! CMS will lead a plenary on Monday, April 29th to provide the latest updates on Electronic Visit Verification (EVV)... read more
Every year we receive numerous requests for financial support so that participants and family members can attend our conference. This year is no exception.
In response to these requests, we’re offering a “Sponsor a Participant” option... read more
Two new research articles on self-direction and behavioral health were recently published.
Applied Self-Direction just released the Electronic Visit Verification (EVV): A Blueprint for Self-Direction. This ... read more
Merle Edwards-Orr, Senior Consultant at Applied Self-Direction, wrote a blog for AARP titled, Taking it to the... read more
Pyschology Today recently published an article, Can Addicts Change Through Self-Direction?. The article is available on their... read more
Citizen Network is working with the European SKILLS project to identify the extent to which self-directed support is being adopted in different countries around the world.
The project recently published a discussion paper offering: an... read more
Forbes.com just released an article, Does Self-Directed Long-Term Home Care Make Sense For... read more
We are offering a new membership option for state agencies this year! The State Focus option includes 10 monthly calls with our membership team. Each call will be up to one hour. Your team can use these calls to problem-solve specific issues,... read more
The Reinventing Quality planning committee asked Applied Self-Direction to organize a session at their July 2018 Reinventing Quality Conference in Baltimore, Maryland. The... read more
Mollie Murphy, President of Applied Self-Direction, presented to the Missouri Council for In-Home Services members on Fiscal/Employer Agent tax policies and procedures on June 13, 2018.... read more
What effect does self-direction have on functional outcomes like housing and employment?
To find out, HSRI researchers and colleagues, including the NRCPDS Founding Director, Kevin J. Mahoney, looked at approximately four years’ worth of... read more
CMS has just released two major pieces of Electronic Visit Verficiation (EVV) guidance: an informational bulletin and... read more
We are excited to announce that three representatives from the Disabled and Elderly Health Programs Group in the Centers for Medicare and Medicaid Services (CMS) Central Office will be leading a session on Electronic Visit Verification... read more
Refer an organization to FMS, Stakeholder, or ... read more
Merle Edwards-Orr, Senior Consultant at Applied Self-Direction, recently co-authored a report with AARP titled, ... read more
In January 2018, Applied Self-Direction released a Request for Information (RFI) to identify EVV vendors interested in serving self-direction programs. It is important that EVV systems in self-direction programs meet the unique needs of self-... read more
Applied Self-Direction is issuing a Request for Information (RFI) to identify Electronic Visit Verification (EVV) vendors interested in serving self-direction programs. It is important that EVV systems in self-direction programs meet... read more
A new HSRI Research Brief summarizes the results of new research on self-direction... read more
The Human Services Research Institute (HSRI) and Applied Self-Direction, the new home for the National Resource Center for Participant-Directed Services (NRCPDS), are pleased to announce the release of a new website,... read more
The Georgetown University Center for Children and Families (CCF) and NHeLP jointly developed 50 state (and DC) specific fact sheets on... read more
The Georgetown Center on Poverty and Inequality released a new report, Building the Caring Economy: Workforce Investments to Expand Access to Affordable, High-Quality and Long-Term Care, proposing caregiving jobs investments to address... read more
The Kaiser Family Foundation recently released the issue brief, State Variation in Medicaid Per Enrollee Spending for Seniors and People with Disabilities, showing major variations in Medicaid spending across different states and and... read more
A new report describing Medicaid long-term services and supports (LTSS) expenditures is now available on the Medicaid.gov LTSS data page. The... read more
As part of our Membership Committee on Advancing Self Direction in a Changing Environment, we created leave-behind Self Direction... read more
Applied Self-Direction has released an Electronic Visit Verification (EVV) Implementation... read more
For years, people who receive disability-related support services have used self direction to live independently in their communities. Now people with serious mental health conditions are using self direction to transform their lives. A new... read more
Questions for the Record “Hearing to Consider the Nomination of Seema Verma to be Administrator of the Centers for Medicare & Medicaid Services” Before Senate Finance Committee is available... read more
The Kaiser Family Foundation recently published a report on whether a state's adoption of the ACA Medicaid expansion for low-income adults affects the size of its HCBS waiver waiting lists. The full report can be found... read more
The article, Dust Off: Veteran-directed care benefits everyone, was posted on TCPalm about the Veteran-Directed Home and Community-Based Services (VD-HCBS) program in West Palm Florida. You can access the full article... read more
The Department of Labor (DOL) recently posted new information on their website about Labor Costs for Direct Care Workers. The document explains a... read more
The Gerontological Society of America released a press release announcing their new issue of the Public Policy & Aging Report, Participant Self-Direction in Long-Term Supports and Services. The issue can be viewed... read more
In December 2016, the State Health Reform Assistance Network released an issues brief titled, Capping Federal Medicaid Funding: Key Financing Issues for States.
President-Elect Donald Trump and Republican congressional leadership... read more
Report: Travelling Hopefully: Best Practice in Self-Directed Support by Simon Duffy
South Australia has firmly committed itself... read more
On November 9, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) seeking information and data on additional reforms and policy options that we can consider to accelerate the provision of home and... read more
The Public Policy & Aging Report, published quarterly, explores policy issues generated by the aging of American society. The January 2016 issue focuses on Self Direction in Long-Term Services and Supports and includes several... read more
Quartz website posted the article, The future of senior care could be paying your friends and family.This article serves as a great introduction to self direction and includes comments and quotes from the NRCPDS and several other... read more
The report, “Money Follows the Person (MFP) Demonstration: Overview of State Grantee Progress, January to December 2015,” summarizes progress between January and December 2015 by the 44 MFP grantee states (including the District of Columbia) that... read more
This Open Forum describes a September 2015 international learning exchange meeting in which experts in self-direction and mental health from seven nations convened for sharing best practices, discussing challenges, and laying the groundwork for a... read more