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PEOPLE FIRST: THE CONSUMERS IN CONSUMER DIRECTION
By: Marisa A. Scala and Thomas Nerney
Much of the discussion of consumer direction and self-determination focuses
on issues, models, and policies. Consumer direction as a philosophy emphasizes
consumers' capacity to "assess their own needs, determine how and
by whom these needs should be met, and monitor the quality of services
they receive" (National Institute of Consumer-Directed Long-Term
Services, 1996). As a practice, consumer-direction consists of consumers
making decisions and managing delivery of long-term-care services. Self
determination represents a much broader concept related to individuals'
overall control of their lives an ability to participate fully in society
and rests on four basic principles:(1) freedom to exercise the same rights
as other citizens,(2) authority to control the funding needed for services
and support,(3) support through the organization of resources as determined
by the person with the disability, and (4) responsibility to use public
dollars wisely.
However, at the heart of the movements toward consumer direction and
self-determination are, of course, people-the individuals with disabilites
who are directing and receiving services and support. In this article,
we will discuss four populations that have been involved in the struggle
toward consumer direction: older adults, younger adults with physical
disabilities, people with developmental disabilities and those with cognitive
disabilities. We will focus on the history of each group in the area of
consumer direction, strategies, and supports needed to enhance consumer
direction in each community, and special issues to consider for each population.
People with Physical Disabilities
The very foundation of consumer direction lies in the independent living
movement led by individuals with physical disabilities during the 1960s
and 1970s who demanded their rights to be full participants in mainstream
society and to live independently in their communities. The premise behind
the independent living model is that people with disabilities are hindered
or impaired by barriers in their environment rather than by their physical
or cognitive disabilities. One crucial barrier for people with disabilities
has been a lack of appropriate long-term-care services, specifically personal
assistance services. (Litvak, Zukas, and Heumann, 1987; Batavia, DeJung,
and McKnew, 1991).
More commonly known as home-and community-based services within the field
of aging, personal assistance services include assistance with personal
care, instrumental activities of daily living, communication, and paramedical
needs like administering medication, as well as home modifications, case
management and other similar supports, and assistive technologies (Doty,
Kasper, and Litvak, 1996). The term personal assistance services has gained
more widespread acceptance among younger adults with disabilities because
it implies that services can be delivered outside as well as in the home,
in schools, and on the job. The term also suggest more of a social, rather
than medical, model of service delivery Without argument, one of the most
critical needs of younger adults with disabilities in relation to consumer
direction and self determination is access to and funding for personal
assistance services. Personal assistance services are so critical because
they enable individuals with disabilities to lead active, independent
lives-that is, to go to work and to school and to participate fully in
society. Disability rights advocates and others in the independent living
movement have long mistrusted the current long-term care system in the
United States because of its reliance on a medical model of service delivery
and its bias toward institutional care (Litvak, Zukas, and Heuman, 1987).
Instead, they advocate for services in the most integrated settings (as
required by the Americans with Disabilities Act) and for service funding
that follows the person, rather than the provider, as evidenced by the
development of the Medicaid Community Attendant Services and Supports
Act, which offers Medicaid-eligible people with disabilities the option
of choosing "community attendant services and supports" rather
than placement in a long-term care facility (Kafka, 1999).OLDER PEOPLE
While consumer direction has a long history among younger adults with
disabilities, it has been much slower in coming to the field of aging
services, only gaining prominence within the past several years. The overarching
goal of home and community based services in the United States has focused
on keeping older people out of nursing homes as the means of promoting
independence and autonomy, and the bias of the current system has reflected
the assumption that all elders are frail, dependent, and in need of protection.
But also mixed in with such assumptions and biases are some very real
concerns about balancing autonomy and risk and about quality assurance
and fraud and abuse (Scala and Mayberry, 1997).
Despite these concerns, however, consumer direction has expanded within
aging services in recent years because of worker shortages, the need to
cut rising long-term care cost, and a desire to provide services that
are more suited to consumers' individual needs and preferences (Simon-Rusinowitz
et al., 1997). A 1996 National Council on Aging survey of state administrators,
providers, consumers and caregivers identify 103 consumer-directed programs
throughout the United States (Lagoyda et al., 1999). However, in contrast
to the independent living movement, the trend toward consumer direction
in aging services has been spearheaded by professionals in the field,
rather than by consumers.
Several strategies can enhance consumer direction and self-determination
among the aging population. One critical support needed for elders in
consumer-directed programs is training-training in service responsibilities
(e.g., recruiting and hiring workers or quality assurance), self-advocacy,
and self-care. (Eustis 1999). It is unreasonable to expect people in such
programs to take on theses responsibilities without offering them some
information and resources (whether through face-to face or phone interactions
or, at the very least, written materials) to prepare them. Also important
are what are often called supportive intermediary services, which can
offer consumer assistance with their responsibilities, if needed. This
help may include assistance with payroll and taxes for workers, care management
services, help with recruiting personal assistance, and back ground checks
on workers.
Finally, there is a need for flexibility in consumer-directed programs
to accommodate issues of surrogacy. Within home-and community-based programs
for older adults, many times it is family members who either collaborate
with older family members in decision making or who make decision on behalf
of older relatives, because of delegation of that authority or because
the services recipient has severe cognitive impairments. Programs must
be flexible enough to allow for such arrangements.
PEOPLE WITH DEVELOPMENTAL AND COGNITIVE DISABILITIES
The first formal demonstration of self directed supports with population
of individuals with cognitive disabilities (mental retardation and acquire
brain injury) occurred in an early 1990s project funded through the Robert
Wood Johnson Foundation's Building Health Care System initiative and based
at Madnadnock Developmental Services, Inc. a regional authority in New
Hampshire. At the time, self-direction was not a common term among those
with cognitive disabilities. Later, the notion of self-direction or self-determination
grew out of a recognition that, no matter the disability, having control
over major aspects of one's life was just as important to those with intellectual
disabilities as it was for any other person with a disability.
Because the system of typical services to these populations was so dominated
by congregate models of care, the four principles of self-determination-freedom,
authority, support, and responsibility-were articulated to guide implementation
issues. Unlike more typical self-directed supports, the self-determination
approach relied on the creation of formal system requirements in order
to ensure that individuals with significant cognitive disabilities could
also take advantage of the authority and the responsibility that accompany
this freedom.
In this vision of self-direction, it is critical that those who need assistance
in decision-making indicate the people they trust for this assistance,
regarding where they want to live and with whom(Nerney and Crowley, 1994;
Nerney and Shumway, 1996). The importance of support networks or "circles"
seem crucial to success for many individuals with cognitive disabilities.
Members of these circles must be individuals freely chosen by the person
with a disability, and they must have a trusting and respectful relationship
with that person.
Two relatively innovative assumptions are beginning to undergird the
self-determination movement for individuals with cognitive disabilities.
One is simply that all people will "have their own place". People
with disabilities may indeed choose to live with another person for companionship
or to share living expenses, but that is always a freely chosen situation
and one susceptible to renegotiations when necessary. The second assumption
is that virtually all individuals can work in meaningful employment or
produce income through the development of microenterprises. More and more
projects across the country are gradually changing the goal from "getting
a job" to one of "producing income". This shift emphasizes
the idea that there are many ways to both secure employment and start
a small business. Within their budgets and with assistance from a variety
of sources, individuals can contract directly with employers for coworker
support, transportation, and even training. Individual budgets can be
used to help secure or pay down the cost of equipment necessary for a
small microenterprise.
In order to achieve true self-determination, there are three critical
supports that people with cognitive or developmental disabilities need.
These are individual budgets, support brokering and fiscal intermediaries
Individual budgets. Individual budgets reflect the principles of self-determination
when the budget is actually controlled by the person and his or her support
circle. Public dollars should be viewed as an ongoing investment in the
person's live, and the obligation to be responsible as well as contribute
to one's community becomes part of the budget development. These budgets
must be individually created by the person with a disability and his or
her support circle within the amount of funding allocated to the individual
for support and services. This includes the creation of unique line items
that reflect the distinct dreams and ambitions of the person with a disability.
Budgets must also be flexible; that is, within approved amounts, individuals
should be able to move dollars from line item to line item (as well as
create new items and eliminate old ones) as long as the essential supports
as maintained. Finally, people with disabilities must retain their social
support network, even is another organization assumes some legal responsibility
to become the employer of record.
Independent support coordination. The linchpin to the success of creative,
highly individual budgets and life plans is the function that is variously
referred to as independent support coordination, personal agents, or independent
brokering. The support coordinator is a person who may help with plan
development, assist in organizing the unique resources that a person needs
and even assist with ongoing evaluation of these supports. There are many
ways that this function can be carried out, from family members to case
managers assuming new roles. Several places now allow the person with
a disability to select anyone they know and trust and pay the person separately,
if necessary. The characteristics of an independent brokering function
include independence from service provision, to avoid both the appearance
and the reality of conflict of interest, and real authority from the state
or publicly sanctioned authority to adequately represent the person with
a disability (although again, it should be clear that the person who carries
out this function works for the person with a disability).
Fiscal intermediaries.
Fiscal intermediaries are simply organizations, places really, where
an individual budget gets parked or banked. The functions carried out
by a fiscal intermediary include, but are not limited to, check writing
for all bills and personal costs, tax withholding, paying worker's compensation,
health insurance, and other tax and benefits that might be appropriate
depending on the individual's budget. The fiscal intermediary works for
the individual and remains accountable for ensuring compliance with all
federal and state laws. Ideally, fiscal intermediaries should keep individual
budgets isolated from any other and certainly from traditional provider
contracts. They must also have no other duties that conflict with their
role and must be independent of service provision. Finally, fiscal intermediaries,
to the extent possible, should be generic neighborhood community organizations
that enable the person with a disability to create relationships with
personnel who work there in regular community settings. The closer this
function moves to a "neighborhood bank," the better for the
person with a disability.
IMPLICATIONS AND CONCLUSION
Consumer direction and self-determination have gained prominence in recent
years in the field of long-term care. We have witnessed increased commitment
from funders such as the Robert Wood Johnson Foundation through the Cash
and Counseling and Independent Choices initiatives, and even from legislators
through the introduction of the Medicaid Community Attendant Services
and Supports Act in 1998 more recently, the Supreme Court decision on
L.C. & E. W. v. Olmstead has prompted states to examine the issue
of consumer direction more closely.
As we examine the histories of three of the populations that have been
involved in the movement toward consumer direction and self-determination,
it becomes clear that autonomy and control are of paramount importance,
no matter what a person's age or disability. It should also be mentioned
that the populations described in this article are by no means the only
groups involved in and affected by this movement. Youth, families, and
people with psychiatric disabilities are also integral parts of this growing
contingent.
Lessons for policy makers, program administrators and advocates are implicit
in these descriptions as well. First, there is more to consumer direction
than simply hiring, firing, and paying one's workers. Consumers must have
adequate information about the service systems in which they participate,
and as the self-determination movements shows us, they must be given the
opportunity, the supports, and the authority to make decisions about their
services and how (and by whom) they are provided. Consumers-older and
younger-can also play vital roles in monitoring and improving the quality
of the services they receive, since they deal with their workers or assistants
on a daily basis and are on the frontline when problems occur.
Second, the diversity among consumer populations indicates the need for
flexibility in programs. Support programs must respond to needs of individuals,
rather than having a "one size fits all" approach to the provision
of services. A range of models and supports are needed so that consumers
may choose their desired level of responsibility. Some consumers may wish
to handle all aspects of service management. Others may wish to deal with
a limited number of those responsibilities, or they may want to delegate
that responsibility to others whom they trust. Programs must accommodate
these consumer preferences as much as possible and must provide training
so that consumers of all ages are prepared to handle their authority and
chosen responsibilities.
Finally, individualized funding that follows the person, rather than
the provider, is long overdue in the world of long-term care. As the experiences
of all of the populations described-and indeed, recent legislation and
court cases illustrate-consumers must have access to services and supports
in the settings of their choice-their homes, schools, and workplaces.
It is only when this happens that consumers will be able to exercise true
choice, which is the foundation of consumer direction and self-determination.
Marisa A. Scala is a research associate, Institute for the Future of
Aging Services, American Association of Homes and Services for the Aging,
Washington, D.C.
Tom Nerney is president, Center on Self-Determination, a national technical
assistance and training center hosted by Community Living Services, Wayne,
Mich.
REFERENCES
Batavia, A. I., DeJung, G., and McKnew, L.B. 1991. "Toward a National
Personal Assistance Program: The Independent Living Model of Long-Term
Care for Persons with Disabilities." Journal of Health Politics,
Policy and Law 16(3): 523-45.
Doty, P., Kasper, J., and Litvak, S. 1996. "Consumer Directed Models
of Personal Care: Lessons from Medicaid." Milbank Quarterly 74 (3):
377-409.
Eustis, N.N. 1999. "Strategies to Enhance Consumer Direction and
Self-Determination for Seniors." Paper prepared for the 1999 National
Leadership Summit on Self-Determination, Consumer Direction and Control,
Bethesda, Md.
Kafka, B. 1999. "ADAPT Campaign for Real Choice Self-Determination
for People with Disabilities." Paper prepared for the 1999 National
Leadership Summit on self-determination- Consumer Direction and Control,
Bethesda, Md.
Lagoyda, R., et al. 1999. Survey of State Administrators: Consumer-Directed
Home and Community-Based Services. Washington, D.C.: National Council
on the Aging.
Litvak, S., Zukas, H., and Heumann, J.E. 1987. Attending to America:
Personal Assistance for Independent Living. Berkeley, Calif.: World Institute
on Disability.
National Institute of Consumer-Directed Long-Term Services. 1996. Principles
of Consumer-Directed Home and Community Based Services, Washington, D.C.:
National Council on the Aging.
Nerney, T., and Crowley, R. 1994. An Affirmation of Community. Durham,
N. J.: University of New Hampshire Institute on Disability.
Nerney, T., and Shumway, D. 1996. Beyond Managed Care: Self-Determination
for Persons with Developmental Disabilities. Durham, N.H.: University
of New Hampshire Institute on Disability.
Scala, M.A., and Mayberry, P.S. 1997. Consumer-Directed Home Services:
Issues and Models. Oxford, Ohio: Scripps Gerontology Center.
Simon-Rusinowitz, L., et al. 1997. "Determining Consumer Preferences
for a Cash Option: Arkansas Survey Results." Health Care Financing
Review 19 (2): 73-96.
Printed with the permission from the authors and Generations
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