How Did Cash and Counseling Participants Spend their Budgets, and Why Does That Matter for CLASS?

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This policy brief addresses some similarities between the Cash and Counseling (C&C) model and CLASS, including participant control over a cash benefit, the ability to develop an individualized spending plan, the ability to hire family members as workers, and the availability of a range of programmatic supports to help participants manage their responsibilities.

Date Updated: 04/06/2011

Cash and Counseling (C&C) is one of the most flexible models of participant direction (also called consumer direction or self-direction) in personal assistance services (e.g., help with daily living activities such as dressing, eating, using the toilet, etc.). The model offers participants who have disabilities and are eligible for publicly-funded supports the authority to manage a personal assistance budget. Flexible spending accounts, which are integral to the C&C model, provide an individualized budget comparable in amount to what the individual would have received through state Medicaid services (less administrative costs). C&C participants develop a spending plan for administering the budget. Participants can hire, supervise, and dismiss their own workers, set the schedule to meet their own daily rhythms (including evenings or weekends), and pay their worker more or less wages depending…


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