Guidance for Program
Case studies indicate overall satisfaction with IndependentChoices, especially as compared with previous agency experience. Consumers and families described how important this program has been to them and indicated their desire to see the program continue. This conclusion is consistent with both background research conducted for the CCDE and early evaluation findings. Background research (surveys and focus groups) conducted prior to cash option implementation asked consumers and representatives about their preliminary interest in a consumer-directed cash option. In the AR survey about 1/3 of consumers and over 1/2 of representatives were interested in the cash option. Focus group participants frequently spoke of dissatisfaction with agency services. Early evaluation findings (n=200) indicated that 9/10 consumers would recommend IndependentChoices to others and more than 8/10 consumers said the monthly allowance had improved their lives.The case studies offer rich examples illustrating satisfaction with IndependentChoices, which can be helpful to the Arkansas office in working with state policymakers to help make this a permanent option.
Arkansas and the other CCDE states (New Jersey and Florida) are working with the Scripps Gerontology Center to learn more about developing quality management programs that are appropriate for consumer-directed services. The Arkansas case studies add to our knowledge about consumers’ and workers’ views about important skills and qualities for a personal care worker in this setting.Consumers frequently spoke about important personal qualities and described good workers with: a pleasant personality (easy to talk to, not moody), a sense of humor, as well as patience and kindness. Consumers also talked about the importance of dependability, reliability, and trustworthiness as traits for workers. Being discreet, neat, and clean as well as keeping the consumer’s business private was also important to consumers.In regard to work-related qualities, workers with common sense who can do what needs to be done were valued. Some consumers focused on the importance of worker training for the technical aspects of the job (e.g. proper lifting, medical care) while others spoke to the importance of prior caregiving experience (e.g. relatives with many years of caring for a family member, caring for children). Other’s mentioned the importance of keeping the consumer’s home neat and clean.
The case studies indicated varying degrees of counselor involvement with consumers and their families. About one-third of the counselors had detailed knowledge about the consumer and their families. In about one-third of the cases counselors offered monthly services but were more detached. In most of these cases consumers had strong family support and a knowledgeable worker. In the remaining one-third of the cases, consumers were not connected to any specific counselor or in regular communication with the program. This knowledge is helpful in guiding Arkansas as it moves from an initial focus on program implementation to program refinement and moving toward making IndependentChoices a permanent option. Questions to consider include: How much counselor contact is enough and appropriate? Should this amount vary according to the degree of family support and worker knowledge/stability? How effective is counselor training in helping counselors perform their duties? What type of degree of counselor monitoring/quality assurance is needed?