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Arkansas Qualitative Report

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Arkansas Report Table of Contents

Executive Summary   |   Introduction

Executive Summary

The following report presents twenty-seven case stories about the experience of adults with disabilities who receive the cash option in the IndependentChoices Program in Arkansas. The report focuses on how “care units,” composed of consumers and/or representatives, paid workers, and counselors interacted around issues of consumer directed care. The study addresses several broad research questions: (1)has IndependentChoices made a difference in the lives of consumers, representatives, and workers, and if so, how; (2) how does participation in IndependentChoices compare with previous arrangements; (3) how are services provided; and (4) how does the program work? Two University of Maryland Baltimore County (UMBC) researchers conducted a total of fifty-nine interviews on three separate trips to Arkansas from the period of March through June 2000. After consultation with the Cash & Counseling Demonstration and Evaluation (CCDE) management team, twenty-seven care units were selected. All the consumers interviewed had been enrolled in Arkansas IndependentChoices for at least eight months at the time of the interview and received at least two hundred dollars per month in the cash option. Care unit members were interviewed in face-to-face, hour long interviews which were tape-recorded for later transcription. Interviews were analyzed with the help of a qualitative data management and analysis software package, NUD*IST4. The stories in the report were written based on the transcripts and incorporate the perspectives of all three members of the care unit; consumer, caregiver, and counselor. The UMBC researchers worked together, writing and discussing the stories. All stories were written with an eye to allowing participants to speak for themselves. The stories were analyzed for cross-cutting topics and themes that emerged in the interviews. Themes include the family context of care, the meaning of independence, and the community context of care. In addition, participants spoke of topics such as the skills and qualities needed for a caregiver and the value of IndependentChoices to them. Important topics also included the value of IndependentChoices personal care services, alternative uses of the cash benefit, previous experiences with agency workers, and problems with IndependentChoices.

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The following report presents twenty-seven stories about what it is like as an adult with a disability to participate in a program called Arkansas IndependentChoices. Researchers from the University of Maryland Baltimore County (UMBC) traveled to Arkansas to interview participants about the program and how it worked for them. In their own words we learn what it is like to arrange and pay for your own care with or without a representative’s help, how participants direct and pay their caregivers, and how participants negotiate the program itself. The twenty-seven stories presented here also yield common themes and concerns which help us understand how Arkansas IndependentChoices works and the meaning it has for participants.

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Cash and Counseling Banner of Participants' Smiling Faces