Case Studies of Six State Personal Assistance Service Programs Funded by the Medicaid Personal Care Option. State Program Selection

12/01/1991

Selection of programs was based on information gathered in the 1985 and 1989 surveys, as well an interview conducted with Deborah Lewis-Idema, a researcher who had just completed a study of the Medicaid Personal Care Option. The states were chosen in order to represent different systems of service delivery, different provider arrangements, different sized programs, and different geographical areas. An attempt was made to avoid visiting programs which had already been studied intensively by other researchers in the field (i.e., NY, OK). The six sites chosen and the dates of the site visits were:

  1. Montana Medicaid Personal Care Services Program--October 22-26, 1990; Inter-Mountain Region; Small program (736 clients in 1988); Single statewide agency provider; Switched to this provider mode from independent providers.

  2. Michigan Home Help Program--November 12-16, 1990; Midwest Region; Large program (33,000 clients in 1988); Independent providers including some family members.

  3. Oregon In-Home Services Program--December 3-7, 1990; Northwest Region; Medium program (2,594 clients in 1988); Agency Providers contracted by the counties; Part of an integrated service delivery system (Senior and Disabled Services Division).

  4. Massachusetts Independent Living Personal Care Program--January 21-25, 1991; Northeast Region; Small program (1,518 clients in 1988); Independent providers with training, support, and billing through independent living centers.

  5. Maryland Medical Assistance Personal Care Services Program--January 28-31, 1991; Eastern Seaboard Region; Medium program (4,000 clients in 1988); Independent providers bill state Medicaid office at a daily reimbursement rate.

  6. Texas Primary Home Care Program--February 25-March 1, 1991; Southwest Region; large program (33,000 clients in 1988) Multiple agency providers compete for each client contract.

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