Consumer and Counselor Experiences in the Arkansas IndependentChoices Program. APPENDIX: Additional Tables

01/01/2004

TABLE A.1. Consumer Characteristics at Baseline
(Percent)
  Overall Under 65 65 or Older
DEMOGRAPHIC CHARACTERISTICS
Age      
-- 18 - 39 7.2 25.8  
-- 40 - 64 20.6 74.2  
-- 65 - 79 36.4   50.3
-- 80 or older 35.9   49.7
Sex      
-- Female 77.7 67.4 81.7
Race      
-- Self-identified as white only 61.2 66.8 59.0
-- Self-identified as black only or black and some other race 32.9 26.0 35.6
-- Self-identified as some other race 5.9 7.2 5.4
-- Hispanic 1.3 1.1 1.4
Years of Education      
-- 8 or fewer 53.7 24.4 65.1
-- 9 to 12, non-graduate 22.1 30.5 18.9
-- 12 (high school graduate) 16.4 25.4 12.9
-- More than 12 (some college) 7.8 19.7 3.2
Living Arrangement/Marital Status      
-- Lives alone 32.1 37.3 30.1
-- Lives with spouse only 8.4 7.5 8.7
-- Lives with others/not married or married and Living with 2 or more other people 59.6 55.2 61.2
HEALTH AND FUNCTIONING
Health Status      
-- Excellent or good 21.5 20.1 22.1
-- Fair 30.9 29.9 31.3
-- Poor 47.5 50.0 46.5
Health Compared with Last Year      
-- Better or about the same 46.0 49.1 44.8
-- Worse 54.0 50.9 55.2
Expected Health Next Year      
-- Better 15.4 18.6 14.2
-- Worse 36.9 29.4 39.7
-- Same 29.9 38.0 26.8
-- Could not say 17.8 14.0 19.3
Last week, Not Independent In:e      
-- Transfer 65.1 63.1 65.9
-- Bathing 89.6 87.5 90.5
-- Using toilet 66.4 63.4 67.5
Functioning Compared with Last Year      
-- Better or about the same 35.3 40.5 33.3
-- Worse 64.7 59.5 66.7
Has Cognitive Impairment (Inferred)h 23.9 15.8 27.0
UNPAID AND PAID PAS
Had Unpaid or Paid Help at Home Last Week with:      
-- Personal carea 88.1 85.0 89.2
-- Transportationb 61.6 71.0 57.9
-- Routine health carec 74.7 68.5 77.1
-- Household activitiesd 95.7 93.9 96.4
Number of Unpaid Caregivers Last Week      
-- None 9.3 8.6 9.5
-- One 28.3 25.8 29.2
-- Two 28.8 27.2 29.4
-- Three or more 33.7 38.4 31.9
Primary Unpaid Caregiver Relationship to Consumer      
-- Spouse 5.7 7.2 5.1
-- Parent 5.2 18.6 0.0
-- Child 53.1 29.4 62.2
-- Other relative 17.6 20.8 16.4
-- Nonrelative 9.1 15.4 6.6
-- Had no primary informal caregiver 9.4 8.6 9.7
Primary Informal Caregiver Employed 32.7 32.9 32.7
Number of Paid Caregivers Last Week      
-- None 32.2 44.1 27.7
-- One 40.2 35.8 41.9
-- Two 18.6 13.6 20.5
-- Three or more 9.0 6.5 10.0
Had Paid Live-in Caregiver Last Week 1.5 1.4 1.5
Received Help at Home Paid by Privately Paid Source Last Week 13.6 11.1 14.5
GOODS AND SERVICES PURCHASED LAST YEAR
Social/recreational programs 9.4 11.9 8.4
Adult Day Care 6.2 5.0 6.7
Transportation 27.8 35.8 24.7
Home or van modification 37.9 34.1 39.4
Equipment purchase 30.8 29.9 31.2
UNMET NEED FOR AND ACCESS TO PAS
Last Week, Needed Help (or More Help) with:      
-- Personal carea 62.5 69.3 59.9
-- Transportationb 46.2 60.5 40.6
-- Household activitiesd 66.6 76.9 62.7
Potential Difficulty Hiring Due to Location      
-- Lives in a rural area 38.2 37.5 38.4
-- Live in a nonrural area but transportation difficult or high crime 30.7 35.7 28.8
-- Lives in a nonrural area, but transportation not difficult and not high crime 31.1 26.8 32.8
SATISFACTION WITH PAID PAS
Satisfaction with How Paid Help Providedf      
-- Very satisfied 29.6 24.4 31.6
-- Satisfied 21.7 14.3 24.5
-- Dissatisfied 14.5 14.7 14.5
-- No paid help with personal care, routine health care, housework 34.2 46.6 29.4
Satisfied with When Paid Help Provided Among Those Receiving Personal Caref      
-- Very satisfied 19.4 13.7 21.7
-- Satisfied 17.1 9.7 20.0
-- Dissatisfied 16.0 18.0 15.3
-- No paid help with personal care 47.4 58.6 43.1
Satisfied with Paid Services and Goods Overall      
-- Very satisfied 38.1 27.5 42.2
-- Satisfied 33.0 26.4 35.5
-- Dissatisfied 19.9 31.2 15.7
-- No paid services or goodsg 8.9 14.9 6.6
QUALITY OF LIFE
Satisfied with Life Overall      
-- Very satisfied 13.1 10.6 14.0
-- Satisfied 18.4 25.9 15.6
-- Dissatisfied 19.1 38.0 11.8
-- Proxy respondent not asked 49.4 25.6 58.6
EMPLOYMENT EXPERIENCE
Ever employed 84.3 82.1 85.2
Ever supervised someone 29.5 42.9 24.3
Ever hired someone privately 32.3 42.4 28.4
TYPE OF RESPONDENT
Majority of Baseline Questions Answered by Proxy Respondent 48.3 24.7 57.4
NUMBER OF CONSUMERS RESPONDING TO SURVEY 1,004 279 725
SOURCE: Age and sex come from IndependentChoices program records. All other data come from MPR baseline survey conducted in Arkansas between December 1998 and April 2001.
NOTE: "Last week" refers to the week before the baseline survey.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Transportation includes both medical and nonmedical transportation.
  3. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Received hands-on or standby help or did not perform activity at all.
  6. For 48 cases, proxy respondent is providing own level of satisfaction because sample member reportedly not capable of forming opinion.
  7. Skipped satisfaction question because no paid help, community services, home or vehicle modifications, or equipment purchased.
  8. Consumer could not respond to interview due to physical or mental limitation and used a representative to manage allowance.


TABLE A.2: Home Care at Enrollment and Use of Representative for IndependentChoices
(Percent)
  Overall Under 65 65 or Older
Length of Time With Publicly Funded Home Care      
-- Participant says no care last week and program says not a current Medicaid PAS user 26.1 39.4 20.9
-- Participant says no care last week, but program says current Medicaid PAS user 9.4 9.3 9.4
-- Participant says getting care less than a year 20.9 16.9 22.4
-- Participant says getting care 1 to 3 years 22.4 17.2 24.4
-- Participant says getting care more than 3 years 21.3 17.2 22.9
Number of Hours Per Week of Planned PAS      
-- Less than or equal to 6 22.6 16.8 24.8
-- More than 6, but less than or equal to 11 37.5 32.6 39.3
-- More than 11, but less than or equal to 15 37.6 45.9 34.5
-- More than 15 2.3 4.7 1.4
Mean Monthly Allowancea $319 $362 $302
Had an IndependentChoices Representative at Enrollment 40.8 26.2 46.5
NUMBER OF CONSUMERS RESPONDING TO SURVEY 1,004 279 725
SOURCE: MPR baseline survey conducted in Arkansas between December 1998 and April 2001 and IndependentChoices program records.
NOTE: “Last week” refers to the week before the baseline survey. PAS is personal assistance services.
  1. IndependentChoices calculated the monthly allowance by multiplying the planned weekly PAS hours of care by 4.33 (weeks per month), $8 (dollars per hour), and an agency-specific discount rate. The discount rate, which ranged from 70 to 91 percent and was meant to promote budget neutrality, took into account the fact that agencies usually delivered fewer hours of care than appeared in care plans.


TABLE A.3: Counselor Characteristics and Experience with IndependentChoices
NUMBER OF COUNSELORS BY CHARACTERISTIC
Professional Background  
-- Social work/social services 5
-- Nursing 1
-- Other (speech pathologist) 1
Highest Educational Degree  
-- Less than high school 0
-- High school graduate or GED 2
-- Associate 0
-- Baccalaureate 3
-- Master’s or doctorate 2
Sex  
-- Female 4
Hispanic or Latino 0
Race  
-- White 4
-- African American/black 2
-- White and American Indian/Alaska Native 1
Country of Birth  
-- United States 7
TIME WORKING FOR INDEPENDENTCHOICES
A year or less 4
More than a year 3
NUMBER OF CONSUMERS WITH WHOM COUNSELOR HAS WORKED SINCE STARTED WITH INDEPENDENTCHOICES
Mean 284
Median 405
Minimum 95
Maximum 405
NUMBER OF CONSUMERS WITH WHOM COUNSELOR WORKING AT PRESENT
Mean 268
Median 405
Minimum 75
Maximum 405
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.


TABLE A.4: Program Features Important to Consumers at Enrollment
(Percent)
  Age
Overall Less than 65 65 or Older
Paying Family Members to Help      
-- Very important 78.3 79.9 77.7
-- Important or somewhat important 12.5 11.8 12.8
-- Not important 9.1 8.2 9.5
Paying Friends to Help      
-- Very important 60.3 67.0 57.7
-- Important or somewhat important 18.5 18.3 18.6
-- Not important 21.2 14.7 23.7
Primary Informal Caregiver Expressed Interest in Being Paid 29.6 33.5 28.1
Having a Choice About When Helpers Come      
-- Very important 82.0 82.1 82.0
-- Important or somewhat important 13.8 13.6 13.8
-- Not important 4.2 4.3 4.2
Having a Choice About the Type of Help Services Received      
-- Very important 85.9 87.8 85.1
-- Important or somewhat important 11.9 10.8 12.4
-- Not important 2.2 1.4 2.5
NUMBER OF RESPONDENTS TO BASELINE 1,004 279 725
SOURCE: MPR baseline survey conducted in Arkansas between December 1998 and April 2001.


TABLE A.5a: Enrollment Flow and Length of Stay, All Consumers
  Percentage of Consumers Enrolled
Enrollment Montha  
-- December 1998 - June 1999 29.6
-- July 1999 - December 1999 19.6
-- January 2000 - June 2000 24.5
-- July 2000 - December 2000 14.6
-- January 2001 - April 2001 11.7
Length of Enrollment During Followup Year  
-- Less than 2 months 11.7
-- 2 months or more, but less than 6 months 13.8
-- 6 months or more, but less than 12 months 12.6
-- 12 months 62.0
Length of Allowance Receipt During Followup Year  
-- Never received 15.1
-- 6 months or less 16.2
-- 7 to 10 months 9.7
-- 11 months 33.6
-- 12 months 25.4
NUMBER OF CONSUMERS ENROLLED 1,004
SOURCE: IndependentChoices program records.
  1. IndependentChoices enrolled consumers for the evaluation between December 1998 and April 2001.


TABLE A.5b: Enrollment Flow and Length of Stay, by Consumer Age And Public Home Care Tenure
  Percentage of Consumers Enrolled
Age Length of Time with Public Home Care
Less than 65 65 or Older Less Than 1
Year or Not at
Enrollment
1 Year or
Longer
Enrollment Montha        
-- December 1998 - June 1999 28.7 29.9 23.1 38.2
-- July 1999 - December 1999 25.1 17.5 20.6 18.5
-- January 2000 - June 2000 24.4 24.6 26.4 22.2
-- July 2000 - December 2000 10.4 16.3 14.4 14.9
-- January 2001 - April 2001 11.5 11.7 15.6 6.2
Length of Enrollment During Followup Year        
-- Less than 2 months 7.5 13.2 9.4 14.7
-- 2 months or more, but less than 6 months 10.4 15.2 10.8 17.9
-- 6 months or more, but less than 12 months 12.2 12.7 12.9 11.9
-- 12 months 69.9 58.9 66.8 55.6
Length of Allowance Receipt During Followup Year        
-- Never received allowance 10.8 16.8 11.4 20.1
-- 6 months or less 13.6 17.2 14.9 18.1
-- 7 to 10 months 11.1 9.1 9.0 10.3
-- 11 months 33.7 33.5 34.4 32.7
-- 12 months 30.8 23.3 30.3 18.8
NUMBER OF CONSUMERS ENROLLED 279 725 564 437
SOURCE: IndependentChoices program records.
  1. IndependentChoices enrolled consumers for the evaluation between December 1998 and April 2001.


TABLE A.6: Disenrollment During Followup Year and Reasons for Disenrollment
(Percent)
  Overall Under 65 65 or Older
Disenrolled (or Died) at Any Time During Followup Year According To Program Records 38.1 30.1 41.1
Among Those Who Disenrolled (or Died) According To Records, Did So During Months      
-- 1 to 3 48.7 44.1 50.0
-- 4 to 6 22.5 21.4 22.8
-- 7 to 9 16.8 20.2 15.8
-- 10 to 12 12.0 14.3 11.4
Among Those Who Disenrolled (or Died) According To Records      
-- Disenrolled (or died) before started receiving allowance 44.0 39.3 45.3
-- Disenrolled after started receiving allowance 38.7 42.9 37.6
-- Died after started receiving allowance 17.3 17.9 17.1
Disenrolled (or Died) At Any Time During 9-Month Survey Followup Period According to Self-Reports 33.1 25.3 36.0
Among Those Who Disenrolled (Or Died) During The 9-Month Survey Followup Period According to Self-Reports, Did So      
-- Between baseline and 4- month interview 61.3 63.6 60.6
-- Between the 4- and 9- month interview 38.7 36.4 39.4
REASONS FOR DISENROLLMENT
Among Those Who Disenrolled (or Died) According to Records, Reason      
-- Death 21.7 22.6 21.5
-- No longer eligible for Medicaid 9.7 8.3 10.1
-- No longer eligible for PAS 18.3 15.5 19.1
-- Abuse or mismanagement of allowance 0.0 0.0 0.0
-- Program initiated disenrollment for some other reason 0.8 1.2 0.7
-- Consumer initiated disenrollment 49.5 52.4 48.7
Among Those Who Disenrolled (or Died) According to Self-Reports, Reason      
-- Death 22.7 17.4 24.0
-- Left the state 0.0 0.0 0.0
-- Entered hospital or nursing home 6.3 0.0 7.8
-- Lost or needed representative 4.2 0.0 5.2
-- No longer eligible for PAS 21.0 21.7 20.8
-- Program initiated disenrollment 2.5 10.9 0.5
-- Not able to hire in allowed time 0.0 0.0 0.0
-- Consumer-initiated disenrollment 43.3 50.0 41.7
Among Those with Consumer-Initiated Disenrollment According to Self-Reports, Reason:      
-- Allowance Not Enough 28.6 27.3 29.0
-- Other problems with allowance 1.0 4.6 0.0
-- Conflict with program staff/too many rules about use of allowance 6.1 9.1 5.3
Changed mind/satisfied with traditional services/did not understand program 28.6 22.7 30.3
-- Program never contacted consumer 4.1 4.6 4.0
-- Problem with employer responsibilities 26.5 18.2 29.0
-- Consumer/worker/helper health worsened 8.2 9.1 7.9
-- Problem with fiscal responsibilities 8.2 9.1 7.9
-- Other reasons 4.1 4.6 4.0
NUMBER OF CONSUMERS ENROLLED (AND THUS WITH PROGRAM RECORDS) 1,004 279 725
NUMBER OF CONSUMERS RESPONDING TO 4-MONTH OR 9-MONTH SURVEY 952 261 691
SOURCE: IndependentChoices program records; MPR telephone surveys with consumers 4 and 9 months after random assignment.


TABLE A.7: Activities Conducted by Counselors
Average Number of Hours Counselors Worked per Week for IndependentChoices 44
Number of Counselors Spending at Least 20 Percent of Consulting Time on the Following Activities with Consumers:  
-- Reinforcing decision to participate 0
-- Assisting with spending plan or advising about purchases 3
-- Advising about payroll activities for workersa 2
-- Advising about worker training 1
-- Assisting in disputes with workers or advising about firing 0
-- Linking to peer counseling or other local services 0
-- Monitoring or investigating misuse of allowance or abuse/neglect/exploitation 0
-- Assisting with emergency backup arrangements 0
-- Listening or providing encouragement or support 1
-- Administrative activitiesb 3
-- Reassess Medicaid plans or investigate Medicaid problems 1
Number Of Counselors Reporting The Following As Valuable To Consumers  
-- Assistance with spending plan or advising about purchases 7
-- Advising about payroll activities for workers 2
-- Advising about worker training 5
-- Assisting in disputes with workers or advising about firing 4
-- Linking to peer counseling or other local services 4
-- Assisting with emergency backup arrangements 6
-- Listening or providing encouragement or support 7
-- Assisting with paperwork 7
Average Number Of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: MPR mail survey of IndependentChoices counselors conducted between May and June 2000.
  1. “Payroll activities” refer to activities such as setting wages, including estimating payroll taxes.
  2. “Administrative activities” include record keeping, updating case notes, or making contacts with other program staff.


TABLE A.8: Consumer Monitoring
Number of Counselors Reporting That Some Consumers Needed Extensive Monitoring 6
Average Number of Consumers on Caseload Who Needed Extensive Monitoring 20
Number Of Counselors Reporting the Following Reasons for Monitoring  
-- Consumer or representative appeared to be abused, neglected, or financially exploited 4
-- Consumer or representative appeared to be abusing or financially exploiting worker 1
-- Consumer’s living environment was unsafe 5
-- Consumer or representative was having difficulty staying on budget 2
-- Representative changed 3
-- Consumer or representative was ill 4
-- Consumer or representative had no experience as employer 2
-- Consumer or representative had difficulty completing paperwork 3
-- Workers changed frequently 5
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: MPR mail survey of IndependentChoices counselors conducted between May and June 2000.
NOTE: Counselors were asked about consumers or representatives who required extensive monitoring due to concerns about their ability to manage the cash benefit or about their safety.


TABLE A.9: Counselor Reports of Abuse of Consumers and Workers
FINANCIAL EXPLOITATION OF CONSUMERS
Number of Counselors Reporting Evidence of Financial Exploitationa 3
Average Number of Consumers for Whom There Was Evidence of Financial Exploitation 1
Number of Counselors Reporting Financial Exploitation of Consumers by:  
-- Representatives 1
-- Workers 2
PHYSICAL OR VERBAL ABUSE OR NEGLECT OF CONSUMERS
Number of Counselors Reporting Evidence of Abuse or Neglect 4
Number of Counselors Reporting Abuse or Neglect by Type  
-- Physical or sexual abuse 0
-- Neglect of physical needs or abandonment 3
-- Self-neglect 4
-- Verbal, emotional, or psychological abuse 0
Average Number of Consumers for Whom There Was Evidence of Abuse or Neglect 3
Number of Counselors Reporting Abuse or Neglect of Consumers by:  
-- Representatives 3
-- Workers 3
PHYSICAL OR VERBAL ABUSE OF WORKERS
Number of Counselors Reporting Evidence of Abuse of Workers by Consumers, Their Representatives, or Families 3
Number of Counselors Reporting Worker Abuse or Neglect by Type  
-- Physical or sexual abuse 0
-- Verbal, emotional, or psychological abuse 3
Average Number of Consumers for Whom There Was Evidence of Abuse of Workers 2
Number of Counselors Reporting Abuse of Workers by:  
-- Representatives 0
-- Consumers 2
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: MPR mail survey of IndependentChoices counselors conducted between May and June 2000.
  1. Financial exploitation includes stealing money or possessions from consumers, intentional overbilling, coercing to sign over assets.


TABLE A.10a: Time Between Random Assignment and Monthly Allowance Start, Disenrollment, or Death, All Consumers
  Percentage of Consumers
Started Monthly Allowance by End of:a  
-- 1 month 23.5
-- 2 months 76.1
-- 3 months 81.2
-- 4 months 82.6
-- 5 months 82.8
-- 6 months 83.2
-- 7 months 83.6
-- 8 months 83.9
-- 9 months 84.1
-- 10 months 84.4
-- 11 months 84.5
-- 12 months 84.9
Snapshot at End of 3 Months  
-- Enrolled and started allowance 75.7
-- Enrolled and allowance not started 6.4
-- Disenrolled 14.9
-- Deceased 3.0
Snapshot at End of 6 Months  
-- Enrolled and started allowance 71.5
-- Enrolled and allowance not started 2.6
-- Disenrolled 20.8
-- Deceased 5.1
Snapshot at End of 9 Months  
-- Enrolled and started allowance 66.7
-- Enrolled and allowance not started 1.3
-- Disenrolled 25.0
-- Deceased 7.0
Snapshot at End of 12 Months  
-- Enrolled and started allowance 63.1
-- Enrolled and allowance not started 0.6
-- Disenrolled 28.1
-- Deceased 8.3
NUMBER OF CONSUMERS ENROLLED 1,004
SOURCE: IndependentChoices program records.
  1. Percentages in this panel are cumulative and include consumers who started on cash prior to the referenced month, but subsequently disenrolled or died.


TABLE A.10b: Time Between Random Assignment and Monthly Allowance Start, By Consumer Age and Public Home Care Tenure
  Percentage of Consumers
Age Length of Time with Public Home Care
Less than 65 65 or Older Less Than 1
Year or Not at
Enrollment
1 Year or
Longer
Started Monthly Allowance by End of:a        
-- 1 month 26.9 22.2 27.1 18.5
-- 2 months 80.3 74.5 80.5 70.3
-- 3 months 86.0 79.3 84.9 76.2
-- 4 months 87.5 80.7 86.4 77.6
-- 5 months 87.5 81.0 86.7 77.6
-- 6 months 87.5 81.5 87.1 78.0
-- 7 months 88.5 81.7 87.6 78.3
-- 8 months 88.9 81.9 87.8 78.7
-- 9 months 89.3 82.1 87.8 79.2
-- 10 months 89.3 82.5 88.1 79.4
-- 11 months 89.3 82.6 88.1 79.6
-- 12 months 89.3 83.2 88.7 79.9
Snapshot at End of 3 Months        
-- Enrolled and started allowance 80.7 73.8 80.1 69.8
-- Enrolled and allowance not started 7.2 6.1 6.6 6.2
-- Disenrolled 9.7 17.0 9.9 21.5
-- Deceased 2.5 3.2 3.4 2.5
Snapshot at End of 6 Months        
-- Enrolled and started allowance 78.9 68.7 76.2 65.2
-- Enrolled and allowance not started 2.9 2.5 3.2 1.8
-- Disenrolled 15.1 23.0 15.3 28.2
-- Deceased 3.2 5.8 5.3 4.8
Snapshot at End of 9 Months        
-- Enrolled and started allowance 74.6 63.7 71.5 60.4
-- Enrolled and allowance not started 1.8 1.1 2.0 0.5
-- Disenrolled 17.9 27.7 19.3 32.5
-- Deceased 5.7 7.5 7.3 6.6
Snapshot at End of 12 Months        
-- Enrolled and started allowance 71.0 60.0 67.9 56.8
-- Enrolled and allowance not started 1.1 0.4 1.1 0.0
-- Disenrolled 21.2 30.8 23.1 34.6
-- Deceased 6.8 8.8 8.0 8.7
NUMBER OF CONSUMERS ENROLLED 279 725 564 437
SOURCE: IndependentChoices program records.
  1. Percentages in this panel are cumulative and include consumers who started on cash prior to the referenced month but subsequently disenrolled or died.


TABLE A.11: Use of Representatives
Percentage of Consumers with Whom Counselor Worked Who Used Representatives 46.4
Of Those Using Representatives:  
-- Percentage of consumers for whom counselor questioned suitability of representative 3.0
-- Percentage of consumers who disenrolled because representative was unsuitable 1.9
-- Percentage of representatives who acted according to the wishes and best interest of consumers 76.6
-- Percentage of representatives who had a serious divergence of wishes or interests from consumers 1.0
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.


TABLE A.12a: Use of and Satisfaction with Program Services
  Percentage of
Consumers
Reporting
Percentage Of Users
Reporting Service
Useful/Satisfied
With Service
Help Developing Allowance Spending Plan Between Baseline and 4-Month Interviews 83.3 96.3
Help Revising Allowance Spending Plan Between 4-Month and 9-Month Interviews 30.5 n.a.
Help Identifying Programs or Services with Little or No Cost to Consumer Between Baseline and 4-Month Interviews 50.0 n.a.
Materials with Information About How to Recruit Workers Received Between Baseline and 4-Month Interviews (Among Those Who Tried to Hire) 74.8 81.5
Advice About How to Recruit Workers Between Baseline And 4-Month Interviews (Among Those Who Tried To Hire) 51.6 91.3
Advice or Materials About How to Recruit Workers Between 4-Month And 9-Month Interviews (Among Those Who Tried to Hire) 37.1 n.a.
Use of Program Bookkeeping Services Between Baseline and 9-Month Interviews (Among Those Receiving Allowance) 94.7 98.0
Advice About How to Train Workers Between Baseline and 4-Month Interviews (Among Those Who Hired) 54.2 80.0
Advice About How to Train Workers Between 4-Month and 9-Month Interviews (Among Those Who Hired) 28.8 n.a.
Use of Peer Counseling Services Between Baseline and 4-Month Interviews (Among Those Receiving Allowance) 1.3 100.0
Use of Peer Counseling Services Between 4-Month and 9-Month Interviews (Among Those Receiving Allowance) 1.0 n.a.
NUMBER OF RESPONDENTS TO 4-MONTH INTERVIEW 924  
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 885  
SOURCE: MPR telephone interviews with consumers 4 and 9 months after random assignment.
n.a. = means not applicable.


TABLE A.12b: Use of and Satisfaction with Program Services, Elderly Adults
  Percentage of
Consumers
Reporting
Percentage Of Users
Reporting Service
Useful/Satisfied
With Service
Help Developing Allowance Spending Plan Between Baseline and 4-Month Interviews 81.7 95.2
Help Revising Allowance Spending Plan Between 4-Month and 9-Month Interviews 27.9 n.a.
Help Identifying Programs or Services with Little or No Cost to Consumer Between Baseline and 4-Month Interviews 52.5 n.a.
Materials with Information About How to Recruit Workers Received Between Baseline and 4-Month Interviews (Among Those Who Tried to Hire) 73.6 81.4
Advice About How to Recruit Workers Between Baseline And 4-Month Interviews (Among Those Who Tried To Hire) 49.4 91.1
Advice or Materials About How to Recruit Workers Between 4-Month And 9-Month Interviews (Among Those Who Tried to Hire) 34.5 n.a.
Use of Program Bookkeeping Services Between Baseline and 9-Month Interviews (Among Those Receiving Allowance) 95.1 98.0
Advice About How to Train Workers Between Baseline and 4-Month Interviews (Among Those Who Hired) 53.6 78.2
Advice About How to Train Workers Between 4-Month and 9-Month Interviews (Among Those Who Hired) 31.9 n.a.
Use of Peer Counseling Services Between Baseline and 4-Month Interviews (Among Those Receiving Allowance) 0.8 100.0
Use of Peer Counseling Services Between 4-Month and 9-Month Interviews (Among Those Receiving Allowance) 0.8 n.a.
NUMBER OF RESPONDENTS TO 4-MONTH INTERVIEW 670  
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 642  
SOURCE: MPR telephone interviews with consumers 4 and 9 months after random assignment.
n.a. = means not applicable.


TABLE A.12c: Use of and Satisfaction with Program Services, Nonelderly Adults
  Percentage of
Consumers
Reporting
Percentage Of Users
Reporting Service
Useful/Satisfied
With Service
Help Developing Allowance Spending Plan Between Baseline and 4-Month Interviews 87.4 99.1
Help Revising Allowance Spending Plan Between 4-Month and 9-Month Interviews 37.1 n.a.
Help Identifying Programs or Services with Little or No Cost to Consumer Between Baseline and 4-Month Interviews 44.6 n.a.
Materials with Information About How to Recruit Workers Received Between Baseline and 4-Month Interviews (Among Those Who Tried to Hire) 77.8 81.6
Advice About How to Recruit Workers Between Baseline And 4-Month Interviews (Among Those Who Tried To Hire) 57.0 91.6
Advice or Materials About How to Recruit Workers Between 4-Month And 9-Month Interviews (Among Those Who Tried to Hire) 40.7 n.a.
Use of Program Bookkeeping Services Between Baseline and 9-Month Interviews (Among Those Receiving Allowance) 93.6 98.0
Advice About How to Train Workers Between Baseline and 4-Month Interviews (Among Those Who Hired) 55.7 83.9
Advice About How to Train Workers Between 4-Month and 9-Month Interviews (Among Those Who Hired) 24.5 n.a.
Use of Peer Counseling Services Between Baseline and 4-Month Interviews (Among Those Receiving Allowance) 2.7 100.0
Use of Peer Counseling Services Between 4-Month and 9-Month Interviews (Among Those Receiving Allowance) 1.4 n.a.
NUMBER OF RESPONDENTS TO 4-MONTH INTERVIEW 254  
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 243  
SOURCE: MPR telephone interviews with consumers 4 and 9 months after random assignment.
n.a. = means not applicable.


TABLE A.13: Aspects of Program Services Found Useful
  Percentage
Overall Under 65 65 or Over
Among Those Receiving Help with Allowance Spending Plan, What Aspect of Help Found Useful:      
-- Explaining program rules 79.3 78.7 79.6
-- Clarifying goals, options, and priorities 47.4 53.2 44.9
-- Handling paperwork 9.5 6.5 10.8
-- Determining service costs 5.6 10.2 3.6
-- Getting approval for special uses of allowance 6.6 6.5 6.6
Among Those Receiving Advice About How to Recruit Workers, What Aspects of Advice Found Useful:      
-- Locating potential workers 24.6 27.9 22.9
-- Setting wage or benefit levels 16.2 17.1 15.7
-- Screening or interviewing potential workers 36.5 41.4 34.1
-- Arranging for background check 5.1 5.4 4.9
-- Provided training or advice of unspecified nature 40.7 34.6 43.7
NUMBER OF RESPONDENTS TO 4-MONTH INTERVIEW 924 254 670
SOURCE: MPR telephone interview of consumers 4 months after random assignment.


TABLE A.14: Difficulties Assuming the Role of Employer
  Percentage
Overall Under 65 65 or Over
HIRING WORKERS
Hiring Workers with Allowance Between Baseline and 9-Month Interviews      
-- Hired a worker 79.3 85.4 77.0
-- Tried to hire a worker, but did not 10.9 9.5 11.5
-- Did not try to hire a worker 9.7 5.1 11.5
Among Those Who Hired with Allowance Between Baseline and 9-Month Interviews, Found Hiring Hard 19.6 20.7 19.1
Among Those Who Found Hiring Hard Between Baseline and 4-Month Interviews, Aspect That Was Hardest      
-- Could not find interested/qualified workers 40.3 36.8 41.9
-- Wages offered were too low 18.6 15.8 19.8
-- Applicants disliked hours or tasks 19.4 23.7 17.4
-- Getting references/judging qualifications 7.3 2.6 9.3
-- Did not trust applicants 7.3 7.9 7.0
TRAINING WORKERS
Among Those Who Hired with Allowance, Provided Training for Workers Hired with Allowance Between Baseline and 9-Month Interviews      
-- Showed worker how to carry our tasks 31.3 37.0 28.8
-- Arranged for training outside the home 2.4 1.4 2.8
Among Those Who Trained Workers Between Baseline and 9-Month Interviews, Found Training Hard 9.3 7.8 10.1
Among Those Who Found Training Hard Between Baseline and 4-Month Interviews, Aspect That Was Hardest      
-- Worker did not seem to understand/worker had no previous experience/difficult to communicate what was wanted 15.4 0.0 18.2
-- Worker wanted to do task some other way 0.0 0.0 0.0
-- Consumer or family unable to demonstrate task/answer questions about task 23.1 50.0 18.2
-- Difficult to find training programs 7.7 0.0 9.1
-- Worker had no experience 15.4 0.0 18.2
-- Difficult to train and also get work done 15.4 50.0 9.1
-- Difficult for consumer and worker to get used to each other 23.1 0.0 27.3
NUMBER OF RESPONDENTS TO THE 4-MONTH OR 9-MONTH INTERVIEW 952 261 691
SOURCE: MPR telephone interviews with consumers 4 and 9 months after random assignment.


TABLE A.15: Recruiting Methods
  Percentage
Overall Under 65 65 or Older
RECRUITING METHODS ATTEMPTED, AMONG THOSE WHO HIRED OR TRIED TO HIRE WORKER
Tried to Hire      
-- Family member 80.5 76.4 82.2
-- Friend, neighbor, or church member 30.1 41.1 25.6
-- Home care agency worker 14.8 17.4 13.7
Asked Family or Friend To Recommend Worker 19.4 23.2 17.8
Posted or Consulted Advertisements 5.1 8.3 3.8
Contacted Employment Agency 3.3 2.1 3.8
RECRUITING METHODS RESULTING IN HIRES, AMONG THOSE WHO HIRED
Hired family member 77.2 72.4 79.3
Hired friend, neighbor, or church member 20.1 30.4 15.8
Hired former agency worker 7.2 9.7 6.1
Hired worker recommended by family or friend 6.1 7.8 5.3
Posted or consulted advertisement 3.2 6.0 2.0
Contacted employment agency 0.4 0.0 0.6
NUMBER OF RESPONDENTS TO EITHER THE 4-MONTH OR 9-MONTH INTERVIEW 952 261 691
SOURCE: MPR telephone interviews with consumers 4 and 9 months after random assignment.


TABLE A.16: Satisfaction with Workers as Reported by Counselors
Of Consumers with Whom Counselor Has Worked, Percent of Consumers Who Included a Paid Worker in Allowance Spending Plan 85.0
Of Consumers Who Planned to Hire a Paid Worker, Percent Who Had Serious Problem with Turnover Due to Workers Resigning or Being Fired 11.1
Of Consumers Who Planned to Hire a Paid Worker, Percent Who Hired a Relative 72.1
Of Consumers Who Hired a Relative as a Paid Worker, Percent Who Were Very Satisfied with Worker 88.3
Of Consumers Who Hired a Relative as a Paid Worker, Percent Who Were Very Dissatisfied with Worker 1.4
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.


TABLE A.17: Paid Human Assistance
  Percentage
Overall Under 65 65 or Over
Hired a Worker With Monthly Allowance Between Baseline and 9-Month Interview 77.2 83.5 74.8
Had Paid Worker in 2 Weeks Prior to 9-Month Interview 82.8 88.9 80.5
Hired Worker Paid with Monthly Allowance Between Baseline and 9-Month Interview and Had Paid Worker in 2 Weeks Prior to Interview 68.2 77.0 64.8
AMONG THOSE WHO HIRED WORKER WITH MONTHLY ALLOWANCE AND HAD WORKER IN DURING 2 WEEKS PRIOR TO 9-MONTH INTERVIEWa
Had 1 worker 67.8 81.8 61.4
Had 2 workers 22.0 11.8 26.7
Had 3 or more workers 10.2 6.4 11.9
Had a visiting worker(s) 72.5 75.9 70.9
Had live-in worker(s) 39.1 28.9 43.7
At least one worker was consumer’s:      
-- Spouse 0.0 0.0 0.0
-- Parent 4.5 13.9 0.2
-- Child 45.4 28.9 52.9
-- Other relative 25.2 26.7 24.5
-- Not related 26.2 30.5 24.3
Hours of paid care      
-- 14 or fewer 15.0 18.4 13.5
-- 15 to 42 71.9 71.8 71.9
-- 42 to 70 8.6 4.9 10.3
-- 71 or more 4.5 4.9 4.3
Worker helped with routine health careb 78.3 78.5 78.4
Worker helped with personal carec 94.8 95.2 94.7
Worker helped with housework or community choresd 97.8 98.4 97.6
Worker helped with transportatione 58.7 75.8 51.0
Worker helped before 8 am on weekdays 49.1 43.9 51.5
Worker helped after 8 pm on weekdays 64.2 61.0 65.7
Worker helped on weekends 77.0 74.3 78.2
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 885 243 642
SOURCE: MPR telephone interviews with consumers 9 months after random assignment.
  1. Description is of all paid workers for treatment group members who hired with the allowance, which includes workers for 5 percent of the sample who had disenrolled from IndependentChoices and were likely reporting on help received from agency workers.
  2. Routine health care includes taking medications, checking blood pressure, and doing exercises. Among those receiving paid help with routine health care and who had hired with allowance (n=445), 8 percent said all help was provided by person hired with the allowance.
  3. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Transportation includes both medical and nonmedical transportation.


TABLE A.18a: Uses of the Monthly Allowance, All Consumers
During Month 8 After Random Assignment Percent with
Cash Use
Mean
Expenditure ($)
Mean Percent
Spent
Hired a Worker 88.3 249 74.6
Purchased Home Care Agency Services 0.0 0 0.0
Purchased Home Modifications 1.5 2 0.6
Purchased Vehicle Modifications 0.6 <1 0.1
Purchased Equipmenta 4.3 3 1.1
Purchased Personal Care Suppliesb 48.7 37 11.1
Purchased Community Servicesc 15.0 13 3.5
Received Petty Cashd 36.5 14 3.7
Received Cash for Emergency Expensese 2.1 3 0.8
Other Expenses 1.0 <1 0.2
Total Expenses Paid During Month 8 95.5 324 n.a.
NUMBER OF CONSUMERS WHO USED BOOKKEEPING SERVICE AND HAD SPENDING RECORD FOR MONTH 8   718  
SOURCE: IndependentChoices program bookkeeper records.
NOTE: Of the 1,004 treatment group members, 274 had disenrolled or died before month 8, and 12 were still enrolled but had no record for month 8 with the bookkeeper. In addition, 32 were still enrolled and had a record for month 8, but the record showed no spending for goods or services during that month; these cases are included in the means as zeros.
n.a. = not applicable.
  1. Equipment includes that to assist with mobility, transfer, bathing, communication, personal safety, meal preparation, or housekeeping, for example.
  2. Supplies for personal care include diapers or pads to protect bedding, ostomy supplies, or feeding equipment.
  3. Community services include day care, day programs, medical and nonmedical transportation, home- delivered meals, food from commercial establishments, congregate meals, chore services, grocery delivery, laundry services.
  4. Treatment group members may request a check for petty cash each month to pay for goods and services directly. In Arkansas this is limited to 10 percent of the allowance each month. Petty cash may have been used to purchase personal care supplies.
  5. Clothing, pest control, utilities.


TABLE A.18b: Uses of the Monthly Allowance, Elderly Adults
During Month 8 After Random Assignment Percent with
Cash Use
Mean
Expenditure ($)
Mean Percent
Spent
Hired a Worker 88.6 243 76.0
Purchased Home Care Agency Services 0.0 0 0.0
Purchased Home Modifications 1.2 2 0.5
Purchased Vehicle Modifications 0.8 <1 0.1
Purchased Equipmenta 2.6 1 0.3
Purchased Personal Care Suppliesb 47.4 37 11.1
Purchased Community Servicesc 13.5 11 3.2
Received Petty Cashd 35.5 13 3.5
Received Cash for Emergency Expensese 2.0 3 0.8
Other Expenses 1.0 <1 0.1
Total Expenses Paid During Month 8 95.6 311 n.a.
NUMBER OF CONSUMERS WHO USED BOOKKEEPING SERVICE AND HAD SPENDING RECORD FOR MONTH 8   498  
SOURCE: IndependentChoices program bookkeeper records.
NOTE: Of the 1,004 treatment group members, 274 had disenrolled or died before month 8, and 12 were still enrolled but had no record for month 8 with the bookkeeper. In addition, 32 were still enrolled and had a record for month 8, but the record showed no spending for goods or services during that month; these cases are included in the means as zeros.
n.a. = not applicable.
  1. Equipment includes that to assist with mobility, transfer, bathing, communication, personal safety, meal preparation, or housekeeping, for example.
  2. Supplies for personal care include diapers or pads to protect bedding, ostomy supplies, or feeding equipment.
  3. Community services include day care, day programs, medical and nonmedical transportation, home- delivered meals, food from commercial establishments, congregate meals, chore services, grocery delivery, laundry services.
  4. Treatment group members may request a check for petty cash each month to pay for goods and services directly. In Arkansas this is limited to 10 percent of the allowance each month. Petty cash may have been used to purchase personal care supplies.
  5. Clothing, pest control, utilities.


TABLE A.18c: Uses of the Monthly Allowance, Nonelderly Adults
During Month 8 After Random Assignment Percent with
Cash Use
Mean
Expenditure ($)
Mean Percent
Spent
Hired a Worker 87.7 264 71.6
Purchased Home Care Agency Services 0.0 0 0.0
Purchased Home Modifications 2.3 3 1.1
Purchased Vehicle Modifications 0.0 0 0.0
Purchased Equipmenta 8.2 8 2.8
Purchased Personal Care Suppliesb 51.8 37 11.0
Purchased Community Servicesc 18.6 19 4.0
Received Petty Cashd 38.6 17 4.1
Received Cash for Emergency Expensese 2.3 3 0.7
Other Expenses 0.9 1 0.3
Total Expenses Paid During Month 8 95.5 354 n.a
NUMBER OF CONSUMERS WHO USED BOOKKEEPING SERVICE AND HAD SPENDING RECORD FOR MONTH 8   220  
SOURCE: IndependentChoices program bookkeeper records.
NOTE: Of the 1,004 treatment group members, 274 had disenrolled or died before month 8, and 12 were still enrolled but had no record for month 8 with the bookkeeper. In addition, 32 were still enrolled and had a record for month 8, but the record showed no spending for goods or services during that month; these cases are included in the means as zeros.
n.a. = not applicable.
  1. Equipment includes that to assist with mobility, transfer, bathing, communication, personal safety, meal preparation, or housekeeping, for example.
  2. Supplies for personal care include diapers or pads to protect bedding, ostomy supplies, or feeding equipment.
  3. Community services include day care, day programs, medical and nonmedical transportation, home- delivered meals, food from commercial establishments, congregate meals, chore services, grocery delivery, laundry services.
  4. Treatment group members may request a check for petty cash each month to pay for goods and services directly. In Arkansas this is limited to 10 percent of the allowance each month. Petty cash may have been used to purchase personal care supplies.
  5. Clothing, pest control, utilities.


TABLE A.19: Specific Types of Consumer Purchases as Reported by Counselors
Number of Counselors Reporting Assistive or Safety Devices, by Type of Device  
-- Talking computer 0
-- Other communications device 4
-- Device to aid with vision or hearing 5
-- Device to aid with mobility 6
-- Home security or personal emergency response system 6
-- Other assistive device or device related to safety 0
Average Number of Consumers Who Purchased Assistive or Safety Devices 87
Number of Counselors Reporting Personal Care Products and Appliances, by Type  
-- Supplies for urinary catheter or ostomy 4
-- Incontinence supplies 7
-- Enteral/parenteral feeding supplies 4
-- Special eating tools 1
-- Dietary supplements or products 7
-- Supplies related to use of home oxygen or ventilator 3
-- Electric toothbrush or shaver 3
-- Personal hygiene products 7
-- Other personal care products or appliances (e.g., talking thermometer) 2
Average Number of Consumers Who Purchased Personal Care Products and Appliances 254
Number of Counselors Reporting Home or Vehicle Modification, by Type of Modification  
-- Install interior or exterior ramp 6
-- Widen doorway 1
-- Change door handles or light switches 0
-- Lower counters or other kitchen remodeling 2
-- Install shower stall or other bathroom remodeling 7
-- Modify van or automobile 6
-- Other home or vehicle modifications 0
Average Number of Consumers Who Purchased Home or Vehicle Modifications 109
Number of Counselors Reporting Home or Yard Appliances, by Type of Appliance  
-- Clothes washer or dryer 0
-- Microwave oven 7
-- Other kitchen appliances 6
-- Lawn mower 0
-- Snow removal device 0
-- Other home or yard appliance 0
Average Number of Consumers Who Purchased Home or Yard Appliances 54
Number of Counselors Reporting Commercial Services, by Type  
-- Chore or homemaker services 4
-- Delivery of prepared food from a restaurant or groceries from a retail store 4
-- Transportation from a taxi or other car or van service 5
-- Laundry service 2
-- Errand or shopping services 1
-- Commercial snow removal 0
-- Other commercial services 0
Average Number of Consumers Who Purchased Commercial Services 50
Number of Counselors Reporting Training or Educational Services, by Type of Service  
-- Training or education for consumer 3
-- Training or education for worker 0
-- Other training or education 0
Average Number of Consumers Who Purchased Training Or Educational Services 12
Number Of Counselors Reporting Other Or Atypical Purchases, by Type Of Purchase  
-- Service animal 0
-- Equipment repair or backup equipment rental or purchase to use during repair 4
-- Day care 1
-- Exercise equipment or other devices to aid in rehabilitation 0
-- Over-the-counter medications 7
-- Prescription medications in excess of Medicaid limits 7
-- Other Medicaid services in excess of coverage limits 4
-- Other purchases not listed elsewhere 0
Average Number of Consumers Who Made Other or Atypical Purchases 128
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.
NOTE: Table contains responses to questions about specific types of consumer purchases (or approved plans to purchase) with the monthly allowance.


TABLE A.20: Flexibility and Constraints of the Monthly Allowance
Number of Counselors Reporting Particularly Creative Purchases, by Type of Purchase  
-- Combination of paid care with equipment purchases and modifications 1
-- Changed worker’s hours, wages, or duties to stay in budget 2
-- Bought Internet account to join online support group 1
-- Paid for professional housecleaning 1
Number of Counselors Reporting Denied Purchases, by Type of Purchase  
-- Food, dietary supplements, cigarettes, alcohol 2
-- Home or vehicle modification not related disability or health 1
-- Furniture, appliances, and equipment not related to disability 4
-- Utility bills 1
-- Recreational goods and services 2
Percentage of Consumers Reporting Program’s Spending Rules Kept Them from Getting Things That Would Have Enhanced Independencea 12.1
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
NUMBER OF RESPONDENTS TO THE 4-MONTH SURVEY 924
SOURCE: MPR mail survey of IndependentChoices counselors conducted between May and June 2000 and telephone interviews with consumers 4 months after random assignment.
  1. Among 254 consumers under age 65, 13.7 percent reported program rules kept them from getting things that would have enhanced independence, as compared with 11.5 percent of 670 consumers age 65 and over.


TABLE A.21: Counselor Reports of Misuse of the Monthly Allowance
Number of Counselors Reporting Evidence of Misuse of the Allowance 5
Number of Counselors Reporting Misuse, by Type  
-- Purchased nonpermissible goods or services 4
-- Had worker purchase nonpermissible goods or services 3
-- Overspent allowance 0
-- Did not keep adequate records 3
-- Did not report worker hours in timely way 3
-- Did not pay worker on time or correct amount 0
Number of Counselors Reporting Misuse More Likely Among Consumers Without Representative 0
Number of Counselors Reporting Misuse Less Likely Among Consumers Without Representative 0
Average Number of Consumers for Whom There Was Any Evidence of Allowance Misuse 5
Average Number of Consumers for Whom Counselors Had to Follow Up on Evidence of Allowance Misuse 4
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.


TABLE A.22a: Satisfaction with IndependentChoices, by Type of Respondent
  Percentage
Overall Consumer
Respondents
Proxy
Respondents
Would Recommend the Program to Others 96.2 97.3 94.9
Effect of Monthly Allowance on Quality of Life, Among Those Ever Receiving Allowance      
-- Improved a great deal 55.9 57.5 53.9
-- Improved somewhat 25.2 25.4 25.0
-- Stayed the same 18.6 16.5 21.1
-- Reduced somewhat 0.0 0.0 0.0
-- Reduced a great deal 0.3 0.5 0.0
Most Important Ways Monthly Allowance Improved Life, Among Those Who Reported the Program Improved Their Lives      
-- Benefit enables consumer to choose caregivers 13.7 12.7 15.1
-- Benefit enables consumer to get the right types of care 8.8 9.6 7.7
-- Benefit enables consumer to get enough care or care at the right time 9.6 7.8 12.0
-- Benefit enables consumer to purchase medications not covered by Medicaid 13.9 16.0 11.2
-- Benefit enables consumer to purchase other items related to personal care or health, food or nutritional supplements, or care-related supplies 16.1 13.6 19.3
-- Benefit enables consumer to purchase, modify, or repair equipment or home 17.6 17.5 17.8
-- Consumer feels more independent or in control of care 4.9 6.0 3.5
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 885 462 423
SOURCE: MPR telephone interview with consumers 9 months after random assignment.


TABLE A.22b: Satisfaction with IndependentChoices, by Consumer Age
  Percentage
Overall Under
Age 65
65 or
Older
Would Recommend the Program to Others 96.2 97.5 95.7
Effect of Monthly Allowance on Quality of Life, Among Those Ever Receiving Allowance      
-- Improved a great deal 55.9 62.6 53.1
-- Improved somewhat 25.2 21.5 26.8
-- Stayed the same 18.6 15.5 19.9
-- Reduced somewhat 0.0 0.0 0.0
-- Reduced a great deal 0.3 0.5 0.2
Most Important Ways Monthly Allowance Improved Life, Among Those Who Reported the Program Improved Their Lives      
-- Benefit enables consumer to choose caregivers 13.7 12.0 14.5
-- Benefit enables consumer to get the right types of care 8.8 8.7 8.9
-- Benefit enables consumer to get enough care or care at the right time 9.6 6.0 11.3
-- Benefit enables consumer to purchase medications not covered by Medicaid 13.9 14.1 13.8
-- Benefit enables consumer to purchase other items related to personal care or health, food or nutritional supplements, or care-related supplies 16.1 13.6 17.2
-- Benefit enables consumer to purchase, modify, or repair equipment or home 17.6 19.0 17.0
-- Consumer feels more independent or in control of care 4.9 6.5 4.2
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 885 243 642
SOURCE: MPR telephone interview with consumers 9 months after random assignment.


TABLE A.23a: Satisfaction with and Unmet Need for Personal Assistance, by Type of Respondent
  Percentage
Overall Consumer
Respondents
Proxy
Respondents
Current Satisfaction with      
-- Overall care arrangementsa      
  -- Very satisfied 68.6 68.3 69.2
  -- Satisfied 25.4 25.2 25.9
  -- Dissatisfied 6.0 6.6 4.9
-- Ability to get transportation when neededb,i      
  -- Very satisfied 72.1 68.3 79.1
  -- Satisfied 18.4 19.9 15.5
  -- Dissatisfied 9.5 11.8 5.3
Among Those Who Hired with Allowance and Had Paid Help in Two Weeks Before Interview, Satisfied withc, j      
-- Relationship with paid caregiver 99.8 99.7 100.0
-- How paid caregiver helps with personal cared 99.5 99.3 100.0
-- How paid caregiver helps with routine health caree 99.0 99.0 98.9
-- How paid caregiver helps with housework or community choresf 99.0 99.0 99.1
-- Times of day help provided 96.9 96.6 97.6
Among Those Who Hired with Allowance and Had Paid Help in Two Weeks Before Interview, Would Not Have Been Difficult to Change the Times of Day Help Providedc, j 51.6 52.6 49.2
Among Those Who Hired with Allowance, Paid Caregiverg, j      
-- Always or almost always completed all tasks 87.1 86.7 87.9
-- Never neglected consumer 92.0 90.9 94.3
-- Never left early or arrived late, among those with regular schedule 60.5 60.1 61.2
-- Never was rude or disrespectful 90.6 90.8 90.3
-- Never helped when help was not wanted 63.7 64.2 62.7
-- Did not steal 96.6 95.8 98.2
Needs Help or More Help withh      
-- Housework or community chores 40.1 38.3 42.8
-- Personal care 32.6 25.0 44.1
-- Routine health care 28.1 21.6 37.9
-- Transportationi 29.0 26.9 32.2
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 885 462 423
SOURCE: MPR telephone interviews with consumers 9 months after random assignment.
  1. Satisfaction with overall care not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion.
  2. Satisfaction with ability to get transportation not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion, or if no transportation sought.
  3. Satisfaction with paid caregiver relationship and performance, and ability to change paid caregiver schedule not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion, if consumer did not hire a caregiver with allowance, or if consumer had no paid help during the 2 weeks before interview.
  4. Personal care includes bathing, transfer from bed, eating, and using the toilet. Not asked if consumer had no paid help with personal care.
  5. Routine health care includes taking medications, checking blood pressure, and doing exercises. Not asked if consumer had no paid help with routine health care.
  6. Housework and community chores include light housework, yard work, meal preparation, and shopping. Not asked if consumer had no paid help with housework or community chores.
  7. Satisfaction with paid caregiver attitude and respectfulness not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion, or if consumer did not hire a caregiver with allowance.
  8. Unmet need not asked if proxy respondent is also paid caregiver.
  9. Transportation includes both medical and nonmedical transportation.
  10. Description is of all paid caregivers for consumers who hired with the allowance (with the exceptions noted) and includes paid caregivers for roughly 5 percent of consumers who had disenrolled from IndependentChoices and were likely reporting about satisfaction with agency workers.


TABLE A.23b: Satisfaction with and Unmet Need for Personal Assistance, by Consumer Age
  Percentage
Overall Under
65
65 or
Over
Current Satisfaction with      
-- Overall care arrangementsa      
  -- Very satisfied 68.6 70.7 67.6
  -- Satisfied 25.4 22.9 26.7
  -- Dissatisfied 6.0 6.3 5.8
-- Ability to get transportation when neededb,i      
  -- Very satisfied 72.1 70.9 72.7
  -- Satisfied 18.4 16.3 19.5
  -- Dissatisfied 9.5 12.8 7.8
Among Those Who Hired with Allowance and Had Paid Help in Two Weeks Before Interview, Satisfied withc, j      
-- Relationship with paid caregiver 99.8 99.4 100.0
-- How paid caregiver helps with personal cared 99.5 100.0 99.2
-- How paid caregiver helps with routine health caree 99.0 98.4 99.4
-- How paid caregiver helps with housework or community choresf 99.0 99.4 98.8
-- Times of day help provided 96.9 97.5 96.5
Among Those Who Hired with Allowance and Had Paid Help in Two Weeks Before Interview, Would Not Have Been Difficult to Change the Times of Day Help Providedc, j 51.6 52.8 50.8
Among Those Who Hired with Allowance, Paid Caregiverg, j      
-- Always or almost always completed all tasks 87.1 88.9 86.0
-- Never neglected consumer 92.0 90.6 92.8
-- Never left early or arrived late, among those with regular schedule 60.5 61.6 59.8
-- Never was rude or disrespectful 90.6 90.1 91.0
-- Never helped when help was not wanted 63.7 58.1 67.0
-- Did not steal 96.6 95.9 97.0
Needs Help or More Help withh      
-- Housework or community chores 40.1 42.3 39.0
-- Personal care 32.6 26.8 35.4
-- Routine health care 28.1 26.1 29.1
-- Transportationi 29.0 27.9 29.5
NUMBER OF RESPONDENTS TO THE 9-MONTH INTERVIEW 885 243 642
SOURCE: MPR telephone interviews with consumers 9 months after random assignment.
  1. Satisfaction with overall care not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion.
  2. Satisfaction with ability to get transportation not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion, or if no transportation sought.
  3. Satisfaction with paid caregiver relationship and performance, and ability to change paid caregiver schedule not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion, if consumer did not hire a caregiver with allowance, or if consumer had no paid help during the 2 weeks before interview.
  4. Personal care includes bathing, transfer from bed, eating, and using the toilet. Not asked if consumer had no paid help with personal care.
  5. Routine health care includes taking medications, checking blood pressure, and doing exercises. Not asked if consumer had no paid help with routine health care.
  6. Housework and community chores include light housework, yard work, meal preparation, and shopping. Not asked if consumer had no paid help with housework or community chores.
  7. Satisfaction with paid caregiver attitude and respectfulness not asked if proxy respondent used and proxy is also paid caregiver or cannot give consumer opinion, or if consumer did not hire a caregiver with allowance.
  8. Unmet need not asked if proxy respondent is also paid caregiver.
  9. Transportation includes both medical and nonmedical transportation.
  10. Description is of all paid caregivers for consumers who hired with the allowance (with the exceptions noted) and includes paid caregivers for roughly 5 percent of consumers who had disenrolled from IndependentChoices and were likely reporting about satisfaction with agency workers.


TABLE A.24: Effect of Consumer Characteristics on Whether Started on Allowance Within Three Months of Random Assignment
Characteristic Estimated
Coefficient
P-Value of
Coefficient
DEMOGRAPHIC CHARACTERISTICS
Age    
-- (18 to 39)    
-- 40 to 64 -1.27** 0.05
-- 65 to 79 -1.15* 0.08
-- 80 or older -1.30** 0.05
Female -0.11 0.65
Race    
-- (Self-identified as white only)    
-- Self-identified as black only or black and some other race 0.12 0.56
-- Self-identified as some other race 0.43 0.29
Years of Education    
-- Did not graduate high school 0.26 0.24
-- (High school graduate)    
Living Arrangement/Marital Status    
-- Lives alone -0.16 0.50
-- (Lives with others)    
HEALTH AND FUNCTIONING
Health Status at Enrollment    
-- (Excellent or good)    
-- Fair -0.34 0.20
-- Poor -0.52** 0.04
Last Week, Not Independent ine    
-- Transfer -0.21 0.45
-- Bathing -0.19 0.65
-- Using toilet 0.23 0.41
UNPAID AND PAID PAS
Had Unpaid or Paid Help at Home Last Week with    
-- Personal carea -0.01 0.97
-- Transportationb 0.15 0.44
-- Routine health carec 0.09 0.73
-- Household activitiesd 0.11 0.83
Number of Unpaid Caregivers Last Week    
-- (None)    
-- One 0.04 0.92
-- Two 0.14 0.71
-- Three or more 0.40 0.32
Primary Unpaid Caregiver Employed -0.20 0.33
Number of Paid Caregivers Last Week    
-- (None)    
-- One 0.61 0.36
-- Two or more 0.64 0.35
Length of Time with Publicly Funded Home Care    
-- (Participant says no care last week and program says not a current Medicaid PAS user)    
-- Participant says no care last week, but program says current Medicaid PAS user -0.92*** 0.01
-- Participant says getting care less than a year -1.39** 0.04
-- Participant says getting care 1 to 3 years -1.06 0.12
-- Participant says getting care more than 3 years -1.55** 0.03
UNMET NEED FOR AND ACCESS TO PAS
Last Week, Needed Help (or More Help) With: Personal Care, Transportation, or Things Around the House and Community    
-- Personal carea -0.36 0.11
-- Transportationb 0.00 0.99
-- Household activitiesd -0.05 0.83
Potential Difficulty Hiring Due to Location    
-- Lives in a rural area -0.14 0.53
-- Live in a nonrural area but transportation difficult or high crime -0.43 0.06
-- (Lives in a nonrural area, but transportation not difficult and not high crime)    
SATISFACTION WITH PAID PAS
Satisfied with Paid Services and Goods Overall    
-- Very satisfied -0.16 0.57
-- Satisfied -0.40 0.13
-- (Dissatisfied)    
-- No paid services or goodsf 0.47 0.38
EMPLOYMENT EXPERIENCE
Ever employed -0.28 0.32
Ever supervised someone -0.29 0.18
Ever hired someone privately -0.21 0.30
TYPE OF RESPONDENT
Majority of Baseline Questions Answered by Proxy Respondent -0.81*** 0.00
ENROLLMENT IN INDEPENDENTCHOICES
Number of Hours Per Week of Planned Care    
-- (Less than or equal to 6)    
-- More than 6, but less than or equal to 11 0.65*** 0.00
-- More than 11 0.52** 0.03
Had a Representative at Enrollment -0.23 0.33
Enrolled in 2000 or 2001 0.56*** 0.00
Being Allowed to Pay Family or Friends Very Important 0.59** 0.02
Having a Choice About Worker Schedule Very Important -0.16 0.52
Having a Choice About Types of Help Received Very Important 0.14 0.61
Primary Unpaid Caregiver Expressed Interest in Being Paid 0.54*** 0.01
NUMBER OF CONSUMERS 1,004  
SOURCE: MPR baseline survey conducted in Arkansas between December 1998 and April 2001 and IndependentChoices program records for independent variables; program records for dependent variable (whether started allowance within 3 months of random assignment).
NOTE: The relationship between consumer characteristics and the dependent variable estimated with a binary logit model. "Last week" refers to the week before the baseline survey. PAS stands for personal assistance services.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Transportation includes both medical and nonmedical transportation.
  3. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Received hands-on or standby help or did not perform activity at all.
  6. Skipped satisfaction question because no paid help, community services, home or vehicle modifications, or equipment purchased.

* Significantly different from zero at the .10 level, two-tailed test.
** Significantly different from zero at the .05 level, two-tailed test.
*** Significantly different from zero at the .01 level, two-tailed test.


TABLE A.25: Effect of Consumer Characteristics on Whether Found Hiring Difficult
Characteristic Estimated
Coefficient
P-Value of
Coefficient
DEMOGRAPHIC CHARACTERISTICS
Age    
-- (18 to 39)    
-- 40 to 64 -1.27*** 0.00
-- 65 to 79 -1.25*** 0.00
-- 80 or older -1.11*** 0.01
Female 0.53* 0.06
Race    
-- (Self-identified as white only)    
-- Self-identified as black only or black and some other race -0.26 0.29
-- Self-identified as some other race 1.28*** 0.00
Years of Education    
-- Did not graduate high school -0.07 0.80
-- (High school graduate)    
Living Arrangement/Marital Status    
-- Lives alone 0.35 0.20
-- (Lives with others)    
HEALTH AND FUNCTIONING
Health Status at Enrollment    
-- (Excellent or good)    
-- Fair 0.10 0.75
-- Poor 0.12 0.67
Last Week, Not Independent ine    
-- Transfer 0.10 0.73
-- Bathing -0.65 0.15
-- Using toilet 0.24 0.46
UNPAID AND PAID PAS
Had Unpaid or Paid Help at Home Last Week with    
-- Personal carea 0.67 0.12
-- Transportationb 0.05 0.83
-- Routine health carec 0.20 0.50
-- Household activitiesd 0.21 0.72
Number of Unpaid Caregivers Last Week    
-- (None)    
-- One -0.46 0.33
-- Two -0.45 0.35
-- Three or more -0.79* 0.10
Primary Unpaid Caregiver Employed 0.06 0.79
Number of Paid Caregivers Last Week    
-- (None)    
-- One -0.57 0.39
-- Two or more -0.10 0.89
Length of Time with Publicly Funded Home Care    
-- (Participant says no care last week and program says not a current Medicaid PAS user)    
-- Participant says no care last week, but program says current Medicaid PAS user 0.46 0.26
-- Participant says getting care less than a year 0.71 0.31
-- Participant says getting care 1 to 3 years 0.87 0.21
-- Participant says getting care more than 3 years 0.22 0.76
UNMET NEED FOR AND ACCESS TO PAS
Last Week, Needed Help (or More Help) With: Personal Care, Transportation, or Things Around the House and Community    
-- Personal carea 0.17 0.51
-- Transportationb -0.01 0.96
-- Household activitiesd 0.67** 0.02
Potential Difficulty Hiring Due to Location    
-- Lives in a rural area -0.28 0.28
-- Live in a nonrural area but transportation difficult or high crime -0.05 0.86
-- (Lives in a nonrural area, but transportation not difficult and not high crime)    
SATISFACTION WITH PAID PAS
Satisfied with Paid Services and Goods Overall    
-- Very satisfied -0.48 0.12
-- Satisfied -0.21 0.46
-- (Dissatisfied)    
-- No paid services or goodsf -0.52 0.27
EMPLOYMENT EXPERIENCE
Ever employed 0.73** 0.03
Ever supervised someone 0.18 0.48
Ever hired someone privately -0.05 0.85
TYPE OF RESPONDENT
Majority of Baseline Questions Answered by Proxy Respondent 0.27 0.38
ENROLLMENT IN INDEPENDENTCHOICES
Number of Hours Per Week of Planned Care    
-- (Less than or equal to 6)    
-- More than 6, but less than or equal to 11 -0.11 0.72
-- More than 11 0.17 0.57
Had a Representative at Enrollment 0.47* 0.10
Enrolled in 2000 or 2001 0.05 0.82
Being Allowed to Pay Family or Friends Very Important -0.25 0.43
Having a Choice About Worker Schedule Very Important -0.65** 0.02
Having a Choice About Types of Help Received Very Important 0.57 0.12
Primary Unpaid Caregiver Expressed Interest in Being Paid -0.38 0.12
NUMBER OF CONSUMERS 725  
SOURCE: MPR baseline interview conducted in Arkansas between December 1998 and April 2001 and IndependentChoices program records for independent variables; 4-month and 9-month interviews for dependent variable (whether found hiring difficult, among those who hired with the program allowance between baseline and 9-month interviews).
NOTE: The relationship between consumer characteristics and the dependent variable estimated with a binary logit model. "Last week" refers to the week before the baseline survey. PAS stands for personal assistance services.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Transportation includes both medical and nonmedical transportation.
  3. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Received hands-on or standby help or did not perform activity at all.
  6. Skipped satisfaction question because no paid help, community services, home or vehicle modifications, or equipment purchased.

* Significantly different from zero at the .10 level, two-tailed test.
** Significantly different from zero at the .05 level, two-tailed test.
*** Significantly different from zero at the .01 level, two-tailed test.


TABLE A.26: Effect of Consumer Characteristics on Whether Consumer Found Program Spending Rules Restrictive
Characteristic Estimated
Coefficient
P-Value of
Coefficient
DEMOGRAPHIC CHARACTERISTICS
Age    
-- (18 to 39)    
-- 40 to 64 -0.13 0.79
-- 65 to 79 0.03 0.96
-- 80 or older 0.00 0.99
Female -0.17 0.54
Race    
-- (Self-identified as white only)    
-- Self-identified as black only or black and some other race 0.47* 0.07
-- Self-identified as some other race 0.92** 0.02
Years of Education    
-- Did not graduate high school -0.30 0.28
-- (High school graduate)    
Living Arrangement/Marital Status    
-- Lives alone 0.27 0.33
-- (Lives with others)    
HEALTH AND FUNCTIONING
Health Status at Enrollment    
-- (Excellent or good)    
-- Fair -0.32 0.35
-- Poor -0.17 0.59
Last Week, Not Independent ine    
-- Transfer 0.13 0.69
-- Bathing 0.67 0.20
-- Using toilet 0.02 0.96
UNPAID AND PAID PAS
Had Unpaid or Paid Help at Home Last Week with    
-- Personal carea -0.44 0.31
-- Transportationb 0.24 0.36
-- Routine health carec 0.09 0.78
-- Household activitiesd 0.07 0.91
Number of Unpaid Caregivers Last Week    
-- (None)    
-- One -1.26** 0.02
-- Two -0.50 0.33
-- Three or more -1.07** 0.04
Primary Unpaid Caregiver Employed 0.23 0.35
Number of Paid Caregivers Last Week    
-- (None)    
-- One -0.87 0.26
-- Two or more -0.84 0.28
Length of Time with Publicly Funded Home Care    
-- (Participant says no care last week and program says not a current Medicaid PAS user)    
-- Participant says no care last week, but program says current Medicaid PAS user -0.22 0.62
-- Participant says getting care less than a year 0.96 0.23
-- Participant says getting care 1 to 3 years 0.86 0.28
-- Participant says getting care more than 3 years 0.62 0.44
UNMET NEED FOR AND ACCESS TO PAS
Last Week, Needed Help (or More Help) With: Personal Care, Transportation, or Things Around the House and Community    
-- Personal carea 0.41 0.17
-- Transportationb 0.73*** 0.01
-- Household activitiesd 0.00 0.99
Potential Difficulty Hiring Due to Location    
-- Lives in a rural area 0.14 0.62
-- Live in a nonrural area but transportation difficult or high crime -0.12 0.70
-- (Lives in a nonrural area, but transportation not difficult and not high crime)    
SATISFACTION WITH PAID PAS
Satisfied with Paid Services and Goods Overall    
-- Very satisfied -0.64** 0.05
-- Satisfied -0.41 0.18
-- (Dissatisfied)    
-- No paid services or goodsf -0.91 0.11
EMPLOYMENT EXPERIENCE
Ever employed 0.23 0.55
Ever supervised someone -0.08 0.79
Ever hired someone privately 0.51** 0.05
TYPE OF RESPONDENT
Majority of Baseline Questions Answered by Proxy Respondent -0.10 0.77
ENROLLMENT IN INDEPENDENTCHOICES
Number of Hours Per Week of Planned Care    
-- (Less than or equal to 6)    
-- More than 6, but less than or equal to 11 -0.45 0.15
-- More than 11 -0.22 0.50
Had a Representative at Enrollment 0.30 0.31
Enrolled in 2000 or 2001 0.41* 0.09
Being Allowed to Pay Family or Friends Very Important -0.15 0.69
Having a Choice About Worker Schedule Very Important -0.06 0.86
Having a Choice About Types of Help Received Very Important 0.46 0.26
Primary Unpaid Caregiver Expressed Interest in Being Paid 0.17 0.52
NUMBER OF CONSUMERS 859  
SOURCE: MPR baseline survey conducted in Arkansas between December 1998 and April 2001 and IndependentChoices program records for independent variables; 4-month interviews for dependent variable (consumer found program spending rules kept him/her from getting something that would have promoted independence).
NOTE: The relationship between consumer characteristics and the dependent variable estimated with a binary logit model. "Last week" refers to the week before the baseline survey. PAS stands for personal assistance services.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Transportation includes both medical and nonmedical transportation.
  3. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Received hands-on or standby help or did not perform activity at all.
  6. Skipped satisfaction question because no paid help, community services, home or vehicle modifications, or equipment purchased.

* Significantly different from zero at the .10 level, two-tailed test.
** Significantly different from zero at the .05 level, two-tailed test.
*** Significantly different from zero at the .01 level, two-tailed test.


TABLE A.27: Effect of Consumer Characteristics on Satisfaction and Unmet Need
Characteristic Estimated Coefficient (P-Value of Coefficient)
IndependentChoices
Improved Life
Quality a Great Deal
Very Satisfied
with Overall
Care
Has Unmet
Need for
Personal Carea
DEMOGRAPHIC CHARACTERISTICS
Age            
-- (18 to 39)            
-- 40 to 64 -0.46 (0.23) 0.04 (0.92) -0.42 (0.31)
-- 65 to 79 -0.51 (0.19) -0.06 (0.90) -0.39 (0.36)
-- 80 or older -0.43 (0.28) -0.42 (0.36) -0.03 (0.94)
Female -0.13 (0.54) 0.12 (0.62) 0.14 (0.56)
Race            
-- (Self-identified as white only)            
-- Self-identified as black only or black and some other race -0.35* (0.06) -0.05 (0.82) 0.54** (0.02)
-- Self-identified as some other race 0.95** (0.02) 0.34 (0.44) 1.19*** (0.00)
Years of Education            
-- Did not graduate high school 0.16 (0.45) 0.07 (0.78) -0.11 (0.65)
-- (High school graduate)            
Living Arrangement/Marital Status            
-- Lives alone 0.44** (0.03) -0.21 (0.37) 0.24 (0.33)
-- (Lives with others)            
HEALTH AND FUNCTIONING
Health Status at Enrollment            
-- (Excellent or good)            
-- Fair 0.14 (0.53) -0.47* (0.10) 0.14 (0.61)
-- Poor 0.40* (0.08) -0.28 (0.33) 0.38 (0.17)
Last Week, Not Independent ine            
-- Transfer -0.04 (0.87) -0.32 (0.26) 0.06 (0.83)
-- Bathing -0.84** (0.02) -1.07*** (0.01) 0.04 (0.92)
-- Using toilet 0.26 (0.30) 0.45 (0.11) 0.41 (0.16)
UNPAID AND PAID PAS
Had Unpaid or Paid Help at Home Last Week with            
-- Personal carea 0.28 (0.38) -0.15 (0.70) 0.45 (0.26)
-- Transportationb 0.36** (0.04) 0.52*** (0.01) -0.45** (0.03)
-- Routine health carec 0.20 (0.37) 0.06 (0.80) 0.28 (0.28)
-- Household activitiesd -0.71 (0.12) -0.94 (0.06) 0.00 (0.99)
Number of Unpaid Caregivers Last Week            
-- (None)            
-- One 0.85** (0.03) 0.75* (0.07) 0.25 (0.56)
-- Two 0.74* (0.06) 1.37*** (0.00) 0.39 (0.38)
-- Three or more 0.83** (0.04) 0.84** (0.05) 0.41 (0.36)
Primary Unpaid Caregiver Employed -0.04 (0.82) 0.42* (0.06) 0.18 (0.40)
Number of Paid Caregivers Last Week            
-- (None)            
-- One 0.12 (0.82) 0.07 (0.90) 0.41 (0.45)
-- Two or more -0.02 (0.97) 0.66 (0.27) 0.32 (0.56)
Length of Time with Publicly Funded Home Care            
-- (Participant says no care last week and program says not a current Medicaid PAS user)            
-- Participant says no care last week, but program says current Medicaid PAS user -0.09 (0.79) 0.17 (0.67) -0.04 (0.92)
-- Participant says getting care less than a year -0.46 (0.40) 0.23 (0.71) -0.40 (0.48)
-- Participant says getting care 1 to 3 years -0.36 (0.51) -0.48 (0.42) -0.23 (0.67)
-- Participant says getting care more than 3 years 0.08 (0.88) -0.18 (0.77) -0.29 (0.60)
UNMET NEED FOR AND ACCESS TO PAS
Last Week, Needed Help (or More Help) With: Personal Care, Transportation, or Things Around the House and Community            
-- Personal carea -0.35* (0.08) -0.66*** (0.01) 0.12 (0.61)
-- Transportationb -0.07 (0.70) -0.35* (0.10) 0.25 (0.22)
-- Household activitiesd 0.12 (0.60) 0.03 (0.90) 0.60** (0.02)
Potential Difficulty Hiring Due to Location            
-- Lives in a rural area 0.03 (0.89) 0.42* (0.09) -0.23 (0.35)
-- Live in a nonrural area but transportation difficult or high crime -0.08 (0.72) 0.33 (0.17) 0.09 (0.72)
-- (Lives in a nonrural area, but transportation not difficult and not high crime)            
SATISFACTION WITH PAID PAS
Satisfied with Paid Services and Goods Overall            
-- Very satisfied -0.49** (0.05) -0.20 (0.49) -0.20 (0.48)
-- Satisfied -0.32 (0.21) 0.03 (0.90) -0.04 (0.89)
-- (Dissatisfied)            
-- No paid services or goodsf -0.59* (0.10) -0.23 (0.61) -0.47 (0.32)
EMPLOYMENT EXPERIENCE
Ever employed -0.24 (0.31) 0.15 (0.62) 0.19 (0.52)
Ever supervised someone 0.30 (0.14) 0.29 (0.21) 0.08 (0.72)
Ever hired someone privately 0.18 (0.35) -0.15 (0.52) 0.16 (0.46)
TYPE OF RESPONDENT
Majority of Baseline Questions Answered by Proxy Respondent 0.12 (0.61) 0.06 (0.84) 0.75*** (0.01)
ENROLLMENT IN INDEPENDENTCHOICES
Number of Hours Per Week of Planned Care            
-- (Less than or equal to 6)            
-- More than 6, but less than or equal to 11 0.27 (0.23) 0.02 (0.94) -0.57** (0.02)
-- More than 11 0.53** (0.03) 0.12 (0.64) -0.57** (0.03)
Had a Representative at Enrollment -0.03 (0.88) 0.07 (0.79) 0.19 (0.46)
Enrolled in 2000 or 2001 -0.55*** (0.00) 0.13 (0.52) -0.06 (0.75)
Being Allowed to Pay Family or Friends Very Important -0.24 (0.38) 0.56** (0.05) 0.13 (0.64)
Having a Choice About Worker Schedule Very Important 0.53** (0.02) 0.32 (0.23) -0.74*** (0.01)
Having a Choice About Types of Help Received Very Important 0.21 (0.43) 0.25 (0.39) -0.70*** (0.01)
Primary Unpaid Caregiver Expressed Interest in Being Paid -0.04 (0.84) -0.23 (0.31) 0.15 (0.50)
NUMBER OF CONSUMERS 741 621 659
SOURCE: MPR baseline interview conducted in Arkansas between December 1998 and April 2001 and IndependentChoices program records for independent variables; 9-month interview for dependent variables (IndependentChoices improved life quality a great deal, very satisfied with overall care, and had unmet need for personal care as of 9-month interview).
NOTE: The relationship between consumer characteristics and the dependent variable estimated with a binary logit model. "Last week" refers to the week before the baseline survey. PAS stands for personal assistance services.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Transportation includes both medical and nonmedical transportation.
  3. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Received hands-on or standby help or did not perform activity at all.
  6. Skipped satisfaction question because no paid help, community services, home or vehicle modifications, or equipment purchased.

* Significantly different from zero at the .10 level, two-tailed test.
** Significantly different from zero at the .05 level, two-tailed test.
*** Significantly different from zero at the .01 level, two-tailed test.


TABLE A.28: Effect of Consumer Characteristics on Voluntary Disenrollment
Characteristic Estimated Coefficient (P-Value of Coefficient)
Whether Disenrolled
According to Program
Records Within 1 Year
of Enrollment
Whether Disenrolled
According to Self-
Reports Within 9
Months of Enrollment
DEMOGRAPHIC CHARACTERISTICS
Age        
-- (18 to 39)        
-- 40 to 64 0.47 (0.38) 0.87 (0.29)
-- 65 to 79 0.22 (0.68) 0.64 (0.44)
-- 80 or older 0.47 (0.39) 0.84 (0.31)
Female -0.01 (0.95) -0.26 (0.37)
Race        
-- (Self-identified as white only)        
-- Self-identified as black only or black and some other race -0.04 (0.86) -0.68** (0.02)
-- Self-identified as some other race -0.15 (0.70) -0.74 (0.16)
Years of Education        
-- Did not graduate high school -0.26 (0.23) -0.23 (0.42)
-- (High school graduate)        
Living Arrangement/Marital Status        
-- Lives alone 0.19 (0.41) 0.20 (0.50)
-- (Lives with others)        
HEALTH AND FUNCTIONING
Health Status at Enrollment        
-- (Excellent or good)        
-- Fair 0.04 (0.87) 0.29 (0.41)
-- Poor 0.27 (0.29) 0.33 (0.32)
Last Week, Not Independent ine        
-- Transfer -0.18 (0.51) -0.01 (0.97)
-- Bathing 1.13*** (0.01) 0.73 (0.23)
-- Using toilet -0.25 (0.35) -0.09 (0.80)
UNPAID AND PAID PAS
Had Unpaid or Paid Help at Home Last Week with        
-- Personal carea -0.30 (0.41) 0.47 (0.41)
-- Transportationb -0.18 (0.35) -0.41 (0.10)
-- Routine health carec -0.16 (0.51) 0.33 (0.32)
-- Household activitiesd 0.58 (0.24) 0.29 (0.67)
Number of Unpaid Caregivers Last Week        
-- (None)        
-- One -1.30*** (0.00) -0.91** (0.05)
-- Two -1.20*** (0.00) -0.73 (0.11)
-- Three or more -1.50*** (0.00) -0.97** (0.05)
Primary Unpaid Caregiver Employed 0.26 (0.20) -0.13 (0.64)
Number of Paid Caregivers Last Week        
-- (None)        
-- One -0.28 (0.67) 0.50 (0.56)
-- Two or more -0.35 (0.61) 0.10 (0.91)
Length of Time with Publicly Funded Home Care        
-- (Participant says no care last week and program says not a current Medicaid PAS user)        
-- Participant says no care last week, but program says current Medicaid PAS user 0.62 (0.13) 1.16* (0.07)
-- Participant says getting care less than a year 1.08 (0.11) 1.08 (0.23)
-- Participant says getting care 1 to 3 years 1.03 (0.12) 1.02 (0.25)
-- Participant says getting care more than 3 years 1.41** (0.04) 1.29 (0.15)
UNMET NEED FOR AND ACCESS TO PAS
Last Week, Needed Help (or More Help) With: Personal Care, Transportation, or Things Around the House and Community        
-- Personal carea 0.48** (0.04) 0.25 (0.39)
-- Transportationb 0.17 (0.39) 0.28 (0.26)
-- Household activitiesd 0.26 (0.28) 0.27 (0.39)
Potential Difficulty Hiring Due to Location        
-- Lives in a rural area 0.08 (0.71) -0.15 (0.61)
-- Live in a nonrural area but transportation difficult or high crime 0.28 (0.22) 0.24 (0.41)
-- (Lives in a nonrural area, but transportation not difficult and not high crime)        
SATISFACTION WITH PAID PAS
Satisfied with Paid Services and Goods Overall        
-- Very satisfied 0.40 (0.14) 0.52 (0.16)
-- Satisfied 0.63** (0.02) 0.73** (0.04)
-- (Dissatisfied)        
-- No paid services or goodsf 0.23 (0.66) 0.09 (0.92)
EMPLOYMENT EXPERIENCE
Ever employed 0.50* (0.09) 0.29 (0.43)
Ever supervised someone 0.25 (0.24) -0.04 (0.88)
Ever hired someone privately 0.12 (0.58) 0.02 (0.94)
TYPE OF RESPONDENT
Majority of Baseline Questions Answered by Proxy Respondent 0.73*** (0.01) 0.41 (0.24)
ENROLLMENT IN INDEPENDENTCHOICES
Number of Hours Per Week of Planned Care        
-- (Less than or equal to 6)        
-- More than 6, but less than or equal to 11 -0.41* (0.07) -0.62** (0.03)
-- More than 11 -0.57** (0.02) -0.62** (0.04)
Had a Representative at Enrollment -0.03 (0.89) -0.12 (0.72)
Enrolled in 2000 or 2001 0.16 (0.41) -0.24 (0.33)
Being Allowed to Pay Family or Friends Very Important -0.34 (0.20) -0.05 (0.88)
Having a Choice About Worker Schedule Very Important 0.21 (0.42) 0.24 (0.47)
Having a Choice About Types of Help Received Very Important 0.21 (0.42) 0.24 (0.47)
Primary Unpaid Caregiver Expressed Interest in Being Paid -0.68*** (0.00) -0.76*** (0.01)
NUMBER OF CONSUMERS 1,004 952
SOURCE: MPR baseline interview conducted in Arkansas between December 1998 and April 2001 and IndependentChoices program records for independent variables; 9-month interview for dependent variables (IndependentChoices improved life quality a great deal, very satisfied with overall care, and had unmet need for personal care as of 9-month interview).
NOTE: The relationship between consumer characteristics and the dependent variable estimated with a binary logit model. "Last week" refers to the week before the baseline survey. PAS stands for personal assistance services.
  1. Personal care includes bathing, transfer from bed, eating, and using the toilet.
  2. Transportation includes both medical and nonmedical transportation.
  3. Routine health care includes taking medications, checking blood pressure, and doing exercises.
  4. Housework and community chores include light housework, yard work, meal preparation, and shopping.
  5. Received hands-on or standby help or did not perform activity at all.
  6. Skipped satisfaction question because no paid help, community services, home or vehicle modifications, or equipment purchased.

* Significantly different from zero at the .10 level, two-tailed test.
** Significantly different from zero at the .05 level, two-tailed test.
*** Significantly different from zero at the .01 level, two-tailed test.


TABLE A.29: Consumer Difficulties with Program Responsibilities
Number of Counselors Reporting That Some Consumers Requested Extensive Amounts of Assistance 7
Average Number of Consumers Who Requested Extensive Assistance 57
Number of Counselors Reporting The Following Types of Consumers Requested Extensive Assistance  
-- Consumers under age 65 7
-- Consumer age 65 or older 7
-- Consumers or representatives with little experiences budgeting 3
-- Consumers not using the bookkeeping service 3
-- Consumers who do not have family member or friend to be paid worker 7
-- Consumers or representative who have little experience recruiting, hiring, training or supervising workers 5
-- Consumers or representatives do have experience training or supervising workers 2
-- Consumer or representative with poor problem-solving skills 4
-- Consumer who is ill 5
Number of Counselors Reporting That Some Consumers Made Unreasonable Demands 6
Average Number of Consumers Who Made Unreasonable Demands 4
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.


TABLE A.30: Counselor Assessment of Consumers' Overall Experiences with IndependentChoices
  Number of
Counselors Reporting
Types of Consumers for Whom Independentchoices Was Particularly Effective  
-- At risk of nursing home placement 3
-- Had a family member or friend in mind to hire as worker 2
-- Wished to purchase care-related equipment or services not covered by Medicaid 2
-- Dissatisfied with traditional home care/wanted more control over care 1
Types of Consumers for Whom IndependentChoices Did Not Work Well  
-- Unable to hire or retain suitable worker 5
-- Needed very little care 1
-- Lived in a rural area 1
-- Client unable to manage own care, no representative available 2
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.
NOTE: Counselors were asked to describe consumers for whom the program was particularly effective and those for whom the program did not work well. Their open-ended responses were then categorized, as noted above.


TABLE A.31: Counselor Opinions of and Recommendations for IndependentChoices
  Number of
Counselors Reporting
Recommended Changes to Counseling Activities 0
Types of Changes Recommended to Counseling Activities  
-- Counselors should do less for consumers (for example, play only an advisory role, not have to explain the program to the consumer 0
-- Counselors should do more for consumers (for example, direct consumers to services as a social worker would, generally increase time spent with consumers) 0
Thought They Were Trained Adequately for Their Roles 7
Type of Changes Recommended for Counselor Training  
-- Reduce time between training and first consumer assignment/provide training refreshers 0
-- Make training more practical (for example, use role playing, make training manual more user-friendly, use peer counseling and shadowing) 1
-- Change content of training (for example, put more emphasis on the cash spending plan and program paperwork, put less emphasis on program philosophy, update training as program rules or policies change) 0
-- Make training longer 0
-- Make training shorter 0
Types of Changes Recommended for Program Features Other Than Counselor Role and Training  
-- Outreach: improve description of program to consumers before enrollment, invite home care agencies to refer clients, change eligibility criteria 1
-- Bookkeeping: make bookkeeping service more responsive 0
-- Representatives: encourage wider use, pay them 0
-- Uses of cash: make less restrictive 0
-- Workers: increase pay, provide training 2
-- Cash and cash spending plan: reduce time to review changes to plan, simplify the plan, keep consumer direction but eliminate cash payment to consumers 2
-- Other: provide services in languages other than English, extend program to children with disabilities 1
Average Number of Consumers with Whom Counselors Have Worked 284
NUMBER OF COUNSELORS RESPONDING TO SURVEY 7
SOURCE: Mail survey of IndependentChoices counselors conducted between May and June 2000.


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