IndependentChoices successfully addressed many important concerns about consumer direction. It successfully implemented a consumer-directed program using the Cash and Counseling model without major operational difficulties or adverse outcomes for consumers, their families, or their caregivers. It provided a benefit that allowed consumers with a range of disabilities to meet their personal assistance needs with a high level of flexibility. Agency reports of worker shortages during the demonstration and results of a companion analysis (Dale et al. 2003b) suggest that some consumers who hired family and acquaintances would not have been able to obtain care from agencies had they been in the traditional program. For all of these reasons, most consumers were extremely satisfied with the program and care arrangements.