Counselors were also asked to assess the experiences of consumers in IndependentChoices. On average, IndependentChoices counselors reported about a fifth of consumers in their caseloads required extensive amounts of counselor assistance. Those who required the most help were consumers who were ill or who had not identified a family member or friend to be a paid worker, and consumers (or representatives) who had little experience as employers. Six of seven counselors also reported having a handful of consumers (five or fewer) who made unreasonable demands, such as wanting checks for workers before they had done the work or wanting to make purchases not permitted under program rules (Appendix Table A.29). In addition, several counselors noted that the program worked best for consumers considering nursing home placement, those who had had a family member or friend in mind to hire as a worker, and those who wanted to purchase care-related equipment or services that Medicaid did not cover. In summary, one counselor noted that she heard more than once from consumers: "This is the best program I have ever received. I can finally get some help with my bath and meals. Without this program I would have no one." On the other hand, counselors reported the program did not work particularly well for consumers who could not hire or retain a suitable worker (Appendix Table A.30).
Counselors were also asked to assess the program more generally. Only one counselor recommended changes to counseling activities or counselor training: using more peer counseling in training. At least one counselor recommended each of the following: increasing pay for workers, providing worker training, and simplifying the allowance spending plan. One reported that the provision of "cash" created the incentive for financial exploitation and that just giving consumers control over who works for them and what tasks are carried out would be better. Another recommended expanding the current program to children with disabilities (Appendix Table A.31).