Consumer direction was not intended for all PAS users. Despite consumers reporting high levels of satisfaction with the program and their care during evaluation interviews, program records show that, of the 1,004 consumers who enrolled in IndependentChoices, 189 (19 percent) had disenrolled voluntarily within a year of enrolling (Appendix Table A.6). Of those 189, roughly two-thirds disenrolled before they started on the allowance (not shown). The evaluation's nine-month follow-up interview asked consumers who reported disenrolling voluntarily about their reasons for doing so. Reasons most commonly cited were (1) the allowance was too low, (2) they changed their minds about traditional services, or (3) they had difficulty with employer responsibilities such as recruiting or training (Appendix Table A.6).
Elderly consumers were more likely than nonelderly consumers to disenroll for any reason in the year following enrollment (41 versus 30 percent). Among those who reported disenrolling within nine months, nonelderly consumers were somewhat more likely to say that the disenrollment was voluntary (50 percent, compared with 42 percent for elderly consumers). Elderly consumers who disenrolled voluntarily were more likely to say it was because they changed their mind or that they had difficulty with employer responsibilities. Nonelderly consumers were more likely to say they disenrolled due to conflict with program staff or because the program had too many rules about the use of the allowance (Appendix Table A.6).