Oregon Department of Human Services, Senior and Disabled Services Division
What is Independent Choices?
- Financially eligible for waivered services (300% of SSI standard)
- At risk of nursing facility placement
- Live in 3 count cachement area
- Demonstrated stability
Consumers arrange for care and services
- The care and services purchased
- The employees providing the care
- The payroll for care providers
- The budget for services purchased
Medicaid money is paid directly to consumer
- Prospective payment
- Consumer must meet all obligations of being an employer
Project required Section 1115 waiver
- Waiver effective May 1, 2001
Cognitively impaired consumers can participate with surrogate decision makers
Consumers can employ family members including spouses as caregivers or service providers
Consumers self-select into the program
- Younger adults--original interest
- Elderly--as waiver process went on, more "younger old" became interested
- In 1997, project enrollment estimated as 70% younger disabled/30% elderly
- In 2001, enrollment estimated as 60% younger disabled/40% elderly
Surrogate decision makers
Payroll and tax preparation services
- Consumers who must use payroll service
- Consumers who choose to use the payroll service at their own cost
- Pilot site differences
- How far will the hourly wage go?
- Cash amount based on current hourly wage
- "$8.12 an hour is pretty good money around here."
- Oh, clients are going to have to pay at least $11 or $12 an hour."
- Will more family members be employed in rural areas?
Employing spouses as caregivers
- Who will?