Easing the Burden of Caregiving: The Effect of Consumer Direction on Primary Informal Caregivers in Arkansas

Cash and Counseling, an innovative model of consumer direction, has been implemented as a three-state demonstration designed to weigh the advantages and disadvantages of allowing Medicaid beneficiaries to assume more responsibility for the supportive services they may need. This paper presents estimates of program effects on primary informal caregivers (those providing the most unpaid supportive services at baseline) from Arkansas's Cash and Counseling demonstration, the first of three such demonstrations to enroll and randomly assign Medicaid beneficiaries to direct their own services or to rely on agencies as usual. Arkansas's consumer-directed program, known as IndependentChoices, was designed for elderly and nonelderly adults. [48 PDF pages]