Grant to help center expand program to the national level

Original Source

By: Ashley Schneider

The Atlantic Philanthropies awarded a $3.5 million grant to Kevin Mahoney, a professor in the graduate school of social work and director of the Center for the Study of Home and Community Life (CSHCL), to help the center’s Cash & Counseling Program expand on a national level.

“The major focus [of the CSHCL] is on better ways to address and serve the needs of the elderly and persons with disabilities through very innovative approaches [that center] around the concept of empowerment,” said Alberto Godenzi, dean of the Graduate School of Social Work. The grant received by Mahoney will help the center to continue this focus and spread it across the nation.

The Cash & Counseling program began as a study of the effectiveness of a consumer-directed health care plan across the states of New Jersey, Florida, and Arakansas. “It started out as a real experiment,” Mahoney said. The program separated participants into two groups: one on consumer-directed care and another on a traditional health care plan. “The results were much better than we ever thought they would be,” Mahoney said. According to the study, customers proved more satisfied with their health care plans and health conditions even improved.

The current program was modeled after the initial study. Consumers now design their own health care program with the help of a counselor. The consumer is given the freedom, Mahoney said, to hire family members, friends, or professionals as care givers, to renovate their house for handicap accessibility, and to buy assistive devices, among other options.

After the center conducted the initial study, the Robert Wood Johnson Foundation coupled with federal organizations, The Administration on Aging (AOA), the Office of the Assistant Secretary for Planning and Evaluation (ASPE), and the U.S. Department of Health and Human Services (DHHS), helped the CSHCL replicate the Cash and Counseling program in 12 additional states.

The federal government also abolished the need for special waiver permission to implement these acts in January 2007 when the 2005 Deficit Reduction Act (DRA) took effect. This gave all states the ability to add the consumer-directed plan. The DRA works with the many components of the Cash & Counseling program, including allowing family to be paid as care givers.

Now that Cash & Counseling has been established in 15 states, Mahoney and others hope to expand the health care option to 40 to 50 states. “We have a vision,” Mahoney said, “that this option will be available in every state, and maybe even some day it will be the normal way of doing business, at least the idea of starting with what the consumer needs.” The $3.5 million grant is a part of an expanded effort to launch the Cash & Counseling program nationally.

In September 2007, another grant was given to the project in the amount of $4.75 million, and the AOA, as well as the ASPE, signed major contracts in September. The center is currently in the process of negotiating with another large organization to further help the program, and they are preparing to announce a new name for the program in the next month.

“We’ll be doing a lot more of the training, we’ll continue to [provide] assistance to the states, and there will be more small research projects,” Mahoney said. Currently, the focus is on personnel. “The traditional way,” Mahoney said, “is a very medical model; the professional decides what you need. This is a pretty big change because all of a sudden it’s an empowerment model.”

The counselors need a specific training which is very different from the previous training received. Additionally, applications are piling up for the two open spots at the CSHCL. “The grant helps [Professor Mahoney] to hire some very important players in this area of research,” Godenzi said.

Even though Cash & Counseling has made significant progress, there are still problems that will be encountered. Initial concerns were fraud and abuse, Mahoney said. Right now, Mahoney and the center are tackling thinking through training for counselors. Some agencies are worried about market share and how the program affects them. Another large problem is working with unions.

Despite concerns, Cash & Counseling is expected to be received well by the new Obama administration. The program was inspired by the Clinton administration and the continued support of the Bush administration demonstrated the bipartisan nature of Cash & Counseling.

“This is an approach that I think has across-the-board support,” Mahoney said. Godenzi also agrees that this issue crosses party lines. “The concept is appealing to either Republicans or Democrats,” Godenzi said. “The control piece is critical in moving forward with your own life.”

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