Many seniors have extracted a promise from their children that can be summed up in the phrase “never a nursing home.” However, when faced with the presence of a stranger in their home to provide care, they realize that their wish has come at a very high psychological cost. The loss of independence can undermine the benefit of avoiding nursing home placement. These individuals should be aware of a Medicaid option called the Consumer Directed Personal Assistance Program (CDPAP)1 that can permit them to exercise greater autonomy. It is available to individuals (called “consumers”) who are disabled, medically stable, self-directing and eligible for Medicaid long-term care services. It allows the consumer freedom of choice in selecting her own home care worker (called the “personal assistant”).
In a typical home care case, Medicaid selects the agency that will provide the care, and the consumer has no input into the identity of the worker. The consumer directed program provides an alternative system by allowing the consumer to control the hiring and supervision of the worker. It is appropriate for those who want control over the selection of the aide and those who already have a home care worker whom they have been paying privately.
Nurse Practice Act
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