Assessing the Appeal of the Cash and Counseling Demonstration in Arkansas, Florida, and New Jersey

Assessing the Appeal of the Cash and Counseling Demonstration in Arkansas, Florida, and New Jersey

Published: Jul 30, 2005
Publisher: Princeton, NJ: Mathematica Policy Research
Associated Project

Evaluation of Three Cash and Counseling Programs

Time frame: 1996-2005

Prepared for:

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation

The Robert Wood Johnson Foundation

University of Maryland


Randall Brown

Rachel Shapiro

States considering a Cash and Counseling program are likely to be interested in the number and types of eligible beneficiaries it might attract, factors that could deter interested beneficiaries from participating, and possible increases it might create in the total number of beneficiaries receiving the Medicaid personal care services (PCS) or home- and community-based services (HCBS) benefit. This report assesses the appeal of the demonstration by (1) estimating the proportions of eligible beneficiaries who participated and comparing the characteristics of participants and nonparticipants; (2) describing beneficiaries’ most common reasons for agreeing or declining to participate; and (3) examining whether the demonstration affected the number who access PCS or HCBS over time (program flow). The findings show that Cash and Counseling did not attract large percentages of those known to be eligible, nor did it seem to attract many beneficiaries who were interested in the program allowance but would not use traditional PCS or HCBS. The fairly low participation levels may have resulted from challenges states faced in conducting outreach and enrollment activities, from beneficiaries' satisfaction with their existing care arrangements or disinclination to assume new responsibilities, or simply from the newness of the program.

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