Cash and Counseling had sizable effects on the proportion of people receiving paid care in Arkansas and New Jersey. It also had sizable effects among the nonelderly—but not the elderly—in Florida, where a higher percentage of enrollees were already receiving this type of care before enrollment. The program increased hours of paid care received by the elderly in Arkansas and New Jersey, and by the nonelderly in Florida and New Jersey, but had no effect on total hours of care for any of these groups because the hours of unpaid care decreased or were not significantly different (relative to the control group) for both age groups in all three states. Those in the program had higher levels of satisfaction than those in the control group and suffered no more adverse health outcomes as a result of directing their own care.