Cash and Counseling, a Non-Traditional Medicaid Program, Is Adopted by More States

Many states are now giving Medicaid-eligible seniors a monthly stipend they can use to hire family, friends and/or professionals to care for them at home. The program, called Cash and Counseling, already exists in 15 states and is expected to be implemented soon in 18 more.

Cash and Counseling offers Medicaid consumers who have disabilities more choices about how to get help at home. Specifically, it gives frail elders and adults with disabilities the option to manage a flexible budget and decide for themselves what mix of goods and services will best meet their personal care needs. Cash and Counseling participants may use their budgets to hire their own personal care aides as well as purchase items or services, including home modifications that help them live independently. By redirecting personal assistance funds from agencies to consumers themselves, Cash and Counseling allows people to hire whomever they want to provide their care. The services paid for by the state are all part of the consumer’s authorized care plan. What’s different is that, in many cases, family members and friends chosen by the consumer are providing those services instead of an agency worker.The counseling side of Cash and Counseling provides consumers with assistance in planning their budgets, keeping up with the paperwork required to pay an employee’s wages and withhold taxes, and accounting for expenditures.

A website discussing the Cash and Counseling Program in general can be found here –

An article discussing the Cash and Counseling Program may be found at the website at More states offer choice in long-term care