![]() The demonstration seeks to maximize consumer choice and promote efficiency as consumers who shop for the most cost-effective providers may be able to purchase additional and more individualized services ( Kapp, 1996). The CCDE is cosponsored by RWJF and DHHS/ASPE. One such model, “cash and counseling,” offers a cash allowance and information services to persons with disabilities, enabling them to purchase the services, assistive devices, or home modifications that best meet their needs. Concurrently, there is increasing interest within the aging and disability communities in consumer-directed care ( Kapp, 1996 Simon-Rusinowitz and Hofland, 1993 Ansello and Eustis, 1992 Mahoney, Estes, and Heumann, 1986). As LTC expenditures have risen, policymakers have sought new ways to control costs while maintaining or increasing consumer satisfaction.
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