HSRI Perspectives | Making Self-Direction a Reality: Using Individual Budgets to Promote Choice, Control, and Equity

Date: 06/2019

Self-direction is a fast-growing platform for the delivery of community-based services and supports to people who need long-term care, and many states are choosing to use individual budgeting to make it a reality. Basing budget amounts on assessed need can help ensure that people have equal access to services across a service population.

To better understand the methods that states use to create individual budgets, the benefits and risks of these approaches, and their level of alignment with principles of self-determination, we examined 260 1915(c) Home and Community-Based Service waivers from across the nation.

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