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document
Consumer-directed care for beneficiaries with mental illness : lessons from New Jersey 's Cash and Counseling program . OBJECTIVE Previous research from the Cash and Counseling Demonstration and Evaluation ( CCDE ) programs in New Jersey , Arkansas , and Florida suggests that consumers ' control over personal care greatly improves their satisfaction with care arrangements and their outlook on life . Still , some argue that consumer-directed care may not be appropriate for consumers with a diagnosis of mental illness . This study examined the effectiveness of the CCDE program for those with a diagnosis of mental illness . METHODS This study examined nonelderly Medicaid beneficiaries in New Jersey with a diagnosis of mental illness and compared and contrasted the experiences of those in New Jersey 's CCDE program ( N=109 ) and those who received services provided by an agency ( N=119 ) . Logistic regression analyses were performed on baseline and nine-month follow-up data . RESULTS By examining outcome measures -- including satisfaction with care arrangements , consumers ' perceptions of paid caregivers ' attitudes , unmet needs , adverse events , and satisfaction with life -- this study offers evidence that , from the perspective of consumers , the CCDE program is appropriate for participants with a mental illness diagnosis . For most outcome measures the CCDE program demonstrated a positive effect after baseline characteristics were controlled for . The analysis of measures of adverse events , health problems , and general health status did not yield statistically significant differences between the control group and the treatment group , indicating that CCDE care was at least as safe as agency-directed care . CONCLUSIONS Considering the growing need for long-term care services and the limited resources available , a consumer-directed option can be a valuable alternative for persons with a diagnosis of mental illness .
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Intervention_Educational
compared and contrasted the experiences of those in New Jersey 's CCDE program ( N=109 ) and those who received services provided by an agency ( N=119 )
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Intervention_Educational
Logistic regression analyses were performed on baseline and nine-month follow-up data
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Outcome_Other
care arrangements
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Outcome_Mental
outlook on life .
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Outcome_Other
effectiveness of the CCDE program
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Outcome_Mental
Logistic regression analyses
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Outcome_Other
satisfaction with care arrangements
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Outcome_Mental
consumers ' perceptions of paid caregivers ' attitudes
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Outcome_Adverse-effects
adverse events
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Outcome_Other
satisfaction with life
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Outcome_Other
positive effect
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Outcome_Adverse-effects
adverse events
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Outcome_Physical
health problems , and general health status
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Participant_Condition
beneficiaries with mental illness :