Appendix 212-A Principles of Consumer Direction | HCBS-5300-MANUAL
|
Georgia Division of Aging Services |
|||
Chapter: |
200 |
Effective Date: |
January 2010 |
|
Section Title: |
Principles of Consumer Direction |
Reviewed or Updated in: |
||
Section Number: |
Appendix 212-A |
Previous Update: |
||
Principles of Consumer Direction
-
Systems should be based on the presumption that consumers are the experts [about] their service needs.
-
Different types of services warrant different levels of professional involvement.
-
Choice and control can be introduced into all service delivery environments.
-
Consumer-directed service systems support the dignity of people requiring assistance as well as cost less when properly designed.
-
Consumer direction should be available regardless of payer.[1]
Additional Thoughts on Consumer Directed Care (CDC)
“CDC serves to counteract the protective instincts of providers who resist consumer direction because of concern about legal and regulatory exposure. Choices are not offered because providers feel there is an unacceptable level of risk even if those choices would improve the consumer’s quality of life. With shared risk established within a set or rights and responsibilities, these concerns may be allayed.”[2]
“Policymakers should avoid imposing a heavy-handed regulatory scheme on CDC. The regulatory objectives for CDC should be the prevention of fraud, abuse and neglect and maintaining an acceptable quality of life from the perspectives of the consumer and the caregiver(s). The care counselor should be trained to identify and respond appropriately to fraud, abuse and neglect.”[3]
“The structure and process focus of conventional long-term care regulation is only partially applicable in the context of consumer direction. The counselor certainly needs to ensure that caregivers know their job and that necessary services (i.e., home health care) are being appropriately provided. But the regulatory priority in CDC must be on quality of life and the extent to which criteria based on the concepts of autonomy, dignity, emotional well-being and general life satisfaction are being met. Information on these criteria should be gathered through face-to-face interviews with consumers and caregivers conducted at regular intervals and on an as-needed basis.
The principle focus of this approach to care monitoring is the quality of the consumer’s relationship with the caregiver, service providers and others, rather than the more material conditions of the consumer, except as they bear on her satisfaction with her quality of life.”[4]