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Change and Inertia in the New York State Medicaid Personal Care Services Program: An Institutional Case Study

Journal Article
June 1, 2012

This study provides an analysis of the growth of consumer direction within New York State’s Medicaid Personal Care Services program. The authors conclude that, while the consumer-directed model has grown steadily since it began in 1995, resistance from certain stakeholders has prevented it from reaching its potential. The authors based their conclusion on data gathered by research; statistical analysis; and interviews with primary stakeholders, including union members, consumer advocates, and city and state officials.

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Key Takeaways

The early unionization of personal care workers resulted in relatively generous wages and benefits.
Stakeholders in New York have ensured that the personal care program has remained relatively stable and unchanged.
The resistance of stakeholders has caused the consumer-directed model to remain relatively small.
 
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