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Relates how the self-direction movement was developed, the research that supports it, how the model has spread across the country and the globe, and recommendations and prospects for the future.
In the past, when people with disabilities and older adults needed help with activities of daily living and navigating their communities, they rarely had any choice about who helped them, when that support was delivered, or what the worker would or would not do. The self-direction movement changed all that by offering people the option to select their own workers and even create an individualized budget to help them live more independently. Written by experts who played a key part in the growth, evaluation, and dissemination of this revolutionary approach, Self-Direction describes the development of this movement through the authors' personal accounts. Also included are stories from actual participants in the movement who benefitted from this approach and from policymakers who saw how self-direction could help address states' problems. The book's conclusion discusses recommendations that can improve the way self-direction is delivered and how to spread its message so that all people with disabilities can have this choice.
"…an accessible and thorough history and overview of self-directed supports programs. The authors share their aggregate wisdom and experience with a friendly style that walks the reader through the many programs, policies, experiments, and studies that tell the story of how self-direction has become mainstream. They provide an excellent articulation of the underlying philosophy, the history of implementation in state and federal programs, and most importantly, a summary of the benefits of self-direction in terms of public spending and participant outcomes." — Journal of Aging & Social Policy
"…a comprehensive resource for those who would benefit from understanding the promise of self-direction … I recommend this book to anyone interested in teaching the next generation of health professionals and leaders about the best ways to address the needs of the growing population of people with disability. Those who are interested in influencing, making, or implementing long-term care policies and all who are pursuing research or evaluations about long-term care also will find this a valuable resource." — Richard M. Allman, The Gerontologist
List of Illustrations
Acknowledgments
Preface
1. Self-direction: What It Is and How It Works
2. The History and Policy Antecedents of Self-direction
3. The Federal Role: Less Visible, Just as Important
4. The Status of Self-direction across the Country
5. Setting Individualized Budgets to Support Self-direction
6. The Impact of Self-direction: Results for Participants
7. The Impact of Self-direction: Financial Results
8. Factors That Can Influence the Growth of Self-direction
9. The Expansion of Self-direction to Other Participants
10. International Examples of Self-direction in Human Services
11. Reflections and Recommendations
Postscript
Notes
References
Index