Cash and Counseling: Self-directed home and community long-term care

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Doty, Pamela
Apr 2023
Cash and counseling provides an allowance that recipients can use to purchase home- and community-based long-term care services instead of receiving them from an agency. This scheme gives beneficiaries the choice and independence to self-direct the implementation of their preferred long-term care plan, using an assigned budget, under the supervision of a counselor. One feature of this program is that recipients can choose between hiring a professional or a family member as a caregiver. The objective of this document is to explore how cash and counseling works, with examples of interventions in the United States, and how it is relevant for policy-making in Latin America and the Caribbean.