Formerly IGSW News | VOLUME 21 | WINTER 2014

Issues and Views

From agnostic to believer

Kevin Mahoney: Everyone Wins with Participant-
Directed Long-Terms Supports and Services

By Mary Johnson

Kevin MahoneyWhen his young son underwent brain surgery, Kevin J. Mahoney (photo at right) learned firsthand the value of participant-directed care: "I knew the feeling of wanting to guide his ongoing care," Mahoney said in a recent interview with The LearningEdge. In the year that followed, Mahoney became national program director of the Cash & Counseling Program, a path-breaking model of participant direction of Medicaid-funded personal assistance services in 15 states, and his commitment to the issue was cemented by what he saw at work. "I'd been an agnostic about participant direction," he says. "But as a rigorous experimental evaluation of the program unfolded, it became absolutely clear that participants were more satisfied and did better when they could choose their own mix of services and helpers, with control of the budget that an agency would have used."

In the 15 years since, Mahoney has been at the forefront of adoption of participant direction in long-term services and supports in the United States. He is currently director of the National Resource Center for Participant-Directed Services (NRCPDS) at the Boston College Graduate School of Social Work. NRCPDS is the only national organization assisting states, agencies, and other organizations in offering participant-directed services to people with disabilities of all ages.

One example of the NRCPDS work to expand participant direction is its partnership with the Center for Aging & Disability Education & Research. The two have developed an online course to teach aging and disability agencies how to partner with managed-care organizations that are now providing managed long-term supports and services to help them develop and expand participant direction within those programs. Managed care has become an emerging model of choice for delivering long-term supports and services in a home and community-based setting. The course is part of a project to build the business capacity of the aging and disability network.

"It's a real opportunity for them," Mahoney says. "Individuals increasingly demand participant-directed care, and Medicaid and Medicare strongly recommend it. Aging and disability agencies have been doing it; they know how, and no one else does. Everyone wins: participants, agencies, and managed care organizations."

Photo of Kevin J. Mahoney courtesy NRCPDS

New course for aging and disability agencies

Develop the Business Skills to Help Managed-Care
Organizations Provide Participant-Directed Services

Aging and disability agencies, which have years of experience in participant-directed long-term supports and services, are in a unique position to help managed-care organizations introduce and sustain participant direction, which is increasingly demanded by recipients of supports and services and often required by Medicare, Medicaid, and other payers. In this course you'll learn how your agency can engage in business relationships with MCOs to provide consultation, training, and management for participant-directed services. Building the Aging and Disability Network's Business Capacity: Participant Direction in Managed Long-Term Services and Supports will be available March 31. Sign up now, before April 1, to receive a 10 percent discount (enter code ENews 2014). For more information

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Copyright © 2014 Trustees of Boston University. All rights reserved. This article may not be duplicated or distributed in any form without written permission from the publisher: Center for Aging & Disability Education & Research, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, U.S.A.; e-mail: