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Self-Determination Realized? Consumer direction: A case study of Virginia

Consumer direction, a model of long-term care service delivery where service recipients and their families/advocates have enhanced control and choice over the services that they receive, is a growing phenomenon in United States. As it becomes greater utilized, it is important to understand the model and study its impacts. This dissertation details the history of the consumer direction movement, describes the current landscape of consumer direction in the United States, and presents a comparison study of users of consumer-directed (CD) services in three of Virginia Home and Community Based Services (HCBS) Medicaid Waivers. Self-determination theory is provided as a theoretical framework for understanding consumer direction. The influences of liberty, empowerment, and paternalism are discussed in the context of self-determination theory as well as multidisciplinary influences. Results from the study indicate that overall, CD services facilitate self-determined decision making by enhancing recipients choice and control over services. When comparing differences between waiver groups, the survey domain of “access” was the only domain where statistically significant differences (p<.01) were found. Implications for users, advocates, and administrators of CD services are discussed.

Identiferoai:union.ndltd.org:vcu.edu/oai:scholarscompass.vcu.edu:etd-2653
Date22 October 2008
CreatorsDinora, Parthenia
PublisherVCU Scholars Compass
Source SetsVirginia Commonwealth University
Detected LanguageEnglish
Typetext
Formatapplication/pdf
SourceTheses and Dissertations
Rights© The Author

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