Consumer Direction

Our Position

Multifaceted intermediaries are needed to support consumers and workers in consumer-directed programs, as well as family caregivers, by providing services such as robust registries, training for consumers and family caregivers, supports for independent providers, access to back-up and respite services, and one-stop/single points of access to information and resources.

What We're Doing

  • Creating a publicly accessible state-by-state database of registries and other intermediaries currently in existence or under development that support and provide services to both consumers, workers, and family caregivers.
  • Advising states on the pros and cons of different intermediary structures and functionalities.
  • Examining workforce challenges presented by consumer direction and promoting policy solutions.
  • Supporting the development of resources, including training materials, for consumers who direct their own care.


Over the last decade, our eldercare/disability services system has undergone profound changes. Due to changes in consumer preference and public policy, increasing numbers of consumers are choosing to receive services in their own homes and other community-based settings.

As the country moves toward a decentralized model of service delivery, much greater responsibility is being place on consumers and their families for meeting their needs for eldercare and disability services and on workers for managing their own work lives. However, little infrastructure is in place to provide needed supports to consumers, workers, or family caregivers, including infrastructure that helps consumers and providers identify each other and interface.

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