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How can the values of consumer choice and empowerment be reconciled with managed care service organization and delivery?

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How can the values of consumer choice and empowerment be reconciled with managed care service organization and delivery?

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A fundamental value within the disability community is the concept of consumer choice. People with disabilities and their advocates articulate a need for self-determination. This is especially notable in the personal assistance services (PAS) arena for people with physical disabilities. Rather than rely on formal, agency-directed services, some consumers (particularly younger ones) are seeking flexible policies that allow them to hire, train, and–if necessary–fire the individuals who help with their daily living tasks. This is in direct contrast to the traditional personal care service mode, under which an agency employs, trains and assigns individual providers to a person. As consumers with disabilities and their representatives contemplate moving into managed care, respecting choice and empowerment is a frequently raised theme. Should participation by people with disabilities in managed care always be voluntary? Many states are mandating the participation of welfare recipients and,

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