Purpose: Previous research from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, New Jersey, and Florida suggests that giving consumers control over their personal care greatly increases their satisfaction and improves their outlook on life. Still, some argue that consumer-directed care may not be appropriate for consumers…

Notes that low Medicare reimbursement rates are already causing some mental health professionals to turn away elderly patients. Considers baby boomer cohort who, unlike elders today, have high rates of psychiatric illness and are more likely to seek mental health services. Projects increasing gap over next 25 years between need and availability of…