Episode 86 - Dr. Nicole Ruggiano: Doing It Their Way: Consumer-Directed Long-Term Care

Monday, December 12, 2011, 9:02:12 AM

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In this episode, Dr. Nicole Ruggiano discusses a client-driven and self-directed approach to consumers' long term health care, providing an alternative to traditional, agency-provided and managed care. She describes the positive outcomes related to the consumer-directed model and anticipates the barriers and costs in embracing the approach.

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Average Rating: 3.8 stars (9 listener reviews )

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Average Rating: 1 star  what happened?, Thursday, January 21, 2016

By Anonymous :

What happened? This podcast cut off right in the middle of the discussion. I would have liked to hear more suggestions for controlling fraud in consumer directed services as the facilitator seems to dismiss this problem by pointing out that there is also fraud in... durable medical supplies? How is that relevant?

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Average Rating: 5stars  consumer-direct care: pros and cons, Wednesday, April 25, 2012

By Tom Grace :

Dr. Nicole Ruggiano's podcast focuses on a newer trend in social work, which is consumer-directed care. This is an interesting approach as it places the power and decision-making in the hands of the client, or care recipient. The recipients are able to chose the services, hours of service, or medical equipment they need. However, instances of fraud are heightened by this form of medical care. Stories of Medicare fraud, particularly in the state of Florida, have received much negative attention within the last few years. It is possible that consumer-direct care could be adding to this, because of the lack of followup being done on medical billing. Criminals are able to set up overnight medical practices, charge Medicare for equipment and services, yet deliver neither of which and keep the profits for themselves. Consumer-directed care is still a new and growing trend within social work, problems will arise, but hopefully be fixed.

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Average Rating: 4stars  consumer driven care in the aging population, Wednesday, April 25, 2012

By Janelle :

I find it really interesting that it has taken the push for consumer driven treatment so long to reach the aging population. As Dr. Ruggiano mentions, there has been great movement towards this approach within the populations of persons with developmental and psychiatric disabilities. There is no reason why, an aging adult, or the representative of the adult, should not have the freedom to make choices that plan treatment around the way they want to live their live. This is fundamental to the concept of self determination. As Dr. Ruggiano states, the flexibility within the consumer model is also more cost effective and the services provided are better utilized than those that are regulated by managed care. I think it is important however, to ensure that aging adults have access to service coordinators who can assist them with in negotiating the systems involved in their care coordination. Such coordination, no matter what system was put in place, would likely involve a somewhat complex amount of paperwork and many people in general, regardless of age, would have difficulty in understanding the options available to them and how to access them. In summary, I think that this treatment model would be excellent for the aging population, as long as they are assisted in utilizing it.

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Average Rating: 4stars  episode 86, Friday, April 20, 2012

By Emiily Benedict :

As a social worker, I agree with the idea of moving from agency driven care to consumer driven care. The consumer needs to be empowered to make their own life decisions concerning their care needs and the services needed to meet those needs. I am not sold on the delivery aspect of the consumer directed care model when implemented with older adults. The concern does not rest on the decision making capacities of aging adults, but rather with the navigation through the complex and cumbersome systems of healthcare, insurance, entitlements, etc. they would find themselves immersed in. As a Service Coordinator working with independently living aging adults, age 65 years and older, I have witnessed much angst, anxiety and frustration from the clients when faced with these systems. A social worker or human service professional is able to provide the knowledge and skills needed to allow the consumers to make the best, most well informed decisions concerning their care while maintaining the spirit of the consumer directed care model. This can be achieved through the ethical and informed practices of the professional working with the client to ensure that the decisions made are of the client and that self-determination is maintained.

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Average Rating: 4stars  my review, Wednesday, February 01, 2012

By Briana :

Alot ot different prospectives, on point with discusiion.

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Average Rating: 4stars  episode 86, Monday, January 30, 2012

By Jackeline Bancayan :

Consumer directed care model sounds great since it puts the client in charge of their treatment. This is important since social workers should encourage self-determination, and this is a great way to empower clients. However, I think that having so much freedom with the type of care one receives leaves the client vulnerable to making wrong decisions. What if the client decides he/she needs less care that what he/she actually need? or if they choose a provider that is not necessarily qualified to help them correctly? I think it is great to give clients options, but I do not think it necessarily helps clients receive the professional help they need.
At the same time, I think its is good that this option is cost effective and will help many families provide the care someone needs without costing them a fortune while putting the client in charge of their treatment.

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Average Rating: 3stars  seen this system work, Tuesday, January 24, 2012

By Katinka Sloan :

there are systems like the consumer directed long term care on the Navajo reservation. My grandmother utilized this service for a long time before she went into a nursing home. I think this system is more on the beneficial side for patients because it gives power to the patient to choose the care they need and want and that's what healthcare is about, making the patient comfortable and helping them on their journey to health through the therapies they choose.

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Average Rating: 5stars  social workers & consumer directed care to fit the needs of the consumers., Tuesday, January 17, 2012

By Rachel Hardy :

I feel Consumer Directed Care is a good model of care and services. Although it can be better if all consumers needs, safety, and concerns are met. In the review they talk about issues from fraud, costs, services, to questionable decisions on consumer decision making. I believe anyone in the field of helping and working with these consumers should put their own personal beliefs aside that may affect their consumers because the consumers may have the total opposite beliefs and needs. these consumers should be able to understand all their choices with their services and be able to choose the care they wish to have provided more comforting to them. As well as giving them the security that fraud would be a factor but the option of getting services that could protect and prevent them from fraud. I see on the news and even Americas Most Wanted about workers doing their job innapropriatly. That can be another concern of the consumer weather they have been through the situation or are just fearful of having something happen to them by the workers, Family or Friends who are supposed to help them. I believe with that issue , that it is the duty of the Social Worker or Company to make sure that under no circumstances that should and will never happen for their own safety and piece of mind. This review made me have these concerns addressed and although its easy to suggest better help I know their are steps and procedures that have to be taken for all these services to make the consumers needs, safety, and concerns met.

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Average Rating: 4stars  podcast 1, Monday, January 16, 2012

By Zach Carey :

I thought the idea of consumer directed care was a great idea. Seeing how social workers are supposed to support the idea of self-determination, why not let the clients make the decision of what care they receive. By having them choose when and who is giving them the service, it would allow them to work with someone who they feel comfortable with. The downside to it though, could be that the person they are receiving care from, may not be the best for them. I believe that allowing the consumer to be put in control of their own care allows them to overcome their disabilities. It could give them the ability to identify rights and wrongs of what they need and don't.

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