The Experiences of Workers Hired Under Consumer Direction in Arkansas

In this paper, the authors use data obtained from the first Cash and Counseling demonstration, Arkansas' IndependentChoices, to assess the experiences of directly hired workers. They describe the types and amount of care that paid workers provide, the training and supervision they receive, their working conditions, and their well-being. They also consider how the worker-consumer relationship affects key outcomes. While this study is not an impact analysis, the authors use the experiences of agency workers as a benchmark for comparison of the experiences of directly hired workers. Thus, this analysis should enable policymakers to assess whether directly hired workers fare at least as well as agency workers. They do not expect, however, that agency workers and directly hired workers will necessarily have similar experiences, as most directly hired workers are the relatives or friends of the consumer, serving as part employee, part informal (unpaid) caregiver. This personal relationship will clearly influence caregivers' outcomes. [47 PDF pages]