provides the physical services needed to stay independent and to avoid more costly institutional care.
The Consumer Choices Option program, which costs no more and often less than regular waiver services, allows recipients to direct and tailor their own services, and to hire the people who deliver them. Several safeguards are in place to help with planning and to make payments.
Dreesman said she directs her waiver money to her exact specifications.
“You should see what I can do now,” she said.
“Consumer Choices Option pays for most of my personal trainer, a specialized physical chiropractor, and regular water exercises. It even helped pay for these special shoes” that are built to accommodate her gait.
There is assistance with meal preparation and housekeeping, and a savings account within the CCO budget allowing her to save for special equipment.
“There’s even money for horses,” she laughed.
Her budget provides $180 three times a year for One Heart Equestrian Therapy, a central Iowa program that provides horseback therapy for people with disabilities.
With aggressive personal training, overlaid by fierce determination, Dreesman has learned to walk in many situations without the help of a rolling walker.
“I’d like to be a little more fluid, to walk without swaying so much,” she said. She has progressed so well that specialists have asked to study her case and see if there might be lessons learned for others.
It’s the CCO program, she said, that provides the support she needs to keep her job as an education assistant at an elementary school not far from her home in Ames.
Using her degree in elementary education from the University of Northern Iowa, Dreesman’s specialty is to provide small-group academic services for kindergarteners and first graders, but she’s also keen to teach tolerance.
“I have watched children develop empathy and compassion toward people like me who don’t walk the same as they do, or who don’t walk at all, or who are different in some other way,” she said.
Consumer Choices Option is available only to the 24,000 disabled or senior Iowans who are eligible for Medicaid and choose to receive “waiver” services—such as meals, transportation, or help with toileting or bathing—designed to “waive” regular Medicaid and to keep them independent and in their own homes.
The program does not cost more than regular waiver services. Instead, it allows consumers to be in charge of money that would otherwise be spent in their behalf. They may choose to hire relatives (excluding spouses), neighbors, or friends as caregivers.
Seed money to set up the program was provided by a $250,000 grant from The Robert Wood Johnson Foundation.
A similar program has been operating for several years in Florida, New Jersey, and Arkansas. An independent study determined that in all three states, quality of life improved, satisfaction increased, and access to home care was increased compared to a randomly assigned control group that received services from agencies.
Currently, about 545 people have signed up for Consumer Choice Option. For more information, call any local DHS office or visit http://www.ime.state.ia.us/HCBS/HCBSConsumerOptions.html | 
