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Individual budgets is a process where individuals with developmental disabilities are given more control over the resources, usually composed of state and local dollars, used to support them. Typically an county board of mental retardation and developmental disabilities agency uses the dollar amount of resources used to provide traditional center-based programs and gives some portion of that to an individual with a developmental disability to "purchase" the same or similar service in the community. In the Journal of Disability Policy Studies, 14(4), pp.229-240,Loughlin DM, Simon-Rusinowitz L, Mahoney KJ, Desmond SM, Squillace MR and Powers LE use the term "cash and counseling " in place of individual budget to describe "an alternative to traditional agency-delivered health services" ( Preferences for a Cash Option Versus Traditional Services for Florida Children and Adolescents with Developmental Disabilities). They explain that this option offers greater flexibility for families planning services for their children. This effort is part of the Cash and Counseling Demonstration and Evaluation project, co-sponsored by the Robert Wood Johnson Foundation. The project found, through phone interviews that seventy-nine percent of respondents expressed great interest in the cash and counseling option and a majority of respondents believed a cash option would be easier to use than their present arrangements. According to the Kaiser Commission in a report prepareed by Brenda C. Spillman, Kirsten J. Black, and Barbara A. Ormond of The Urban Institute, "the individual budget model originated in the Cash and Counseling Demonstration sponsored by the Robert Wood Johnson Foundation (RWJF) and the U.S. Department of Health and Human Services in three states in the late 1990s. In concept, the individual budget model is perhaps the most complete expression of the longstanding movement for consumer direction in public long term care benefits. The movement seeks increased beneficiary input into the configuration of public services and supports for persons with disability (Beyond Cash and Counseling: The Second Generation of Individual Budget-based Community Long Term Care Programs for the Elderly, page 5) The 'individual budget' model is a service option that offers beneficiaries an individual budget that they manage to obtain services they need, in place of the traditional package of Medicaid supports and agency-provided services(page 1)." The Erie County Board of Mental Retardation and Developmental Disabilities in Sandusky, Ohio, one of 88 county boards in the state of Ohio, reports that since January 2008 91 out of 161 eligible adults have chosen to access an individual budget in lieu of traditional supports. The expected result is that the user of services can often purchase the same or similar service for less money. This happens for a few reasons. The first is that the user of service is buying only what they need. For example, an individual may have attended a sheltered workshop program for eight hours a day five days a week because they or a parent needed respite for only three hours a day. Given the choice, this individual may only want to pay for service three hours a day. In addition, that three hours may be provided by the next door neighbor, perhaps a stay at home mother, who is willing to do it for a fraction of the cost. The second reason that individual budgets can be more cost effective than traditional services is that the user is able to better negotiate the cost of needed services. As the example shows, the best provider of service may be a neighbor, friend, coworker, or family member. Often, someone close to the individual is willing to provide the same service for much less money than it would cost the county board of mental retardation and developmental disabilities to provide.
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