A grant to Iowa’s Department of Human Services from a private foundation will give some homebound Iowans the choice of who cares for them. D.H.S. spokesman Roger Munns says people with disabilities and Medicaid recipients can have some say in the caretakers who help them remain in their home instead of going to a nursing home or other institution. The Robert Wood Johnson Foundation’s granted 250-thousand dollars for a “Cash and Counseling” program that’ll help poor people getting disability or medicaid services to have a hand in the hiring of the people who provide that care. The grant being announced today could let thousands of people choose the caretakers who provide intimate personal services in their homes. It’s understandably important to know the person who’s providing services as personal as bathing, toileting, dressing and preparing meals, and Munns says having choice or even hiring that person would make such a program more successful than letting someone else do the hiring for a person’s caretaker. Munns says it won’t be for all client — some people don’t want to make such a decision, or aren’t capable of choosing or hiring the state-paid caretaker who will provide services. They’re guessing that there are “many thousands” who would like a direct hand in that decision. Right now a client can pick the agency, but that agency in turns hires the person who’ll knock on your door. Iowa is among eleven states getting similar grants today to try the new system of choosing caretakers. Munns says it’s already been tested and found successful in Florida, New Jersey and Arkansas. Quality of life improved for people in those tests, he says, satisfaction improved, access to home care was improved and they even saved money. Providing services in a person’s home is more economical, but he says it’s also important to consider “the dignity factor.” Munns says there are about 16-thousand people in Iowa already approved for Medicaid waiver programs that permit home care for people who’d otherwise need nursing-home care, and those are the people who’d be eligible for the new pilot program. They can actually pick and hire the person, be it a relative — though it can’t be a spouse — a friend, neighbor, or church acquaintaance to come provide services in their home. It’ll take a couple of years to get the program going, because it will have to be planned, approved, set up and also have accountability to check on how it’s running and how the money’s being used.