Consumer-Directed Personal Care Programs: Department of Veterans Affairs and Medicaid Experience

Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) Aid and Attendance (A&A) program as well as selected state Medicaid programs that permit consumers to hire their own personal care attendants, focusing on whether: (1) the government might be paying twice for persons in nursing homes who also received A&A benefits; (2) there are any existing public programs that could serve as a model for Medicaid; and (3) there is sufficient knowledge about consumer-directed personal care to recommend one of these programs as a model.