State officials' concerns center on states' ability to limit participation in their waiver programs. These providers are paid directly by a state agency, and, thus, consumers have minimal involvement in the payroll process. However, consumers of Medicaid in-home care do verify that the authorized hours of work were performed by signing workers' time sheets. In Oregon, case managers play a significant role in ensuring a successful community-based placement. Consumers work with case managers to obtain the set of services that best meets their functional needs.
Case managers can also arrange for in-home agency providers to assist in case of an emergency.
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