Both follow a vendor payment model.
Some programs restrict which services are covered and which vendors are authorized.
Others offer a somewhat broader range of covered services. Disability rights advocates argue, however, that consumers should direct their own services. As the Independent Living Movement has grown since the early 1970s, the notion of consumer-directed personal assistance services, or CD PAS, has become increasingly accepted. Along with advocates, many analysts now argue that a consumer-directed system could lead to higher consumer satisfaction, higher consumer productivity, consumer empowerment, and possibly lower costs. To test ideas and address knowledge gaps, public and foundation funds have supported large and small demonstration and evaluation projects, including several state initiatives beginning in the 1970s, the federal Channeling Demonstration in the 1980s, and the Nursing Home Transitions and Cash and Counseling Demonstration and Evaluation in the 1990s.