The Need to Ensure Local Competition and Individual Choice in Managing Long Term Support Arrangemen

This paper describes two seminal movements: the move to self-determination and community inclusion in the disabilities field and the move to managed care arrangements in the health care field. It points to the powerful advantage of marrying the two, but warns that the marriage will work only in a competitive community marketplace. Policy-makers, administrators, advocates and providers interested in improving long term supports for people with disabilities are urged to foster managed competition and to avoid the excesses that have stemmed from unmanaged competition for the health care dollar.

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