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Self-directed care (SDC) is a treatment model in which recipients self-manage funds designated for provision of services. The model is designed to cost no more than traditional services while achieving superior participant outcomes. The authors examined the model's impact on outcomes, service costs, and user satisfaction among medically uninsured, low-income individuals with serious mental illness. Adults in the public mental health system (N=42) were randomly assigned (1:1) to receive SDC or services as usual and were assessed at baseline and 6- and 12-month follow-ups. Outcomes included perceived competence for mental health self-management, met and unmet needs, degree of autonomy support, self-perceived recovery, and employment. Mixed-effects random regression analysis tested for differences in longitudinal changes in outcomes between the two study conditions. Differences in service costs were analyzed with negative binomial regression models. Compared with individuals in the control condition, SDC participants reported greater improvement in perceived competence, met and unmet needs, autonomy support, recovery from symptom domination, and employment. No differences were found between the two groups in total per-person service costs or costs for individual services. The most frequent nontraditional purchases were for medical, dental, and vision services (33%) and health and wellness supports (33%). Satisfaction with SDC services was high. Mental health SDC services achieved participant outcomes superior to treatment as usual, with equivalent service use and costs and high user satisfaction. This model may be well suited to the needs of uninsured adults with low income who receive public behavioral health care. [ABSTRACT FROM AUTHOR]

With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvements in their health, making many of their ongoing employment and career goals more realistic. However, people with HIV/AIDS continue to have major concerns regarding the impact of working on their benefits and entitlements, including apprehensions about potential economic hardships related to loss of financial supports and health insurance coverage. This article focuses on factors related to employment status, sources of health benefits, and entitlements among people with HIV/AIDS. In addition, results of the study demonstrate differences in employment status, benefit types, and the amount of financial support individuals receive based on gender. [ABSTRACT FROM AUTHOR]

With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvements in physical and mental health, making many of their ongoing career goals more realistic. However, many people with HIV/AIDS who are unemployed but would like to work continue to have major concerns regarding the impact of employment on their benefits and entitlements. In addition to issues regarding potential financial hardships, many people living with HIV/AIDS express uncertainty related to their health status, and they worry that some working conditions could deleteriously affect their health. The present evaluation focuses on two major issues identified in previous research: health perceptions and sources of insurance and health benefits. In addition, the study utilizes a standardized instrument, the MOS-HIV Scale, designed specifically to characterize aspects of health and well-being among people with HIV/AIDS. [ABSTRACT FROM AUTHOR]