A federal pilot program making it possible for elderly Americans to use Medicaid funds to control their long-term health care at home offers an alternative to more costly institutional care that threatens to put severe financial strain on Medicaid as baby boomers retire.

The Cash and Counseling program allows Medicaid recipients in 15 states to use federal and state assistance to pay for in-home needs as they deem necessary rather than relying solely on home-health care workers through public or private agencies. The flexibility will be even more essential in the coming years when, Stateline.org reported, experts expect the demand for home health services to exceed the supply of trained workers.

Under the pilot program, recipients receive a grant equal to what the state would spend on care provided through a licensed agency. The recipients can use their grant to hire family members or friends to serve as caregivers to help them with their personal needs or housekeeping chores.

The cash can also be spent on other needs that will help the elderly remain in their home such as modifications that will make it eaiser for them to move around in their home.

Counselors assist the elderly in deciding what combination of services is needed to suit their circumstances, making the program more flexible in meeting individual needs.

One of the major advantages of the program is that seniors can stay in their home rather turn to a nursing home or other institutional care at significant savings while also allowing the elderly to maintain their independence.