A former Medicaid program in some states that allowed certain Medicaid beneficiaries, frail elders and adults with disabilities to purchase their own personal care and related services. Medicaid provided a monthly allowance, the amount of which is determined after assessing the beneficiary’s need for community-based long-term services and supports. In October 2011, Cash and Counseling was replaced by the Community First Choice Option, a provision of the Affordable Care Act (ACA) that will be available in all states. (See Long-Term Services and Supports chapter.)