Self-Direction for Providers
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Overview

OPWDD is committed to helping people with developmental disabilities have as much control as possible over how they receive their supports and services. Self-directed services offer the greatest amount of control in how, where, and by whom services are provided. A broad range of options are available through self-direction. A person can choose to develop a plan that is customized in a way that best meets their interests and needs.

The self-direction participant accepts responsibility for co-management of their supports and services. The amount of responsibility varies depending on the level of authority the participant chooses to exercise. Authority is a term used by the Centers for Medicaid and Medicare Services (CMS) to describe the control that a person receiving services uses when they choose to self-direct their services. Participants have a range of options for choosing the level of self-direction authority that they wish to have. There are two types of self-direction authority: Employer Authority and Budget Authority. A person may choose to have either one or both types of authority.

Employer Authority

The person hires, schedules and supervises the staff who support them. They determine the activities that will be supported and the way that support will be provided. Services are provided to the person by agency staff under a co-employment model. In a co-employment model, the person can choose to hire staff, train staff regarding their interests, monitor and provide feedback to staff, and end staff services if they are not consistent with the person’s expectations. If a person chooses to self-hire their staff, they gain Budget Authority and determine the compensation of those staff.

Budget Authority

The person who is self-directing with Budget Authority must work within a Personal Resource Account (PRA) and develop a Self-Direction Budget. The person makes choices about the goods and services he/she wishes to receive and selects who is paid to provide them or how they are purchased. A person who maintains Budget Authority and works within a Personal Resource Account may access needed goods or services through Individual Directed Goods and Services (IDGS). A Fiscal Intermediary (FI) works with the person to complete billing and payment for goods and services identified in the budget. A person who chooses to have Budget Authority can receive and budget for services that are agency supported, self-hired, or direct provider purchased.

Recommendations from Applied Self-Direction

Applied Self-Direction focused on themes of program complexity, inconsistency, quality of Support Brokers, scaling, and person-centeredness in the Fiscal Intermediaries function. Below you will find the recorded webinars that were provided to share the recommendations from Applied Self-Direction.

Webinar for Self-Direction Liaisons

Webinar for Support Brokers

Webinar for Fiscal Intermediaries

Learn More

For more information about self-direction, you can contact the Self-Direction Liaisons at your local Developmental Disabilities Regional Office.

Central Broker Authorization

Resources

For forms related to self-direction, please visit the Forms page