A service model that empowers those with IDD to manage their own services

Self-Direction is an OPWDD (Office for People with Developmental Disabilities) service model that empowers people with developmental disabilities to manage the supports and services they receive, determine who provides the supports, how and where they are provided, and/or which organizations provide them. The Self-Direction participant accepts responsibility for the co-management of their supports and services. The amount of responsibility varies depending on the level of authority the participant chooses to exercise.

Self-Direction Services

While Self-Direction services are determined and directed by the person receiving them, several other people will help the person select services and put together a budget. Effective communication and teamwork are essential to help the person self-directing to successfully customize services in a way that best meets their individual needs.

This team, known as the Circle of Support (COS), includes a person’s Care Manager, Support Broker, Fiscal Intermediary, and other people chosen by the person receiving services. Other people in the COS can be immediate friends, extended family, close friends, support staff, community and/or work connections.

The Care Manager is responsible for connecting people to Self-Direction services if they would like to do so.

View the 10 steps to Self-Direction.

Person-Centered Planning

The Care Manager uses the person-centered planning process to develop and maintain a comprehensive Life Plan for a person. Person-centered planning is the basis for developing the Self-Direction budget. Thus, the Life Plan is the document referenced by the rest of a person’s COS as a guide for the services and supports a person needs to achieve the goals they have determined as important to them. The Care Manager also works with the person self-directing and the rest of the COS to explore and obtain supports and services to help a person reach their goals.

The Support Broker is chosen by the person and provides ongoing support and training regarding decisions and tasks associated with Self-Direction. The Support Broker works closely with a person and their COS to develop a Self-Direction budget that will appropriate funding to services and supports based on what is important to the person and consistent with their Life Plan. The Support Broker meets with the person self-directing and their COS at least twice a year to review the budget and update, as necessary.

The Fiscal Intermediary (FI) serves as the “employer of record” for people with self-hired staff and budget authority by verifying staff employment eligibility, background checks, and training as well as processing time sheets, service records, and payroll.  It is the FI’s responsiblity to track monthly budget expenditures and share them with the person self-directing, their legal guardian, Support Broker, and anyone else they designate. The FI participates in annual or semi-annual Life Plan meetings to discuss issues related to Self-Direction staffing, supports, or budget expenditures as required or requested.

Self-direction services must be compliant with Medicaid and corporate regulations outlined in OPWDD guidance. The FI will ensure compliance and maintain supporting documentation to do so.

 Read OPWDD’s Self-Direction Guidance for Providers

Assessing the Model

OPWDD is evaluating and making changes to the Self-Direction program to better meet the needs of individuals with developmental disabilities. OPWDD has hired a consultant to assess the Self-Direction model starting in 2024.

Based on stakeholder’s feedback, OPWDD recently released some policy clarifications to Self-Direction.

Some highlights include:

  • New technology that allows Self-Direction budget approvals or changes to move forward more quickly.
  • More consistency when reviewing community classes included in the budget and the way Fiscal Intermediaries (FI’s) approve services within the budget.
  • Clarification and updates to current policies about Self-Direction.
  • Fiscal Intermediary agencies will establish a dispute resolution process for participants whose requested reimbursements are denied for service compliance reasons.

View the entire message from OPWDD on Self-Direction