Self-Directed Services

What is self-determination?

Self-determination for a person with a developmental disability means being able to have real control over one’s life. It is not a particular program or service. Self-determined people have supports that are tailored uniquely and specifically to that individual.

Some people with developmental disabilities can clearly express their wishes and needs and are able to make choices independently. Many others can become self-determined by having family, friends, and trusted professionals help them choose how they want to spend their time and with whom.

What does self-determination mean in day to day life?

  • Having control over daily activities: paid or volunteer work, continuing education, recreation
  • Choosing support: family, coworkers, friends, support staff
  • Deciding where to live: an apartment with a roommate, a house with friends, alone or with family
  • Being able to set the rhythms of your day: what time to eat, when to go to sleep
  • Having the right (with any needed assistance) to control the budget, to be able to choose desired supports that best meet their needs people with developmental disabilities, and their circles of support (see below).
  • Having the supports to engage with the community.

What are self-directed services (also called participant-directed services)?

Self-Direction is a way of providing services that gives people with developmental disabilities increased choice, and control over their lives.

Self-directed Services has two features:

  • Employer authority enables individuals to hire, manage and dismiss workers.
  • Budget authority provides participants with a flexible budget to purchase the supports and services they need to live in the community.

What does self-direction with budget and employer authority (formerly called CSS) look like in New York State?

Self-direction with employer and budget authority (self-directed services) is the name of OPWDD’s current self-determination option for people with I/DD. It is funded by federal (Centers for Medicare and Medicaid Services, or CMS) and state Medicaid funds, and administered through Office for Persons with Developmental Disabilities (NYS OPWDD). Implementing a self-directed plan requires a broker, a circle of support, and a fiscal intermediary.

The circle of support is the key decision-making group in self-direction: its members support and advise the person getting services. Among other things, Circle members assist with:

  • Identifying the person’s strength and gifts
  • Finding community opportunities
  • Recruiting staff

Who makes up the Circle of Support?

The team is made up of family members, friends, and trusted professionals, and must include the Medicaid Service Coordinator and Broker. Circles vary greatly; some have three people, some have a dozen. 

Who is the broker?

The broker may be an independent contractor, or may work for an agency. OPWDD pays the broker for working with you on your self-direction plan.

What does the start-up broker do?

  • Explains the self-direction process
  • Guides person-centered planning
  • Writes the actual plan, including all of the budget calculations
  • Helps to identify community connections and resources
  • Acts as the intermediary between the team and the self-direction Liaison at the Developmental Disabilities Regional Office (DDRO), and steers the plan through the acceptance process

How do you choose a start-up broker?

Usually, the Self-Direction Liaison will give you a list of brokers in your area and might make recommendations. It is important that you speak to the broker before you hire them, as you will be working closely with them to plan your child’s day to day life.

What is a Fiscal Intermediary (FI)?

The FI is a non-profit agency that you hire, who will:

  • Perform background checks on staff
  • Keep the books and pay staff
  • Monitor and report on the yearly budget
  • Maintain records needed for Medicaid compliance

My child has high support needs; she needs to have someone around all the time. Can she use self-direction?

Yes! Self-direction is not just for people who require minimal support. The amount of funding the person gets depends on the level of need.

How is the budget determined?

Everyone goes through an assessment process.  When choosing self-directed services, that assessment produces a score that reflects the person’s support needs and is used to determine the Personal Resource Allocation (PRA).

My child’s budget was not approved and I don’t think he will have enough support to live a safe, integrated life in the community. What can I do?

First, discuss the issue with your broker; if it cannot be resolved, contact your local DDRO Liaison who may be able to help, The next step is to contact the Statewide Self-Direction Coordinator, OPWDD Division of Person Centered Supports.

To begin the process of choosing self-direction and a self-determined life, visit OPWDD’s Front Door.

More questions? See Self-Direction in New York: A Practical Guide for Families on our website. 
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Self-Determination Coalition