10 minutes
What self-direction changes Learn what a self-directed option changes about who decides, who employs and who holds the budget, and what stays the same.
What you’ll be able to do Describe the three things a self-directed service option shifts to the person and name two things it does not shift. Compare the responses to this question and explain your choice: What is the most useful reading? Document a next step for What self-direction changes: Find out what share of the people in your area of work use a self-directed option, and what the most common reason is for leaving it. Three shifts, and what stays put A self-directed service option is not a different set of services. It is the same funding, with three things moved toward the person. First, what to buy: within the plan and the rules, the person decides which supports and goods meet their needs. Second, who provides it: the person recruits, hires, trains, schedules and, if necessary, dismisses the people who support them, often with help from a fiscal support entity that handles payroll and tax. Third, how the money is spent: the person manages a budget rather than receiving services chosen by an agency.
What does not move: eligibility, the assessed level of need that sets the budget, the rules about what public money can buy, and the accountability for spending it. Self-direction changes who holds authority inside those constraints. It does not remove them, and a person considering it is entitled to know both halves.
Two arrangements, side by side Agency-directed Self-directed What people say they value
A provider agency employs the workers, schedules them, supervises them and bills for services. The person receives supports chosen from the agency's menu and delivered by the staff the agency assigns. Simpler administratively for the person; less say over who arrives and when.
The person, or a representative they choose, holds the employer role and the budget. They decide what to buy, whom to hire, and how to schedule, with a fiscal entity handling payroll and a support planner helping with the plan. More say; more to manage, and the support to manage it is part of what the option is supposed to provide.
Continuity of staff, the ability to hire someone who already knows them, control over timing, and being treated as the employer rather than the recipient. What they say they struggle with: recruitment, paperwork, and what happens when a worker is sick and there is no agency to send a replacement.
Describe, do not steer What you can change You control whether an option is presented as a choice or as a recommendation dressed as a choice. The words used to introduce it decide most of what happens next.
What to watch for Do not describe an option by its burden alone. Describe what it involves, what it offers, and what support exists, and let the person weigh it.
Your next step Rewrite the two sentences you use to introduce self-direction so they describe rather than advise.
Terms worth keeping straight Self-directed services
An arrangement in which the person decides what supports to purchase, chooses and directs the people who provide them, and manages a budget within program rules.
Representative
A person the participant chooses to help carry or share the employer and budget responsibilities. Chosen by the participant, not appointed for them.
Fiscal support entity
An organization that handles payroll, taxes and payment on the person's behalf so that being an employer does not require becoming an accountant.
Support planner
Someone who helps the person develop and manage the plan and budget. Support with the decision, not a substitute for it.
Carry this forward Self-direction moves three things toward the person: deciding what supports to buy, choosing and directing the people who provide them, and managing a budget within its rules.
It does not remove eligibility requirements, program rules or accountability for public money; it changes who holds the authority inside them.
The paperwork of self-direction can be heavy enough to defeat its purpose, which makes the support to manage it part of the service.
A tabs comparison of agency-directed and self-directed arrangements, a scenario decision and a knowledge check.
Find out what share of the people in your area of work use a self-directed option, and what the most common reason is for leaving it.
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Course overview Next lesson Participation and course completion in this program do not count toward DHS-required training credits unless management, a director, or DHS leadership expressly approves an exception.
