Self Direction monies can be spent with our school!

What are Self Directed Services?…

Self-directed Medicaid services means that participants, or their representatives if applicable, have decision-making authority over certain services and take direct responsibility to manage their services with the assistance of a system of available supports. The self-directed service delivery model is an alternative to traditionally delivered and managed services, such as an agency delivery model. Self-direction of services allows participants to have the responsibility for managing all aspects of service delivery in a person-centered planning process.

Self-direction promotes personal choice and control over the delivery of waiver and state plan services, including who provides the services and how services are provided. For example, participants are afforded the decision-making authority to recruit, hire, train and supervise the individuals who furnish their services. CMS calls this “employer authority.” Participants may also have decision-making authority over how the Medicaid funds in a budget are spent. CMS refers to this as “budget authority.”

History of the Self-Direction Option
Beginning in the 1990s, many states began to offer “consumer-directed” personal care services pursuant to section 1905(a)(24) of the Act, the optional state plan personal care services benefit. During the mid-1990s, the Robert Wood Johnson Foundation awarded grants to develop “Self-Determination” programs in 19 States, with self-direction of Medicaid services being a crucial aspect of self-determination. These projects primarily evolved into Medicaid-funded programs under section 1915(c) of the Act, the home and community-based services waiver program.

In the late 1990s, the Robert Wood Johnson Foundation again awarded grants to develop the “Cash and Counseling” (C&C) national demonstration and evaluation project in three states. These projects evolved into demonstration programs under the section 1115 authority of the Act. The Deficit Reduction Act (DRA) in 2005 authorized two more avenues for states to offer the self-direction option, i.e., section 1915(i)and section 1915(j) of the Act. In 2010, the Affordable Care Act, passed by Congress and signed by the President on March 23, 2010, authorized section 1915(k) of the Act to offer self-directed services.