Frequently Asked Questions About Self-Direction for Families

Families exploring self-direction often face many questions about how it works and what to expect. Self-direction offers individuals and their families more control over the services and supports they receive. This approach can be empowering but also complex. Here, we answer the top 10 questions families ask about self-direction with clear, practical information to help you understand this option better.

Family discussing self-direction options at home

What is self-direction and how does it work?

Self-direction lets individuals or their families manage their own care services instead of relying solely on agencies. This means you can choose who provides support, when, and how. You receive a budget based on your needs and use it to hire workers, buy services, or purchase equipment. This approach gives you more flexibility and control over daily life.

Who can use self-direction?

Self-direction is available for people with disabilities, seniors, or others who qualify for home and community-based services through Medicaid or other programs. Eligibility depends on your state or local rules. Families often find it helpful for children or adults who need ongoing support but want more personalized care.

How do families create a plan under self-direction?

You work with a support planner or case manager to develop a person-centered plan. This plan outlines your goals, the types of support needed, and how the budget will be spent. The plan must meet program requirements but reflects your preferences and lifestyle. Families often include details about daily routines, community activities, and health needs.

What responsibilities do families have in self-direction?

Families often take on roles like employer, scheduler, and budget manager. This means hiring and training workers, keeping track of hours, and managing funds. Some programs offer help through fiscal intermediaries who handle payroll and taxes. Being organized and comfortable with these tasks is important for success.

Can families hire anyone they trust as a caregiver?

In many cases, yes. You can hire friends, neighbors, or family members if they meet program requirements. This flexibility helps build a trusted support team. However, some restrictions may apply, such as excluding spouses or legal guardians. Always check your program’s rules before hiring.

How is the budget determined and managed?

The budget is based on an assessment of your needs and the cost of services in your area. It covers wages, training, equipment, and other approved expenses. Families must keep records and submit reports to show how funds are used. Some programs provide online tools to simplify tracking and reporting.

What happens if the budget runs out before the year ends?

If you spend the budget too quickly, you may need to reduce services or find other funding sources. Careful planning and regular budget reviews help avoid this. Some programs allow adjustments if needs change, but it requires approval. Families should communicate regularly with their support team to stay on track.

How do families find and train workers?

Finding reliable workers can be challenging. Families often use local job boards, community groups, or referrals. Training covers specific care needs, safety, and communication. Some programs offer training resources or require workers to complete certain courses. Clear communication about expectations helps build a strong support team.

What support is available for families managing self-direction?

Many programs provide coaching, peer support groups, and help lines. Fiscal intermediaries or support brokers can assist with paperwork and employer responsibilities. Connecting with other families who self-direct can offer valuable advice and encouragement. Don’t hesitate to ask for help when needed.