From the Editor
My son, Nick, has been self-directing his services for about six years. He is growing in confidence, developing new skills, engaged with the community, and happy. Nick has a great relationship with his staff and calls her “an amazing woman.”

Many parents have asked me what Self-Direction is all about. This issue may answer many of your questions.

Is your loved one already self-directing their services? Read on for ideas on ways to expand their experiences.

Best to you and yours,
Maria Schaertel
Having a say in your life - from OPWDD
Self-Direction gives you the opportunity to choose your own services, so you can live the life you want. When you self-direct your services, you have increased flexibility to choose the right supports for you, the staff you want to work with, a schedule that works best for you, agencies of your choice, and budget authority. This gives you more control over how you want to structure your life.

Things you can self-direct:
  • where you live
  • how you spend your days
  • what to do in your spare time
  • how to stay healthy and active
  • your relationships with family and friends
  • who to hire to assist you

A Care Manager (CM) can help you learn more about Self-Direction and guide you through the steps you need to take.

Self-Direction, step-by-step
Person-centered planning: Your CM will have conversations with your loved one about what they want to achieve in life. Your CM will then discuss service options available to help your loved one meet their life goals and develop a Life Plan (LP). This process is called Person-Centered Planning and is at the heart of Self-Direction.

Understand Self-Direction: From the options presented by your CM, your child can choose to self-direct their services. If they choose to self-direct, they will need to attend a Self-Direction Information Session at your local Developmental Disabilities Regional Office (DDRO). The DDROs are the regional offices of NYS's Office for Persons with Developmental Disabilities (OPWDD). If your child is already Medicaid Waiver eligible, your CM will submit a request for self-directed services through the Front Door. If your child is not Medicaid Waiver-eligible yet, they will need to complete a Waiver application and apply to be enrolled in the Waiver, with help from your CM.

Determine your budget amount: Your loved one’s needs will be assessed with the OPWDD Approved Needs Assessment Tool. It can be done by your CM or an OPWDD Front Door staff. This assessment is also used to determine the maximum budget amount, also known as the Personal Resource Account (PRA).

Hire a support broker and fiscal intermediary: If your child wants to manage their budget with budget authority, your DDRO Self-Direction Liaison will give your child a list of support brokers. Your child can interview brokers from this list. Once you hire a broker, your child signs a contract with that broker that outlines their duties and how they will support your child. Your child and the broker will request a Start-up Budget through OPWDD. When your child’s start-up is approved, the liaison will send you an approval letter. You can now start developing a complete Self-Direction budget. You should also interview and select a Fiscal Intermediary (FI) from a provided list and ask people who support your loved one to make decisions to be part of their circle of support.

Develop your budget and plans: Your loved one will work with their support broker to develop a complete Self-Direction budget that includes the supports and services your loved one identified during person-centered planning. The broker will also develop staff action plans for any self-directed habilitation services that your child chooses to hire their own staff for. During this time, your child should start looking for potential staff. When your child finds staff they like, you can begin the hiring process through the FI.

Submit your budget for approval: Once your child’s budget is complete, your broker will submit it to the Self-Direction Liaison for approval. Once it’s approved, your child, their family or designee, the CM, FI, and broker will receive a letter from the liaison that lists an effective date. This date is when your child’s budget begins and falls on the first of a month.

Hold your launch meeting: Once your loved one's budget is approved, you’ll have a launch meeting to review your budget, self-directed services and plans. Your FI, broker, CM, and other team members will all be invited. CELEBRATE!

Self-Direction is flexible and embraces diverse needs

You can change things in your plan when you want something different; talk to your broker about your child’s needs. And you can always switch back to a more traditional model of supports if Self-Direction doesn't suit your loved one.

Since Self-Direction focuses on the specific needs and wants of your individual child, families can use their budgets on things that are important to you and your culture: you can celebrate customs, attend a cultural heritage festival, explore diverse artists, and even hire someone who speaks your child’s language.

Families' perspectives on Self-Direction
Parent Cloria Sutton-Dowdell describes her family’s experience with Self-Direction.

“Once I got situated and understood the budget, it was an easy transition to self-direct services. Our FI specialist from Starbridge guided us a lot. 

Jordan participates in a lot of gymnastics! He absolutely loves it! My FI recommended a gymnastics studio to me, and it was right around the corner. He also has memberships at the Aquarium of Niagara, the Strong museum, the zoo, and he goes to a YMCA camp during the summer, which his budget pays for!  

I would highly recommend Self-Direction! It has been a phenomenal asset to our family, and we’re thankful that Jordan now has access to a wide range of activities.”
Parent Mandy Kresge shares her family’s experience with Self-Direction.

“Getting Annabelle set up for Self-Direction was not difficult, but it was a bit confusing as to who I would contact and in what order. For that reason, I just included my broker, FI, and care manager in every email. The appropriate person would “respond all,” and things moved forward. 

Annabelle is very active. She is taking social skills class at SAGE Rochester. She participates in dance, Jr Titan’s cheerleading, has a season pass at Wickham Farms, takes music therapy, art therapy, and plays Challenger baseball. 

All these things are not only covered under Self-Direction, but I also get mileage reimbursement for them. Annabelle also has memberships to Seneca Park Zoo, Rochester Museum and Science Center, and Strong Museum of Play. 

We utilize the self-pay respite for date nights which is so wonderful. It gives us a chance to continue working on our marriage while being the best parents we can be.”
Grandparent Cheryl Barcomb shares her adult grandson’s experience with Self-Direction.

“During the four years that Zach has been self-directing his services, I have seen him grow emotionally, socially, and in independence.

Zach has his own apartment that Self-Direction helps pay for. He cooks for himself and his community habilitation staff, maintains his apartment, does his laundry, and takes care of his two cats.

Zach goes to a game store weekly and plays cards with his staff. Recently, his staff couldn’t be there, so Zach went on his own! That is a big step for Zach because previously, he wouldn’t go anywhere alone.

He has been taking voice and acting classes for almost a year, and I can see his self-confidence and excitement growing with this activity. He also started taking a group voice class, and it is going very well being with others. We are grateful that Self-Direction pays for these classes.

Zach has memberships to the zoo, museum, and the Y through Self-Direction, and this has been very helpful in getting him out into the community.

I am so proud of Zach and thankful for his Self-Direction team at Starbridge.” 
Starbridge Self-Direction videos
Our FI and Family Advocacy teams have encountered a lot of questions from individuals and families about Self-Direction.

We created a series of five short videos to help answer some of the most common questions – what Self-Direction is, how to hire staff and launch your budget, and ways to pay for things that may seem out of reach. Special thanks to April Dixon, Fiscal Intermediary Specialist, for being our on-air talent and to the three individuals and families for sharing their experiences!

Mind the Gap program at Starbridge
Could you or someone you know use some help bridging the gap between getting a diagnosis for your child and receiving services? Learn more about Mind the Gap by calling the Starbridge Intake number at (585) 224-7359 or use the Contact form on the Starbridge website.
Additional Resources

In the Driver’s Seat – Find staff, support brokers, fiscal intermediaries, resources, and more.