Choosing to self-direct
From the options presented by your care coordinator, you can choose to self-direct your services. If you choose to self-direct, you will need to attend a self-direction information session at your local Developmental Disabilities Regional Office (DDRO) where you will be assigned a self-direction liaison. If you are already Medicaid Waiver-eligible, your care coordinator will submit a request for self-directed services through the Front Door. If you are not Medicaid Waiver-eligible yet, you will need to complete a Waiver application and apply to be enrolled in the Waiver, with help from your care coordinator.
Determine your budget
Your care coordinator will help you determine your maximum budget amount, also known as a PRA (Personal Resource Allocation).
Find a support broker
From the broker list proved by your self-direction liaison, you can interview brokers. Once you hire a broker, you sign a contract with that broker that outlines their duties and how they will support you. What does a broker do?
- Work with you to build a planning team, or circle of support
- Continue to flesh out your person-centered plan.
- Plan a detailed budget for your services
- Educate on community services and resources
- Provide training and support on hiring and supervising staff
- Develop habilitation plans
- Communicate with the Fiscal Intermediary
Find a Fiscal Intermediary
The Fiscal Intermediary (or FI) is an agency that provides administrative and billing support. The Fiscal Intermediary is responsible for:
- Completing background checks for self-hired staff
- Billing Medicaid or New York State for services in the budget
- Paying staff
- Tracking expenditures
- Providing monthly statements to you
Develop your self-direction budget and plan and hire staff
You will work with your support broker to develop a detailed self-direction budget that includes the supports and services you identified during person-centered planning. Your broker will also develop habilitation plans for any self-directed services that you choose to hire your own staff for. You can network with family and friends to find staff or post a help wanted ad in a variety of community venues such as newspapers. When you find staff you like, you can begin the hiring process through the FI.
Submit your budget for approval
Once your budget is complete, your broker will submit it to the self-direction liaison for approval. Once it’s approved, you, your family or designee, your care coordinator, FI, and broker will receive a letter from the liaison that lists an effective date. This date is when your budget begins and falls on the first of a month.
Hold your launch meeting
Once your budget is approved, you’ll have a launch meeting to review your budget, self-directed services and plans. Your FI, support broker, care coordinator, and other team members will all be invited. It’s time to celebrate a new chapter, your self-directed life.