Our Services
At Citizens Options Unlimited, every service begins with a simple belief: people should have the opportunity to make real choices, build meaningful connections, and live a life grounded in dignity, belonging, and opportunity.
Guided by a mission that centers people and their goals, we partner with each person—and their families—to design supports that reflect who they are and the life they want to lead. Whether through self-directed services, respite supports, residential options, or the Camp Loyaltown community, our focus remains: creating ways for people to live, grow, and participate fully in their communities with the support they choose and trust.
Self Direction
What is Self-Direction?
Self-Direction is a powerful choice that allows a person to maintain control over their life through a person-centered process for accessing supports and services in New York State. It is funded by federal and state Medicaid funds, and is overseen by the New York State Office for People with Developmental Disabilities (OPWDD).
Each person is unique. Self-Direction empowers people to design supports based on their unique strengths and needs. We firmly believe that Self-Direction gives the people we support and their families greater control over the services they receive, how they receive them and who provides them. Self-Direction allows people to develop a self-directed plan which supports choice as to where to live, daily activities, friends, and relationships, and how to participate in the greater community.
Below are two success stories that are a direct result of Self-Directed Services and what it has to offer:
A young man came to Citizens in 2017 looking to obtain Self-Directed Services to support him in participating in activities that he had been unable to engage in at the time. Once he met with his Circle of Support, we were able to complete his budget and hire the staff he chose, and he began to make those goals a reality. In 2021, with the help of his Self-Direction staff, he graduated with an Associate’s Degree in Computer Science. He has his driving permit and is in the process of taking driving lessons supported through his budget, so he can get his license and work to get a car of his own. He exercises every day and utilizes a personal trainer twice a week to help him work on strength training. He is looking forward to the future and has shared that he would like to work toward moving out on his own.
In 2018, a young man came to Citizens seeking support from Self-Directed Services as well as a Housing Subsidy to be able to get his own apartment. He struggled with anxiety and would at times have to leave stores, restaurants, or other public places because he would begin to have a panic attack. His father was offered a new job that would move them all to Florida. He was very upset as he didn’t want to go and was determined to stay in New York. His parents were concerned about him staying in NY independently, although he had his grandparents and other family members who offered to help. Through Self-Direction and housing, we supported him to obtain Self-Directed Services and to hire his best friend (a family friend) for Community Habilitation. His friend supported him through the process of obtaining his driver’s license and an apartment. His friend also agreed to be his ‘paid neighbor’ to be available to him at any time he felt the need, in an emergency, etc. His family chipped in and bought him his own car. With support, he began to shop for himself, make and follow up on doctor’s appointments, and maintain his apartment as independently as he could, while utilizing the supports that have been set up for him. He met a girl and started to date her and is still with her today. Here we are two years later, he is living his best life and is thrilled to have been given this chance. He helps out his grandparents with work around their house and has taken a few trips with his girlfriend to Florida to visit his parents.
Who is eligible for Self-Directed Services?
Anyone who is eligible for OPWDD services and enrolled in the Home and Community Based Services (HCBS) Waiver can choose to self-direct their services. Self-direction may be right for a person if they can make their own decisions (or have help to) and if they want more flexible supports and services.
How does Self-Direction work?
A person can choose if they want an agency to help them to self-direct (agency-supported self-direction) or if they would like to manage their own budget and staff with help from a Fiscal Intermediary and Support Broker (Self-Direction with Budget and Employer Authority). Self-Direction allows people the opportunity to hire their own support staff. FI and Broker Services are necessary to pursue Self-Direction.
Self-Direction gives a person the chance to make decisions about supports and services that help them to:
- Enjoy meaningful relationships with family and friends
- Experience health and growth
- Live in the home and community they choose
- Work, volunteer or do activities they enjoy
- Enhancing community integration and social capital is at the core of self-direction
How is my SD budget determined?
When a person chooses to Self-Direct, their needs will be assessed using the Developmental Disabilities Profile (DDP-2). It can be done by their Care Manager, Broker, FI or an OPWDD Front Door staff. This assessment is also used to determine their maximum budget amount, also known as the Personal Resource Allocation (PRA). They will work with their Support Broker to develop a complete Self-Direction Budget that includes the supports and services they identified during Person-Centered Planning. Their Broker will also develop Habilitation Plans for any self-directed services that they choose to hire their own staff to work with them on.
What is a Broker?
A Support Broker helps a person exercise as much choice and control over their life as possible. The Support Broker guides someone through initiation of a self-directed budget and provides ongoing support. The Support Broker works with a person who self-directs to: Build their Circle of Support team; Plan a budget for their services; Educate on services and community resources; Provide training and support on hiring and supervising staff; Develop habilitation plans, when needed; and Communicate with the Fiscal Intermediary.
What is a Fiscal Intermediary?
The Fiscal Intermediary or FI is an agency that provides administrative and billing support to a person who chooses self-direction. Fiscal Intermediary (FI) is an HCBS Waiver service that funds the financial management of an individual’s Self-Directed Services budget. A Fiscal Intermediary works with the person to implement the person’s desired activities and to complete the billing and payment of the services identified in the budget template as well as proving fiscal accounting and reporting, Medicaid & Corporate Compliance, and general administrative support. The selection of an FI is required when the person has one or more of the following services included in his/her budget: • Individual Directed Goods and Services (IDGS) • Support Brokerage • Community Transition Services (CTS) • Other Than Personal Services (OTPS)- 100% State funded services, or • Self-Hired Staffing for Community Habilitation, Supported Employment (SEMP) or Respite.
Contact Information
Michele LaSpina, Assistant Director
Fiscal Intermediary, ISS and Self-Directed Services
115 East Bethpage Road, Plainview NY 11803
516-293-1111 ext. 5116 | 516-725-2421 cell
mlaspina@citizens-inc.org
In 2015, Citizens was approved to provide Self-Direction Services, including Fiscal Intermediary (FI) and Broker Services.
Respite
Camp Loyaltown
Camp Loyaltown is located in the Catskill Mountains, 2 and 1/2 hours north of New York City and 3 hours north of Nassau County’s western border. Each year, more than 650 campers enjoy the wonders of the outdoors in a safe and fun environment. We are accredited by the American Campers Association (ACA). Campers and staff live in modernized, rustic-style cabins which house anywhere from 4 to 12 campers and staff members. Each cabin has its own showers and restroom facilities.
Click here to learn more about Camp Loyaltown.
Respite Connections
Opportunities to connect, create, and achieve!
Respite Services
Family Support Services (FSS) provides weekday and weekend services throughout the community in Nassau County.
Respite is designed to foster independence and provide support to families so that they can recharge from the daily care of their loved ones. Depending on each person supported, while at respite staff can assist with basic tasks like dressing, eating, bathroom, and physical assistance.
Types of Respite Services
Our Respite Services offer fun and engaging activities like Arts and Crafts, Cooking, Games, Exercise, Meditation, and Karaoke. If you attend a Nassau AHRC Day Program, transportation will be provided from the Day Program site to the Hourly Respite site in Brookville.
To apply, please contact respite@citizens-inc.org; Maura Boden, Program Coordinator Respite/Recreation, at mboden@citizens-inc.org; or Amanda Spletstoser, Operations Manager of FSS, at aspletstoser@citizens-inc.org:
- Please provide a current Life Plan with proper specifications.
- Please provide a current annual, current immunizations, and results of QuantiFERON or PPD series that has been completed within the last 5 years.
- Please note that if your loved one is currently living in a Residential program, they may not be eligible.
- If your loved one is Self-Directed, please check our broker’s information for rates.
- An interview may also be scheduled upon application review.
Eligibility and Guidelines:
- Applicants must be 18 years or older.
- Your loved one must fall into a 1:4 ratio at minimum.
- We can assist with hygienic changes and toileting if they are able to ambulate and assist with transfers.
- Our services do not provide meals or beverages other than water.
- All meals should be nut-free and prepared as per their Diet Order.
- We ask that you send your loved one with a change of clothes, diapers (if needed), and sunscreen.
- We are unable to assist with medications as we do not have a nurse or AMAP staff present. Parents/guardians are able to provide their loved ones with medications.
- All required up-to-date Documents will need to be submitted prior to start.
For additional information, please contact our Program Coordinator at (516) 293-2016 ext. 5142, or via email at FSS@citizens-inc.org
Our Service Rates are as Follows:
Our Site-Based Hourly Respite is available in Brookville on Saturday and Sunday from 9 a.m. – 4 p.m.
| Day | Units per day |
|---|---|
| Saturday | 28 |
| Sunday | 28 |
Transportation will be provided if the person attends a Nassau AHRC Day program. Day Program will drop off and the person will need to be picked up from the site.
If anyone is interested in other days that accommodate their schedule, please contact us to see what we can do!
What makes the attendee eligible for your program?
Eligibility varies per respite service.
Where is drop-off and pick-up?
Our weekend programs take place in the Cissy Burnbaum gymnasium in Brookville.
Can I pay privately or receive a scholarship?
Depending on the program of choice, eligibility may vary. Please click on your choice of program that is located above.
What documents are needed to start? An application can be completed here. Please send all medical documents and Life plans to Respite@citizens-inc.org.
Will meals, snacks, or beverages be provided?
Please remember to adhere to your Primary Care Physicians Diet Order. Lunches will be stored in the refrigerator and will be heated when necessary. Please remember to label the lunch box. We aim to provide a peanut free environment. Please do not send in any peanut butter products.
Are guardians permitted to enter the campus to administer medication?
Yes, a guardian/family member can enter the campus to provide medication.
Do I have to attend every day?
Each person is taking a spot, we ask that the person attend the days that they apply for.
Can a Community Habilitation worker bring the enrollee to this program?
A community Habilitation Worker or other provider cannot be present while services are being received.
Will there be swimming available?
We currently do not have access to a swimming pool.
Will there be off-site trips?
We are not providing off-site trips at this time.
Residential Respite
Spending time away from a loved one with an intellectual or developmental disability (IDD) is not always easy. Knowing that you can leave your family member with caring and dedicated professionals in a safe and friendly environment can give you peace of mind.
What is Residential Respite?
Our respite program provides respite services in a location that is part of the residential program. It can be provided, during the day, evenings or overnight. Respite is an “indirect” service that provides relief to individuals who are responsible for the primary care and support of an individual with a developmental disability. When a family member, Family Care provider or live-in/house-parent staff person has to deal with such things as illness, emergency, and caregiver or staff vacation, respite services can ensure that their loved one’s needs are met.
Who is Eligible for Residential Respite Services? How Can I Become Eligible?
The person’s Care Coordinator/Manager will complete paperwork and submit it to the DDRO. The DDRO shall authorize units of Respite based upon a needs-based assessment of the individual. Authorized Respite units may be used for any of the following categories of Respite: Site-Based, Recreational, In-Home, and Camp Respite. It is the responsibility of the provider to ensure that the appropriate category of Respite is billed for the Respite service delivered.
What Supports are Offered Through the Residential Respite Services?
- Non-Overnight Respite: Non-overnight Respite services are those an individual receives for a portion of the day but not overnight.
- Overnight Respite: Overnight Respite is defined as Respite services provided to a person on two (2) consecutive days when Respite staff are providing oversight to a person during nighttime hours.
- Intensive Respite: These are services that can be provided to individuals with high behavioral or medical needs in a Respite setting.
For more information contact Maria Carmela Melendez at (516) 293-2016 Ext. 5615
Residential Supports
Citizens has a wide range of residential supports throughout Nassau and Suffolk County. Each person receives individualized supports based on needs identified in a person centered planning process. Staff are trained on each persons level of support, and provides assistance with all activities of daily living and community engagement.
What is an ICF? What supports are offered?
An Intermediate Care Facility (ICF) is a community based home that provides clinical and supportive care to people with ID/DD. People living in an ICF typically require long term care, and have a higher level of need related to medical or behavioral complexities. Clinical supports are provided on-site through an interdisciplinary team process. An ICF is regulated by the NYS Department of Health through an annual auditing process by the Office for People with Developmental Disabilities (OPWDD).
What is an IRA? What is a Supervised IRA? What is a Supportive IRA?
An Individualized Residential Alternative (IRA) is a community based home that provides individualized supports based on needs identified in a person centered planning process. People are supported to be independent at their level of ability, and to live the life that they chose. An interdisciplinary team process helps determine priority needs; although there is oversight by a Registered Nurse and Behaviorist, all clinical needs are addressed through services within the community.
There are typically 6-8 people in a home; however, there may be more in a specialized environment (ex: There are 8-16 people in ICFs for people with medical complexities). We attempt to find a setting that can support the person throughout their life; however, there are circumstances that may require relocation to another home (environmental barriers; need for additional support; better peer groups).
Contact Information:
Deanna Allen: 516-293-2016 ext. 5326
Marta Garavito (Plainview ICF): 516-367-2740 ext. 8346
Mary Gilleran (Shoreham ICF) 631-744-7158 ext. 6200