Self-Direction is 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.
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 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 persons 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
Roberta Romano, Assistant Director
Fiscal Intermediary, ISS and Self-Directed Services
115 East Bethpage Road, Plainview NY 11803
516-293-1111 ext. 5113 | 516-382-8634- cell
In 2015, Citizens was approved to provide Self-Direction Services, including Fiscal Intermediary (FI) and Broker Services. Self-Direction allows people to develop a self-directed plan which supports choice as to where to live, day activities, friends and relationships, and how to participate in the greater community. Self-Direction allows people the opportunity to hire their own support staff. FI and Broker Services are necessary to pursue Self-Direction.