Workforce Challenges & DDS Waiver Services Analysis
•
•
Understanding Self Direction
•
Self-direction is a model of long-term care service delivery that helps people of all ages, with all types of
disabilities, maintain their independence at home.
When a person self-directs, they decide how, when, and from whom their services and supports will be
delivered. People may choose to hire friends, family, or neighbors to provide services.
Although federal Medicaid law allows family members to provide these supports through self-direction, prior
to the pandemic, more than half of self-directed HCBS programs restricted this. 15 states began allowing
family members to be hired during the pandemic. See next slide for more information.
This is different than the traditional model, in which a person receives services from a provider agency. The
agency selects the staff who will provide the supports and trains them. In self-direction, the person hires and
trains their staff, as well as setting their schedule.
Self-direction is based on the principle that people with disabilities know their needs best and are in the best
position to plan and manage their own services.
More than 1 million people in the United States self-direct their long-term services and supports. In North
Dakota, people currently have an opportunity to self-direct services through the ID/DD waiver, the Medically
Fragile waiver, and Veteran's Directed Care.
81
ALVAREZ & MARSAL
LEADERSHIP ACTION. RESULTS.View entire presentation