Family-Directed / Self-Directed Services 

Our goal is to support people so they can reach their desired personal life outcomes.  Getting necessary and appreciated supports and services puts dreams within reach for people living with intellectual /developmental disabilities or acquired brain disorders. Community Bridges’ Family-directed / Self-directed services helps people with an intellectual/developmental disability or acquired brain disorder and their family to take a lead role in managing the services and supports they receive.

A Family-directed / Self-directed service approach means that you and your family have optimum control over program management, including designing service plans and choosing who provides services. You also have some level of control over the use of funds for certain services (within the parameters of Medicaid-covered services and guidelines within state regulations). This differs from an agency-managed approach in which a contracted provider agency executes program management, including staff recruitment, hiring and oversight, and management of approved service funds.

Services are intended to promote personal growth, responsibility, health, and safety so participants experience independence, are meaningfully included in the community, are employed, and enjoy a fulfilling home life. Support staff can be directed to provide a wide variety of assistance—all under your direction and supervision.

 

The two types of Family-Directed / Self-Directed Services 

In-Home Supports – He-M 524:
Home and Community-Based Services for In-Home Supports (HCBS-IHS) offers a variety of services for people aged 3 through 21 with a developmental disability and significant medical or behavioral challenges. Supports are intended to help a child live at home with their family and participate in community experiences. Services are geared toward developing basic personal and functional living skills, improving physical functioning, communication, and relational skills, and addressing challenging behaviors.

Specific child and family factors and eligibility criteria help identify whether a particular situation rises to the level of need to request In-Home Support.  There are funding limitations at the state level for new In-Home Support service development. We encourage you to speak with your Service coordinator to arrange an overview of In-Home Support if you would like to learn more.

Participant Directed and Managed Services (PDMS) – He-M 525:
This service structure is for people over the age of 21. The scope can include a wide variety and combination of services allowed under the HCBS-DD or HCBS-ABD Medicaid Waivers.  To be covered through a PDMS budget, the support needs to be related and due to disability and not a generic need or cost that anyone may experience. Service type can include, but is not limited to:

  • Developing increased personal competencies and skills in personal decision-making, daily living skills, accessing community resources, personal, household, and community safety, and maintaining health, well-being, and nutrition.
  • Researching and participating in meaningful community activities, events, organizations, and clubs per personal interest
  • Career development and employment supports
  • Personal Care
  • Environmental or vehicle modifications, assistive technology
  • Therapies – PT, OT, Speech – beyond what regular Medicaid can pay for, or specialized therapies such as Hippo therapy or craniosacral therapy
  • Respite services for those living with their families

 

MITC

He-M 500 Administrative Rules

 

What makes Family-Directed / Self-Directed Services Different?

Customized Budgets & Plans
Participants have the option to create an individualized “budget plan” that meets their personal goals and needs from a wide range of services and activities. This means that you have the control to create a customized plan within the parameters defined by He-M 525. You can adjust the focus, services, who provides supports, and where they take place.

Flexibility in Utilization of Approved Funding
Participants and Family Managers receive monthly reports showing how service funding has been utilized based on documentation the family and family-chosen staff submit. Families can choose to direct available funds toward types of support that are needed at a given time, within some parameters. This promotes the ability to control and maximize funding use.

Recruiting, Hiring, and Supervising Support Staff  
When individuals and their families need to hire support staff, Community Bridges aids in recruiting, interviewing, setting expectations, and training. The Family Manager is responsible for providing supervision, approving hours worked, mileage, and monthly progress notes of staff. The family approves invoices from contracted providers and for approved services, activities, and therapies as well. Community Bridges gladly provides this support and guidance, making your outcomes more successful.

We believe that people deserve to have choice and control over their Home and Community-Based Medicaid Waiver funds made available for use. Participant Directed and Managed Services assists you through workshops and individual guidance to maximize your own success.  “Participant Directed and Managed Services” means just that! It provides the highest level of individual and family direction and decision-making with regard to formal service, as well as flexibility in the utilization of funding.

While the benefits of this service structure may increase the responsibility that a family has, we believe many families are up to the task, which is why we’re here to support them!

 

Primary Contacts - Family-Directed / Self-Directed Services
Laura Spinney, Director of Self-Directed Services  

lspinney@cbinnh.org
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