What are Self-Directed Services?

Self-direction, also called consumer-direction, is a way for people who need long-term care to receive support and stay in their homes and communities.

If you are in a program supported by Medicaid, you may qualify to be authorized by your state Medicaid agency for a certain amount of care at home. The state works with a Financial Management Services (FMS) provider to pay caregivers and support you in buying approved goods and services. The state also checks if you qualify for other types of support.

Self-direction is about personal choice, control, and flexibility.

How Does Self-Direction Work?

In self-direction, you (or someone you trust to make choices for you) pick and train the people who care for you, plan when they’ll help, and choose how they’ll assist you.

With self-directed services:

  • You stay in your home and community.
  • You pick your caregivers, possibly even friends or family.
  • You manage your care. You are in charge.


How does a Financial Management Services (FMS) Provider Help?

In a self-direction program, you are the employer of your caregiver. But you don’t have to handle everything alone. Federal Medicaid rules make sure you get support while you self-direct your care.

These supports include an FMS provider. An FMS helps you with administrative tasks and paying caregivers. Depending on the program’s rules, an FMS may also help you manage your approved budget.

How an FMS supports you:

  • Signs you up as your caregiver’s employer.
  • Offers training materials.
  • Checks backgrounds of employees.
  • Manages payroll and taxes.
  • Reports things like abuse, neglect, exploitation, and Medicaid fraud.
  • Gives summaries each month about what’s spent.
  • Follows all Medicaid rules.
  • Keeps records for employers and employees.

If you need help to stay in your home and receive Medicaid funding as one of your supports, self-directed services may be an option for you.

Would you like to learn more about Self-Directed Services?

We offer services in the following states. Click on your state to contact us and see what programs are available in your area.