Participant Self Direction

Self-Direction of Home- and Community-Based Services: A Training Curriculum for Case Managers

The ability to direct and manage their own services and supports is important to many individuals who need the home- and community-based services (HCBS) provided through state Medicaid programs. These self-directed models may also be known as "consumer direction" and "participant direction" when referring to specific states' programs. In these models, individuals direct many or all of their own HCBS, including selecting and managing direct service workers and/or managing a budget (known in some states as a service cost maximum) for needed services.

Participant Direction in Integrated Care Programs


Examines participant direction and findings from a study of contract language by the National Resource Center for Participant-Directed Services; also describes how Massachusetts' Commonwealth Care Alliance supports members who wish to self-direct services.

Tips for States to Advance Person-Centered Planning in Self-Direction Models

This tip sheet offers suggestions for states operating managed long-term services and supports programs or other managed integrated care programs to: (1) understand the person-centered planning process; (2) establish robust contract requirements and policy guidance that support person-centered self-direction models; and (3) assess managed care plans’ person-centered planning practices in self-directed models.

Frequently Asked Questions about Self-Direction

This document answers common questions about self-direction including: (1) what is self-direction and why is it an important option for individuals receiving HCBS; (2) what are the components of self-direction. The document also defines self-direction terminology. It is intended to be used by case managers and other involved in self direction implementation.