Self-directed Medicaid services means that participants, or their representatives (if applicable), have decision-making authority over certain services and take direct responsibility to manage their services with the assistance of a system of available supports. The self-directed service delivery model is an alternative to traditionally delivered and managed services, such as an agency delivery model. Self-direction of services allows participants to have the responsibility for managing all aspects of service delivery in a person-centered planning process.
Self-direction promotes personal choice and control over the delivery of waiver and state plan services, including who provides the services and how services are provided. In the state of Arkansas, there are currently two (2) programs offering the self-direction model:
IndpendentChoices (1915i State Plan Services)
ARChoices (1915c HCBS Waiver Services)
Participants on either of these programs choosing the self-direction model are afforded the responsibility to recruit, hire, train and supervise the individuals who furnish their services. The Centers for Medicare & Medicaid Services (CMS) calls this “employer authority.” Participants may also have decision-making authority over how the Medicaid funds in a budget are spend. CMS refers to this as “budget authority.”
Participants using the self-direction model will work with a Financial Management Service (FMS) vendor who has contracted with DHS. The FMS vendor is not a provider and does not have Employer Authority. This FMS vendor assists individuals in exercising their budget authority, such as:
– Understanding billing and documentation responsibilities
– Perform payroll and employer-related duties such as withholding and filing federal, state, local and unemployment taxes; purchasing workers’ compensation or other forms of insurance; collecting and processing worker timesheets; calculating and processing employee benefits; and issuing payroll checks on behalf of the employer/participant
– Purchase approved goods and services
– Track and monitor individual budget expenditures
– Identify expenditures that are over or under the budget
ELECTRONIC VISIT VERIFICATION (EVV)
See our self-direction EVV page for more detail.