Self-Direction
Issue:
Self-Direction is the practice of empowering people with developmental disabilities to manage the supports and services they receive. Under a Self-Direction model, the person with developmental disabilities chooses the mix of supports and services that work best for them, decides how and when those services are provided, and selects the staff and/or organizations that provide them.
Under the current Self-Direction model, families and individuals navigate upwards of 10 to 15 service types, all governed by differing regulations and guidelines, and requiring different forms and templates. Providers spend a significant amount of time developing, obtaining, reviewing, and correcting required documents, including mileage reimbursements, timesheets, vouchers, vendor and contactor invoices, monthly notes, and expenditure reports. It is unreasonable to expect families to understand this complex system, and its administration is a drain on provider resources.
In addition to the reporting and administration challenges, there is often a disparity in salary between staff hired directly by individuals through Self-Direction and staff hired by provider agencies. This discrepancy exacerbates the difficulty providers have recruiting and retaining skilled employees.
Self-Direction is further complicated by the “joint employer authority” status for self-hired staff. Individuals participating in Self-Direction may hire and manage their own staff. However, provider agencies overseeing the larger Self-Direction program bear the full billing and employment risk with virtually no authority to manage that staff.
Position:
The Arc New York supports the Self-Direction service model, but believes this program will only see long-term success if OPWDD simplifies the system of service documentation and clarifies the employer/employee relationship and pay scale. We advocate for solutions that will make Self-Direction viable for both provider agencies and the families and individuals participating in the program.
