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Self-Directed Care

Self-direction gives you more choice over who gives your services and how you get care.

If you choose to self-direct your services, you employ the person who will give you your services. You are the employer of the caregivers who work for you.

You must be able to do the things that an employer would do, such as:

  • Hire and train your employee.
  • Supervise your employee.
  • Manage your employee’s pay and service notes.

If you can’t do the above, you can choose a family member or friend to act as an employer. This person is called an “Employer Representative." Your Employer Representative must be at least 18 years old. They must also know about your care.

Self-directed personal care excluded services

Costs for the following items and services are not covered:

  • Child care services.
  • Clothing not related to an assessed medical need.
  • Conference, meeting or similar venue expenses other than the costs of approved services you need while attending the conference, meeting or similar venue.
  • Costs associated with shipping items to the member.
  • Experimental and non-FDA-approved medications, therapies, or treatments.
  • Goods or services covered by other Medicaid programs.
  • Home furnishings such as comforters, linens, or drapes.
  • Home repairs or home maintenance.
  • Homeopathic treatments.
  • Insurance premiums or copayments of any kind, including home insurance, vehicle insurance, etc.
  • Items purchased on installment payments.
  • Motorized vehicles.
  • Nutritional supplements such as vitamins or herbal supplements.
  • Personal entertainment items.
  • Repairs and maintenance of motor vehicles.
  • Room and board, including rent or mortgage payments.
  • School tuition.
  • Service animals.
  • Services covered by third parties or services that are the responsibility of a non-Medicaid program.
  • Sheltered workshop services.
  • Social or recreational purchases not related to an assessed need or goal identified in your service plan.
  • Vacation expenses, other than the costs of approved services you need while on vacation.

Who you can hire for self-directed care

You can hire friends, neighbors, acquaintances, or co-workers. Your employee must:

  • Pass a criminal record before working.
  • Pass an adult and child abuse registry before working.
  • Be able to perform the services you hired them to do. 
  • Be able to communicate with the employer.
  • If your employee is providing self-directed personal care services, he/she must be 16 years old or older.
  • Employees younger than 18 years old must have a parent co-sign an agreement.
  • If your employee is providing the independent support broker service or providing self-directed community supports and employment services, your employee must be 18 years old or older.
  • Only employees with a valid driver’s license may transport you.
  • Your employee may not work more than 40 hours per week.

If you are interested in self-directed care, talk with your case manager. If you want to stop self-directed care, call your case manager at 1-855-332-2440 (TTY 1-844-214-2471) 24 hours a day, 7 days a week.