CHOICE

SELECTION

PERSONAL PREFERENCES

OPTIONS

Section 1915(c)Section 1915(c) of the Social Security Act (SSA) Signed

August 13, 1981

AAMERICANS MERICANS WITH WITH

DDISABILITIES ISABILITIES AACTCT1990

In 1999, HCFA revised its guidelines concerning provision of personal care services under the

Medicaid State Plan, Section 4480 of the State Medicaid Manual states:

“A state may employ a consumer–directed service delivery model to provide personal care services under the personal care optional benefit to individuals in need of personal assistance, including persons with cognitive impairments, who have the

ability and desire to manage their own care.

In such cases, the Medicaid beneficiary may

hire their own provider, train the provider according to personal

preferences, supervise and direct the provision of

personal care services and, if necessary, fire the provider.

The state Medicaid Agency maintains responsibility for ensuring the provider meets state provider qualifications…and for monitoring service delivery.

Where an individual does not have the ability or desire to manage their own care, the state may either provide personal care services without consumer direction or may permit family members or other individuals to direct the provider on behalf of the individual receiving services.”

Fulfilling America’s Promise to Fulfilling America’s Promise to Americans with DisabilitiesAmericans with Disabilities

The New Freedom InitiativeThe New Freedom Initiative2001

The New Freedom InitiativeThe New Freedom Initiative• Access to Assistive and Universally Designed Technology

• Expand Educational Opportunities

• Promote Homeownership

• Integrating Americans Integrating Americans with Disabilities into the with Disabilities into the

WorkforceWorkforce• Expand Transportation Options

• Promote Full Access Promote Full Access to Community Lifeto Community Life

www.whitehouse.gov/news/releases

The State assures that each individual found eligible for the waiver be given free choice of ALLALL qualified providers of EACHEACH service included in his or her written plan of care.

TEX

AS

LE

GIS

LATU

RE

1997 - 2005

VENDOR

FISCAL

INERMEDIARY

CONSUMECONSUME

R R

MANAGEDMANAGED VOUCHER

VOUCHER

STIPEND

CCONSUMER ONSUMER DDIRECTED IRECTED SERVICESSERVICES

VFIVFI

CDSCDS

From Vendor Fiscal Intermediary (VFI) to Consumer Directed

Services (CDS)

CCONSUMEONSUMER R

DDIRECTED IRECTED

SERVICESSERVICES

INDEPENDENCEINDEPENDENCE

SUPPORT &SUPPORT &ASSISTANCEASSISTANCE

RESOURCESRESOURCES

CCONSUMERONSUMER

DDIRECTEDIRECTED

SSERVICESERVICESC D S