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Day 14: Participant Direction is Growing

November 14, 2011

By Elizabeth Maguire, MSW, Assistant Director, Marketing & Communications, National Resource Center for Participant-Directed Services

Have you heard about the emerging model of home and community-based services for older adults and people with disabilities? This model is called participant direction (sometimes referred to as consumer direction or self direction) and it gives people enrolled in programs control over their services- they decide who will help them with their personal care services.

Under the traditional service delivery system, the person has little control over how, when or by whom services are delivered. For example, if you need help getting out of bed in the morning and your agency caregiver doesn’t get in until 10, you’re stuck – even though you might like to get up at 7. If you like Mexican food but your caregiver only knows how to cook American, you’re also stuck. You might have a family member who knows how to provide you the support you need, but they work and can’t always be there to help.

Participant direction turns that around. Under participant direction, the person getting the services is in charge. Participants receive a monthly budget, based on what the funding source (usually Medicaid) would have paid a home care agency. They develop plans for how they will use that budget to preserve their independence. They may use their budgets to pay family members or friends to assist them and to buy things that will help them live more independently.

Participant direction is growing across the country, and with good reason. People with disabilities want participant direction because it helps them live their lives the way they want to. Currently, there are over 230 programs across the country, serving 747,000 people. Our National Resource Center for Participant-Directed Services works to make sure quality programs are increasingly available across the country.

For people who want to be in charge of the services they are receiving, participant direction is a great option to explore. Programs often go by different names from state to state and it can be confusing to track down a program near you. We created a state map of all programs available across the country to help connect people to services. Take a look at Our Program Map. Click on the state where you or your friend/family member lives and find a list of programs you might be eligible for. Each program listing includes links to local contact information.

If you value this type of choice and control over services, you might also consider joining our National Participant Network (NPN). This group of advocates works to make sure quality programs are available to all who want them. Find out more about the NPN. Want to see how participant direction works for people? You can read and view success stories on our NRCPDS website.