State programs
Participant-directed Medicaid program
A participant-directed Medicaid program lets a person, or a representative, direct their own Medicaid-funded services. The person may hire, train, and supervise workers. This is called employer authority. Some programs also let the person manage a service budget. This is called budget authority. Names vary by state.
Why it matters for your family
Self-direction gives control, and it also brings duties. A person with employer authority may choose a caregiver, including in some programs a relative. CMS notes that a financial management services entity usually handles payroll and taxes. A common mistake is to think the program is cash in hand. The money pays workers and approved items only. States set pay ranges and rules. Ask the state agency which services can be self-directed, who can be hired, and what training the worker needs. Some programs also require a backup plan for missed shifts.
Source: medicaid.gov
Related terms
- Home and community-based services (HCBS) waiverA home and community-based services (HCBS) waiver is a Medicaid program that pays for care at home or in the community instead of in a nursing home.
- Community First ChoiceCommunity First Choice is a Medicaid state plan option that lets states offer attendant services at home or in the community.
- Medicaid personal care servicesMedicaid personal care services are hands-on help with daily activities that Medicaid pays for.
- Texas Community Attendant Services (CAS)Texas Community Attendant Services, or CAS, is a Medicaid-funded personal care program run through the Texas Health and Human Services Commission.
- Care coordinatorA care coordinator is a person who organizes a person's care among doctors, agencies, and family.
- Family caregiverA family caregiver is a relative, partner, friend, or neighbor who gives unpaid help to someone with an illness, disability, or age-related needs.
