Self-Directed Personal Assistant Services 1915 (j)
Self-directed personal assistance services (PAS) are personal care and related services provided under the Medicaid State plan and/or section 1915(c) waivers the State already has in place.
- Participation in self-directed PAS is voluntary
- Participants set their own provider qualifications and train their PAS providers Participants determine how much they pay for a service, support or item
1915(j) State Options
- Target people already getting section 1915(c) waiver services
- Limit the number of people who will self-direct their PAS
- Limit the self-direction option to certain areas of the State, or offer it Statewide
At the States option, people enrolled in 1915(j) can:
- Hire legally liable relatives (such as parents or spouses)
- Manage a cash disbursement
- Purchase goods, supports, services, or supplies that increase their independence or substitute for human help (to the extent they'd otherwise have to pay for human help)
- Use a discretionary amount of their budget to purchase items not otherwise listed in the budget or reserved for permissible purchases
1915(j) Person-Centered and Directed Planning Process
- Service plan is based on an assessment of need for PAS
- Service plan and budget plan are developed using a person-centered and directed process
- Participants can engage in and direct the process
- Participants can choose family, friends, and professionals to be involved as needed/wanted
- Participants' preferences, choices, and abilities, as well as strategies to address these preferences must be identified in the service plan
The plan must include an assessment of contingencies that pose a risk of harm to participants and an "individualized backup plan" to address those contingencies, as well as a "risk management plan" that outlines risks participants are willing to assume.
For more information on Supports Brokers & Consultants, Quality Assurance and Improvement Plan, and Financial Management Services (FMS), refer to the Self Directed Services Page.