Redefining Self-Direction
Self-direction isn’t just a program. It’s a power shift. It puts the individual — not the system — in control of how their care is delivered and who delivers it. It’s about dignity, rights, and the freedom to choose.
At Palco, we’ve been mastering self-direction since day one. We’re not here to replicate what’s been done — we’re here to elevate it. With smart tech and a fearless commitment to doing things better, we’re redefining how self-direction works for the people who rely on it most.
What is Self-Direction?
Self-direction is a model of long-term services and supports (LTSS) that puts people in charge of their own care. Instead of being assigned providers or services through a traditional system, participants have the flexibility to choose:
- Who provides their care (family, friends, or other trusted individuals)
- When and how that care is delivered
- How their care budget is used
It’s care that adapts to real life — not the other way around.
A National Model with Local Names
Self-direction can go by different names depending on your state or program:
- Consumer Direction
- Participant-Directed Services
- Self-Directed Medicaid Waivers
- Cash & Counseling
- CDASS, FMS, SDS — and more
But no matter what it’s called, the core principle stays the same: choice, control, and dignity.
Who is Self-Direction For?
Self-direction serves individuals who need long-term services and supports — including:
- People with physical or developmental disabilities
- Older adults aging in place
- Individuals with chronic health conditions
- Families supporting loved ones with complex needs
It’s not a one-size-fits-all solution — and that’s the point. It puts control back into the hands of the people who live with the outcomes every day.
How Do People Qualify?
Eligibility for self-direction varies by state, but typically includes:
- Medicaid eligibility
- A qualifying need for long-term services and supports (LTSS)
- Enrollment in a state-approved self-direction program or waiver
Some states also require assessments, care plans, or service budgets — and that’s where Palco steps in to make the process seamless.
Who We Serve
Participants / Employers
You deserve more than “services.” You deserve options. Self-direction gives you the power to choose the care that fits your life — not the other way around. We bring clarity, tools, and support so you can hire who you trust, manage your budget, and take control with confidence.
State Partners
Let’s change the game — together. Whether you’re advocating for disability rights, running a community org, or helping individuals navigate the system, self-direction is a powerful tool for equity. Palco brings the infrastructure, tech, and data to back up the movement and scale it with purpose.
MCOs & Payers
Innovation doesn’t happen by chance — it happens by design. Self-direction is growing — and it’s reshaping how LTSS is delivered. For MCOs, it’s a scalable, cost-effective model that prioritizes outcomes and member satisfaction. Palco offers trusted infrastructure, real-time data, and compliance expertise to help you deliver it right.
Workers / Employees
Support to make providing care easy. A Palco participant has hired you, and we’re here to make your onboarding smooth and simple. We’ll walk you through the process so you can concentrate on providing great care.
Ready to Learn More?
We’re bold enough to challenge what’s broken, and experienced enough to build what works. Because self-direction isn’t a service. It’s a right.