In the past 20 years, individuals with physical and intellectual and developmental disabilities and their families have been encouraged to take control of their lives through a range of goal-setting, choices and decision-making opportunities under the philosophies of self-determination and self-direction. The philosophy of self-direction (also referred to as consumer direction and participant direction) is based on the premise that individuals with disabilities or chronic conditions, and their surrogates, when appropriate, know best about their needs and how to address them and should be empowered to make decisions about the services they receive and the individuals who provide them. Palco is proud to have pioneered self-direction, which has provided assistance to so many in Arkansas and across the country.
Self-direction helps people—of all ages with different disabilities—live independent lives in their own homes. They choose the services and supports that they need most and receive them at home.
People know their own needs better than anyone, so they can best decide how they would like to receive services. For decades, people all over the country have thrived with self-direction. Self-direction has other names: participant direction and consumer direction.
The two hallmarks of true self-direction are employer authority and budget authority, as described below.
- Individuals choose their own workers
- People have the right to hire, fire, schedule, and supervise their workers
- Services are not arranged by an agency
- Individuals manage a specific allowance
- Allowance can be used to employ workers or purchase goods (transportation, rehabilitation, assistive technology, ramps, and more)
Benefits of Self-Direction
Self-direction provides many benefits to individuals, their families, and communities, as well as to state agencies.
- People with disabilities and those who are elderly overwhelmingly prefer home and community-based services to living in a nursing home or other institution.
- Empowering people through self-direction is cost-effective, much lower than alternatives, such as agency and nursing home care. For example, in Arkansas, self-direction costs just 58% of agency care and anywhere from 20%-34% of nursing home care.
- Research shows that people who direct their own services report higher instances of having their needs met, higher satisfaction, and higher quality of services.
- Participant-direction can support people to work and volunteer, leading to additional benefits for the individual and the community.
- Participant-direction can minimize caregiver burnout, decreasing the risk of nursing home admission down the road.
- Participant-direction creates new opportunities within local communities to employ people who may otherwise not be employed.
- When people have the opportunity to direct their own budget, they can use that money to purchase goods and services within the local community.
- Participant-direction can help ease financial burdens individuals face as caregivers. Families experience less caregiver burnout with self-direction, as the program may offer respite from primary care responsibilities. Reduced burnout translates to less health-related issues amongst family caregivers.
- Financial management procedures for participant-directed services can monitor and address potential fraud, which is rare in self-directed programs.
- Quality management systems for participant-directed services are well established.