Self Determination in Long Term Care

Self-determination is a set of concepts and values that people with disabilities should have the freedom and support to decide how they live and participate in the community.

Self Determination Principles

Freedom The opportunity for the individual to plan a life with necessary supports

Authority The ability of individuals to control budgeted funds for purchasing supports

Support The arranging of resources and personnel – both formal and informal- that will assist and individual to achieve meaningful community participation

Responsibility Acceptance of valued community role and accountability for public dollars

Individual Plan of Services & Supports

Participants, with their allies, develop an individual plan of services and supports through the person-centered planning process

A participant’s allies are chosen by the participants and may include: family members, friends,paid staff,other professionals, and community members, etc

Individual Budget

An individual budget is the cost of implementing a person’s individual plan of services & supports

The individual budget is authorized by the Waiver Agent to provide a defined amount of money to implement the plan

Fiscal Intermediary

A Fiscal Intermediary is an independent legal entity that acts as a fiscal agent of the Waiver Agent for the purpose of assuring financial accountability for the funds in a participant’s individual budget

The Fiscal Intermediary performs essential tasks that support self-determined arrangements for participants

Fiscal Intermediary Functions

Functions as the employer agent for participants directly employing workers

Ensures public funds are properly managed and provider requirements for workers are met

Fiscal Intermediary Functions

Offers supportive services to enable participants to self-determine and direct the services and supports they need

Provide monthly budget status reports to participant and Waiver Agent and monitor the use of the budget

Cash & Counseling

Robert Wood Johnson Foundation sponsors three states to implement consumer-directed personal care services– Arkansas– Florida– New Jersey

Cash & Counseling Outcomes

Cost neutralityIncrease in servicesImproved quality of lifeReduced stress on caregivers

Cash & Counseling in Michigan

Part of 11 states to receive funding from RJWF to implement project

In the second year of a three-year grantSupported by the Boston College Graduate

School of Social Work as the National Program Office

Self Determination in Long Term Care

Michigan’s Cash and Counseling 4 Pioneer Sites are initiating project

– Detroit Area of Aging– Burnham Brook– Tri-County Office on Aging– UPCAP Services

Systems Changes to implement

Amend the current MI Choice WaiverReduce the assessmentProvide training and support to Pioneer

Sites

Project Goals

MI Choice Waiver participants will be able to choose self-determination as a method for receiving supports and services on a state-wide basis

For More Information

Tari Muñiz, Project Coordinator

517.335.5671

munizt@michigan.gov

www.cashandcounseling.org