What Is Self-Directed Care?

Self-directed care is a model of home and community-based services (HCBS) that gives people with disabilities and older adults more control over the services they receive. Instead of an agency deciding who provides your care and when, you become the employer of record — choosing, hiring, training, and managing your own personal assistants.

These programs are funded through Medicaid waivers or state plan amendments and are available in nearly every state, though they go by different names: Consumer Directed Personal Assistance Program (CDPAP) in New York, Community First Choice (CFC) in several states, or Self-Directed Services (SDS) in others.

To qualify, you generally need to meet two main criteria: financial eligibility for Medicaid (which varies by state) and a functional need for assistance with activities of daily living (ADLs) like bathing, dressing, eating, or mobility.

One of the biggest advantages of self-directed care is the ability to hire family members as paid caregivers. Many states allow parents, adult children, siblings, and even spouses to serve as your personal assistant and receive compensation through the program.

The typical process involves: applying for Medicaid if you're not already enrolled, getting assessed for functional needs, enrolling in a self-directed program, receiving a budget allocation, and then hiring your own assistants within that budget.

FindMYPA helps you navigate this process by matching you with the right programs in your state, connecting you with qualified personal assistants, and providing step-by-step application assistance.