The Personal Resource Account (PRA) is the maximum amount of funding allocated to budget your child's supports and services. It is reviewed annually and determined through your child's Developmental Disabilities Profile (DDP-2) scores. The DDP-2 assesses your child's needs in the following areas: medical, sensory/motor, cognitive/communication, behavior, self-care/daily living skills, and clinical services.

The FI is a non-profit agency that serves as the “employer of record” for Self-Direction plans with Budget Authority. The FI is responsible for: • performing background checks on staff • collecting service-related documentation • paying for or reimbursing budget-approved goods and services • providing payroll/benefit services • monitoring and reporting on the yearly budget

Self-direction is a service model designed for individuals with developmental disabilities. This model empowers people to have greater control over the delivery of Waiver and State plan services. It allows individuals to create a customized plan that best meets their needs and interests, providing them with more personal choice and control.

Yes, Yes and Yes! You can utilize the following services with the help of your care manager: • Assistive Technology: Devices that allow a person to live safely in the community. (for example, augmentative communication devices and vehicle modifications) • Environmental modifications: Physical adaptations to the home that increase or maintain an individual’s ability to live independently at home. • Personal Care Assistance: Personal care can be accessed through Consumer Directed Personal Assistance Services (formerly CDPAP).

The Circle of Support (COS) is a group of people you choose to help create and support your child by identifying goals, needs, and supports. The COS is required to meet at least two times per year. A Circle of Support must include: • The person self-directing services (and/or their advocate) • Broker • Care manager Other members may include: • family members, friends • teachers, paraprofessionals, guidance counselors • staff supporting the self-directing person • anyone the self-directing person trusts to provide guidance and support.

Sorry, No! Medicaid believes that academic tutoring is a service that should be pursued through the DOE, school district, or college setting. NOTE: Some FIs are very strict that academic tutoring/homework is not an appropriate task for your staff.

The Broker is a professional that is responsible for: • Providing support to a person who chooses to take on Budget Authority. • Educating the person and their family on Self-Directed service options • Assisting with developing and maintaining a Self-Direction budget • Writing the Staff Action Plans • Assisting the person with creating their Circle of Support • Facilitating Circle of Support Meetings • Other support tasks Brokers can be independent contractors or may work for an agency. Note: There are two types of brokers. A START-UP BROKER assists a Self-Direction participant in developing his/her initial Self-Direction Budget, with reimbursement capped at $2,631. A SUPPORT BROKER assists a Self-Direction participant in managing their already approved budget.

Person-centered planning is the cornerstone of SD services. It is a process that focuses on the individual's unique needs and preferences, and is used to: 1. To assist the person in gaining control over their own life 2. To increase opportunities for participation in the community 3. To recognize individual desires, interests, and dreams 4. Through a team effort, develop a plan to turn dreams into reality 5. To look at an individual in a different way

People who are self-directing their services with Budget Authority may choose to use up to a max of $3,000 from their budget for additional goods and services that are not Medicaid-fundable. OTPS must meet the following criteria: • Relate to a valued outcome in the person’s plan • Increase independence and/or the ability to live safely at home • Other resources must first be explored and exhausted (including community-based and Medicaid-funded resources) • Cannot be on the OTPS Excluded Items List OTPS Categories: • Phone service (cell and/or land line) • Internet • Software related to the person’s disability • Staff activity fees • Cost associated with staff time for planning or training meetings • Personal transportation • Clothing ($250 annual cap) • Board stipend (food) • Utilities • Other goods and services that increase independence • Other goods and services related to health/safety OTPS Excluded List: • Expenses related to hospitalization or nursing home stays • Medical visit co-pays • Expenses related to or that support the purchase of Medicaid services (e.g., therapies) • Any illegal item or activity • Cable television • Common household supplies • Experimental therapies • Repairs (as they should be covered under the lease or by the homeowner) • The self-directing person’s activity fees • Rental cars • Housing costs that exceed the housing subsidy

IDGS are services, equipment, or supplies not otherwise provided through OPWDD’s HCBS waiver or the Medicaid State Plan. A person can manage their IDGS to fully purchase or contribute towards the purchase of items or services that meet the following criteria: • Are related to a need or goal identified in the person-centered care plan/Individualized Service Plan. • Are for the purpose of increasing independence or substituting for human assistance and/or promote opportunities for community living and inclusion. • Can be accommodated without compromising the participant’s health or safety • Are provided to or directed toward the benefit of the participant Examples of IDGS items: • Community classes & and publicly available training/coaching • Health club, organizational memberships • Household-related items and services • Transportation • Camp • Aquatic, art, massage, music, play therapy

Yes, you can change it! The self-direction budget is fluid, meaning you can change anything at any time for(almost)any reason. We can make changes by doing either a Cross Neutral Budget Amendment (CNBA) or what’s called a Full Budget Amendment.

Nope! The budget is automatically renewed each budget year. Your budget year is the anniversary date of the day your initial budget is approved. Example: If your budget is approved on July 1st, 2023, it will reset every year on July 1st, as long as you are still in self-direction. This means that if you have $48,000 approved in your budget on July 1st, 2024, your budget will reset to $48,000 on July 1st, 2024, regardless of how much money you have used from the budget. The only thing that changes the budget amount (PRA) is a change in the DDP2 scores.

Service transportation is for transportation that is directly related to valued outcomes, safeguards, and services identified in the Life Plan. Mileage, Taxi, ***tolls, and MTA are reimbursable. NOTE: Transportation costs are not reimbursed through the Self-Direction Budget for transportation to and from OPWDD-funded services for which transportation costs are included in the price developed and paid for the service. Also, Mileage is not reimbursed for medical appointments. *** Depends on the FI.

Respite that is in addition to, or instead of, Respite that is Direct Provider Purchased, Agency Supported, and Self-Hired. Basically, you can pay whoever you wish (except for a family member living in the same house) to be with your child, and you can get reimbursed. Because the respite worker is not an employee of the FI, they don’t need to complete an application, be fingerprinted., etc. Important things to know: • Designed to be used as needed by a parent/caregiver of someone who is self-directing. •FRR is capped at $3,000 annually.

These are people who provide personalized skills, training, and assistance to individuals within their homes and communities. They aim to improve the person's independence in areas such as personal care, social skills development, financial management, safety, household chores, community involvement, job performance, and more.

There are specific restrictions regarding self-hired staff who are related to a self-direction participant. Except where expressly prohibited (e.g., relatives cannot be hired to deliver Live-In Caregiver or Paid Neighbor services), relatives may be paid as service providers as long as all of the five following criteria are met: 1. They are at least 18 years of age. 2. They are not the parents, legal guardians, spouses, or adult children (including sons and daughters-in-law) of the participant. 3. The service is a function not ordinarily performed by a family member. 4. The service is necessary and authorized and would otherwise be provided by another qualified provider of waiver services. 5. The relative does not reside in the same residence as the participant.

SEMP staff provides job-skills training, resume development, interview preparation, application assistance, intensive job coaching, and follow-up support to individuals seeking competitive employment.

Respite provides temporary relief to caregivers who provide primary care and support for someone with a developmental disability.

Speech, Physical Therapy, and Occupational Therapy are not therapies that can be put in a Self-Direction plan or budget for school-aged children. These types of therapies can be accessed through the school district, your regular Medicaid State Plan Benefits card or other primary insurance carriers. Your Care Manager can help you access these services. There are only a handful of specialized direct therapies that can be built into a Self-Direction Budget. Approved therapies are: • Hippo Therapy • Therapeutic Riding • Aquatic Therapy • Art Therapy• Massage Therapy • Play Therapy NOTE: To be approved, a prescription must be written and signed by your child's medical doctor. The prescription must state the diagnosis and the goal of the treatment. You must submit a copy of the clinical license from the NYSED Office of the Professions http://www.op.nysed.gov/opsearches. The Clinician must complete the necessary paperwork before the delivery of any service: • Conduct an initial assessment and submit a written summary of the findings from the assessment. • Write up a treatment plan which is signed by the medical doctor who prescribed the therapy • Acknowledges the participant’s personal goals and therapeutic activities (along with frequency and duration). • Supports a specific valued outcome from the Life Plan.

No. Staff activity fees are only to cover admissions and other costs incurred by the self-hired staff when supporting the participant. NOTE: Parents' Activity Fees. Expenses and meals incurred by parents when they accompany an individual to an activity are not reimbursed with IDGS funds and must be paid for by the parents. Your child's activity fees, expenses, and meals incurred while participating in an activity related to the Self-Direction Plan are not reimbursed with SD funds either and must be paid for by the individual or his/her family.

Yes! Your child can travel to all of the United States, Canada, Puerto Rico, the US Virgin Islands, and Guam. If you are planning on traveling out of state and using services authorized in the SD budget, you will need prior FI approval. Note: Starting from November 2023, plane tickets are no longer reimbursable for kids or adults except for medical appointments. *** It's best to consult with your FI for their approval criteria and process.

1. Full Amendments to Self-Direction Budgets are usually approved as of the 1st of the month OPWDD approves it. Example: If the DDRO approves your budget change on July 24th, it will not be effective until August 1st. 2. Approval of Cost Neutral Budget Amendments (CNBAs) by the DDRO may be granted retroactively to the preceding month. Example: If we take that same July 24th approval date, the DDRO can approve the CNBA effective July 1st and, in some cases, even June 1st.

People over 18 who choose to live independently may be able to include a Housing Subsidy in their budget. A monthly amount of money that can be used to contribute to rental or mortgage payments. The subsidy requires that the participant contribute 30% of their SSI check and/or income to rent. Subsidies vary depending on the home's location, number of roommates, the individual’s income, and housing expenses. The following criteria MUST be met: • Rental, lease, or mortgage must be in the name of the self-directing person. • If in a shared living environment, the person self-directing must have clear tenancy rights (name on the lease or deed) • The amount is calculated based on the person’s income and Housing and Community Renewal (HCR) payment standards. • Same rules and regulations as ISS. • If receiving housing subsidy, they cannot receive Family Support Services or Family Reimbursed Respite.

LIC is an unrelated care provider who resides in the same household as the self-directing person and provides supports to meet the person’s physical, social and/or emotional needs, so they can safely and happily reside in their home. Important things to know: • LIC cannot be related to the person self-directing by blood or marriage. • This service covers the LIC’s room and board (rent, food, utilities)