What is self-determination?

Self-determination for a person with a developmental disability means being able to have
real control over one’s life. It is not a particular program or service. Self-determined
people have supports that are tailored uniquely and specifically to that individual.

Some people with developmental disabilities can clearly express their wishes and needs,
and are able to make choices independently. Many others can become self-determined
by having family, friends, and trusted professionals help them choose how they want to
spend their time and with whom.

What does self-determination mean in day to day life?

• Having control over daily activities: paid or volunteer work, continuing education, recreation
• Choosing support: family, coworkers, friends, support staff
• Deciding where to live: an apartment with a roommate, a house with friends, alone
• Being able to set the rhythms of your day: what time to eat, when to go to sleep
• Letting people with developmental disabilities, and their circles of support (see below) control their budgets and choose the services and supports that best meet their needs, benefits both the people served and their communities.

What is Self-Direction?

Self-Direction is a way of providing services that gives people with developmental
disabilities increased choice, and control over their lives. It is the term used to
describe self-determination programs in New York’s HCBS (Home and Community
Based Services) Medicaid waiver.

Self-direction has two basic features:

• Employer authority enables individuals to hire, manage and dismiss workers.
• Budget authority provides participants with a flexible budget to purchase the supports and services they need to live in the community.

What is CSS (Consolidated Supports and Services)?

CSS is New York State’s current self-determination program. It is funded by federal and state Medicaid funds, and administered through New York State Office for Persons with Developmental Disabilities (NYS OPWDD).

Implementing a CSS plan requires a start-up broker, a circle of support, and a financial management service.

What is a circle of support (COS)?

The circle of support is the key decision-making group in CSS: its members support and advise the individual getting services. Among other things, circle members assist with:

• Identifying the person’s strength and gifts
• Finding community opportunities
• Recruiting staff

Who is in the circle of support?

The circle is made up of family members, friends, and trusted professionals, and
must include the Medicaid service coordinator and broker. Circles vary greatly;
some circles have three people, some have a dozen. Don’t let concern about finding
people for your circle stop you from using CSS!

Who is the start-up broker?

The broker may be an independent contractor, or may work for an agency. OPWDD
pays the broker on the basis of hours worked on your plan.

What does the start-up broker do?

• Further explains the CSS process
• Guides person-centered planning
• Writes the actual plan, including all of the budget calculations
• Helps to identify community connections and resources
• Acts as the intermediary between the COS and the DDSO and steers the plan
through the acceptance process

How do you choose a start-up broker?

Usually, you will get a list of brokers in your area; or, the liaison may suggest
someone. It is important that you speak to the broker before you hire them, as this
person will have an important role in translating your child’s dreams into reality.

Suggested questions to ask a broker:

• What made you decide to want to be a broker? What other jobs have you had?
• How many plans have you written?
• Can you explain the difference between a start up broker and support broker? Have you performed both roles?
• Tell me about a circle you are involved with.
• What happens at meetings?
• Could you tell me how you guide the process of person-centered planning?
• Who makes the final decisions about how the budget is spent?
• Can you tell me a problem you solved with a creative solution?

What is an FMS (Financial Management Service)?
The FMS is a non-profit agency that you hire, who will:

• Perform background checks on staff
• Keep the books and pay staff
• Monitor and report on the yearly budget

More questions? Contact us at nyselfd@gmail.com.

For extensive information see Developing and Implementing Self-Direction Programs and Policies: A Handbook