GT IndependenceResources and ToolsResourcesWhat Is Self-Direction and How Does It Work in North Carolina

What Is Self-Direction and How Does It Work in North Carolina

June 17, 2021

What Is Self-Direction?

Self-directed care means you decide who supports your long-term care and how those services are delivered. Self-direction has many names, and these names often vary by state. The word self-direction is often considered interchangeable with consumer-direction and self-determination.

  • Self-direction is not a program. It’s a way of life.
  • Self-determination is the inalienable right of all humans, regardless of age or ability, to make choices and have control over their own life.

Here at GT, we support the benefits of self-determination in over 12 states, including North Carolina. We know that with choice there are better outcomes. People participating in self-determination report higher quality of life, rather than people participating in traditional care.

You are the experts when it comes to your own lives and needs, together with your loved ones.

5 Main Principles of Self-Determination

1. Freedom

  • Determine a meaningful life
  • Identify the amount, frequency, and duration of services
  • Choose who will provide the services

2 . Authority

  • Control your budget with assistance
  • Choose (hire) personal assistants who will provide care
  • Train, supervise, and evaluate the personal assistant (worker)

4. Responsibility

  • Negotiate the rate of pay and other benefits
  • Work with a financial manager who will: pay your worker, handle federal/state taxes, and coordinate other details related to the employment of the worker

5. Confirmation

Consumer-directed care confirms that the individual and the family are in control of their care.

Traditional Services vs. Self-Directed Services

With traditional services, you don’t have much power over your services. You can’t recruit workers, set tasks, specify salary and benefits, set work hour schedule, train workers, determine needs and services. All of these are controlled by the agency and/or case manager. Due to Medicaid and government regulations, traditional services must remain within the confines of the agency. And the agencies must abide by governmental restrictions.

With self-directed services, you and/or your representative have more power and control. You can recruit and manage workers, set tasks, specify workers’ salary and benefits (within the Medicaid waiver guidelines/or their ongoing Medicaid budget), assign flexible work hours, and more.

Self-Directed Care Can Give You Control

It’s important to know your rights when it comes to self-direction. You don’t need to leave your home or receive care from a stranger. Often, chosen caregivers have a personal connection or relationship with the person they are serving.

Self-direction can be a solution for caregiver shortages, whether that shortage is due to the participant living in a remote area or the lack of qualified caregivers in the area.

Ready to learn more about Self-direction?

See what options are available in North Carolina. Then review the steps on how to get started.