Self-Directed Services/Self-Direction

What does it mean to self-direct your services?

Self-Directed Services is a way to get home and community-based services that gives you more control over how and from whom you receive help. Instead of having a provider manage your services, you can choose to manage them yourself.

In New Jersey, many people choose to self-direct some or all of their DDD-funded services. This means you can hire your own caregiver, called a self-directed employee, to provide the services you need, within your budget. You can also choose to participate in community programs or classes that are open to the public.

How do DDD self-directed services work?

For DDD-funded services, there are two Self-Directed Employee (SDE) Service Models to choose from. Depending on the model selected, you may have an employer relationship with your SDE. You will also have the responsibility of recruiting staff, securing coverage when staff call out of work, and approving timesheets.

SDE Service models are made possible through a financial management services agency, known as the fiscal intermediary, which conducts some employer-related tasks such as payroll processing and tax withholding. The fiscal intermediary processes self-directed employee timesheets and vendor invoices, and issues payments.

The Boggs Center on Disability and Human Development developed a helpful guide about self-directing services for individuals and families, Deciding to Self-Direct: Making Choices, Becoming Empowered.

Self-Directed Services available through a self-directed employee:

  • Community Based Supports
  • Individual Supports-Hourly (15-minute unit increments)
  • Interpreter Services
  • Respite
  • Supports Brokerage
  • Transportation - Self-Directed Employee

Self-Directed Services available through a community vendor:

  • Assistive Technology
  • Environmental Modification
  • Goods and Services
  • Natural Supports Training
  • Transportation – Single Passenger
  • Vehicle Modification

All Medicaid waiver providers—including self-directed employees (SDEs) in the DDD Self-Directed Employee service models (Vendor Fiscal/Employer Agent model through Acumen Fiscal Agent, or Fee-for-Service Agency with Choice through Easterseals NJ) are required to maintain documentation to support Medicaid reimbursement. Documentation of services provides the evidence that the provider (1) delivered the services, and (2) delivered the services in accordance with the individual’s needs.

Please see the following documents for guidance and more information:

There are two self-directed employee models to choose from:

  • Vendor Fiscal/Employer Agent (VF/EA)
  • Agency with Choice (AWC)

Each model uses a fiscal intermediary to process payments and handle tax and labor law filings. In the VF/EA model, you, or someone you choose, enrolls as the employer of record. In the AWC model, you, or someone you choose, enrolls as a co-managing employer.

Easterseals NJ is the fiscal intermediary for the Agency with Choice model and Acumen is the fiscal intermediary for the Vendor Fiscal/Employer Agent model.

For more information, talk with your Support Coordinator or email the DDD Fee-for-Service Helpdesk: DDD.FeeForService@dhs.nj.gov. 

Effective May 1, 2025, there is an increase to the per-member-per-month rates to participate in the Agency with Choice Self-Directed Employee Model. For details, please see the notice, FY2025 Agency with Choice Per-Member, Per-Month Rate Increases. These increases are reflected in the PMPM Cost Table below.

Visit the Easterseals Agency with Choice website for more information.

Acumen is the fiscal intermediary for the Vendor Fiscal/Employer AGent model. Information, trainings, and forms are available on the Acumen NJ.

Individuals who choose to self-direct their services may feel that they need more assistance for it to work for them.  Supports Brokerage can offer practical skills training to enable families and participants to independently direct and manage program services, or assist more regularly. Please visit the Division's Supports Brokerage web page for more information.

 

Your support coordinator will be able to answer questions you may have about self-directed services. You can also contact our Office of Education on Self-Directed Services, which helps people learn about self-directed services.