LAC 50:XXI.8501. Self-Direction Service Option

A. The self-direction initiative is a voluntary, self-determination option which allows the participant to coordinate the delivery of personal assistance services through an individual direct support professional rather than through a licensed, enrolled provider. Selection of this option requires that the participant utilize a payment mechanism approved by the department to manage the required fiscal functions that are usually handled by a traditional direct service provider. B. Participant Responsibilities. Waiver participants choosing the self-directed services option must understand the rights, risks, and responsibilities of managing their own care and individual budget. If the participant is unable to make decisions independently, he/she must have a responsible representative who understands the rights, risks, and responsibilities of managing his/her care and supports within his/her individual budget. C. Termination of the Self-Direction Service Option. Termination of participation in the self-direction service option requires a revision of the POC, the elimination of the fiscal agent and the selection of the Medicaid-enrolled waiver service provider(s) of choice. 1. Voluntary Termination. A waiver participant may choose at any time to withdraw from the self-direction service option and return to the traditional direct service provider. 2. Involuntary Termination. The department may terminate the self-direction service option for a participant and require him/her to receive provider-managed services under the following circumstances: a. the health or welfare of the participant is compromised by continued participation in the self-directed option; b. the participant is no longer able to direct his/her own care and there is no responsible representative to direct the care; c. there is misuse of public funds by the participant or the responsible representative; or d. the participant or responsible representative: i. places barriers to the payment of the salaries and related state and federal payroll taxes of direct support staff; ii. fails to follow the POC; iii. fails to provide required documentation; iv. fails to cooperate with the department, fiscal agent or support coordinator; v. violates Medicaid Program rules or guidelines of the self-direction option; or vi. fails to receive self-directed services for 90 calendar days or more. D. Employee Qualifications. All employees under the self-direction option must: 1. meet the minimum age requirement per LAC 48:I.Chapter 92; 2. pass required criminal history background and database checks; and 3. be able to complete the tasks identified in the plan of care.