Self-Direction is a method of receiving home and community-based services where the
consumer is the employer. The consumer can have budget and/or employer authority. Budget
authority empowers consumers to set the hourly rate for their self-directed caregivers and set
budgets for goods and services. Employer authority empowers consumers to hire caregivers
who they screen and choose.
Self-Direction was an option in some of the waivers prior to October 2024, but it was not
an option at all in the Ohio Home Care Waiver. Furthermore, for the waivers where it was an
option, it was not a true self-directed option. About a year and a half ago, the Ohio Department
of Medicaid created a workgroup consisting of consumers, advocates, and providers to create a
consistent model for self-direction across waivers. I have been a member of this workgroup
since the inception.
Starting October 1, 2024, consumers on Ohio Home Care Waiver were able to enroll.
As a consumer of the Ohio Home Care Waiver and advocate for self-direction, I started the
process of enrolling. Thus far, it has been a positive experience. I was able to complete the
enrollment process online and “hire” my caregivers/PCAs online as well. The process is not
over, but I am hopeful to have everything up and rolling by the end of October.
If anyone is interested in learning more about Self-Direction and how it may be
appropriate for you, please do not hesitate to contact me at lmarn@sil-oh.org or by phone at
(216) 389-0379.
Lisa M. Marn, M.Ed., PCA Program Contract/LTSS Supervisor
