SELF DETERMINATION (SD)

TRADITIONAL WAIVER

More choice and control over MI Choice authorized services.

Services arranged with Person Centered Thinking.

Care Manager supports participant to self-direct services/supports they choose.

Care Manager, together with participant, directs and manages supports/services.

Participant is the employer of record.

Contracted provider agency is the employer of record.

Participants can directly hire, fire, and supervise direct care workers. Can hire people they choose to provide services - friends, family, neighbors etc.

Provider assigns workers to participants, and workers must work within agency hours and guidelines. Participants must accept direct care workers from contracted provider agencies.

Participants set their workers rate of pay (within limits of individual budget), hours, and days.

Provider agency sets workers rate of pay.

Requires Fiscal Intermediary service to ensure portability of funds and pay providers the participants choose.

No Fiscal Intermediary required. TCOA manages funds and pay contracted providers.

Goods & Services available (services, equipment or supplies not otherwise provided through this waiver or through the Medicaid State Plan)

Gap Funds available (state funded services authorized when needed for a situation that requires immediate attention to alleviate a barrier crucial to independence)

Medicaid funds can be used to pay for non-medical transportation under SD

Only medical transportation included under traditional plan

Out of home respite can be provided by person of participants' choice in a private home setting or facility.

Out of home respite must take place at an approved contracted provider facility only.

Individual budget is managed by participant (with supports) and is established by calculating funds needed to obtain services and supports in Service Plan.

Care Manager arranges services and supports with no budget involvement from participant.