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·Federal program

Medicaid Self-Directed Services

Federal Medicaid authorities allowing beneficiaries to self-direct their home and community-based services, including hiring their own caregivers (including family members). Authorized under Section 1915(j) self-directed personal assistance services and Section 1915(k) Community First Choice option.

What it offers

Medicaid self-directed services let participants, or representatives when applicable, take decision-making authority over certain services and manage service delivery with available supports. Medicaid.gov describes employer authority as the ability to recruit, hire, train, and supervise service workers, and budget authority as participant direction over how Medicaid funds in an individualized budget are spent. States can offer self-direction through state-plan and waiver authorities including 1915(i), 1915(j), 1915(k), and 1915(c). A person-centered planning process, written service plan, individualized budget when budget authority is used, support broker/counselor assistance, and Financial Management Services are part of the federal self-direction framework. State-specific covered services, worker relationship rules, hourly rates, and budgets vary by state and authority.

ServicesCash Stipend
GC1 · Social SupportGC2 · Physical HealthGC4 · Financial Resources

Questions that decide eligibility

GiveCare prepares the questions; the program makes the decision. Bring these to the call or the application:

  1. 01

    What are the current income and asset limits, and whose income counts?

  2. 02

    What counts as a qualifying disability or level of care need, and what documentation shows it?

  3. 03

    Does the VA disability rating meet the program’s minimum (our record lists null%)?

  4. 04

    Which citizenship or immigration statuses does the program accept, and which documents show it?

  5. 05

    Do the work hours meet the minimum (our record lists null hours)?

  6. 06

    Is there a caregiver-specific department, coordinator, or support line? Ask for it by name.

    Many agencies have one that isn’t advertised on the website.

  7. 07

    What documents do you need from us to start an application?

  8. 08

    Is there a waitlist right now, and how long is it?

This page is for discovery and preparation, not an eligibility determination. Program rules change — confirm every detail on the official source. Browse all programs →