Maryland Department of Health
Developmental Disabilities Administration

​Self-Directed Service Model

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​​Services > Self-Directed Service Model​

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The Maryland Developmental Disabilities Administrations (DDA) supports participants' rights to self-determination and choice. Self-determination means making your own choices, learning to effectively solve problems, and taking control and responsibility for your life. People with intellectual and developmental disabilities have the same right to self-determination as all people and are entitled to the freedom, authority, and support to exercise control over the things in their life that are important to them, to the degree that they desire. This right to self-determination exists regardless of guardianship status.

Self-direction, sometimes called consumer-direction or participant-direction, provides participants a greater degree of choice in how Medicaid waiver services are delivered, when, where, and the rate of payment.  The core functions of self-direction are choice and control over how services are provided, and who is being paid to provide these services. 

The DDA's Family Supports Waiver, Community Supports Waiver, and Community Pathways Waiver all offer the option to self-direct services. This is a service delivery model for participants, legal guardians, or their designated representatives who wish to exercise more choice, control, and authority over their supports. 

Self-direction gives waiver participants and families greater control over the services they receive, how they receive them, and who provides them. At the same time, people who self-direct must be willing to take on the responsibility of managing their services. For services you choose to self-direct, you have additional responsibility including:

  • Participants are the common law employer for the delivery and oversight of their services;
  • Participants are in control of an allocated budget which is a fixed dollar amount for the purchase of services and supports available under the DDA waivers;
  • Participants select staff or vendors and arrange for services and supports as authorized in the Person Centered Plan;
  • Participants set wages within reasonable and customary range and the DDA-approved budget;
  • Participants are accountable for using their budget to more effectively meet needs and more efficiently use public dollars;
  • Participants hire, train, supervise, and fire employees.
People who self-direct their services will work with a Coordinator of Community Services (CCS) to guide them through the process, which includes having the option of utilizing a Support Broker to assist with employer responsibilities and working with a Financial Management and Counseling Services (FMCS)​ provider to assist with budget and payment responsibilities (required for participation in the Self-Directed Services Model).