Self-Determination & Self-Directed Supports Definitions- What Does All This Mean?

We have a new language in long-term care. It can be confusing, and we need to learn it so we can understand the many changes and talk to one another about them. In the near future, we will add a more comprehensive glossary of new terms to this site. For now, we want to start by defining just a few really important words, terms, programs and ideas.

Self-Determination is a term that has been increasingly applied to long-term care across the world. It refers to basic principles of freedom; of support to be able to do the best one can to be in charge of one’s life; of having the authority to choose how funding is spent to obtain needed support and services; an understanding that people who receive support can be responsible for the wise use of public dollars; and recognition of the contribution individuals with disabilities can make to their communities.

Self-Directed Supports refer to the ways in which people who receive public long-term care funding in Wisconsin (and other places also use this term) are able to choose and direct how to use all or part of that funding to determine where and with whom they live; what they do during the day to work, to learn, to contribute, to enjoy life; and in general to obtain the support they need to be live ordinary and extraordinary lives in our Wisconsin communities. SDS is the short-hand acronym or nickname for Self-Directed Supports

It is so important to recognize that there are many ways in which people can obtain and use Self-Directed Supports within our current and evolving service systems, and that SDS should be no more difficult to use than any other ways in which people obtain services through CIP, COP, other waiver programs, or Family Care.

Family Care is the core of the managed long-term care system that is in the process of replacing our state-county services system for eligible Wisconsin adults with long-term care needs. If you know of another brief but better description of Family Care, please let us know. There is a wealth of information about Family Care on the DHS web site noted in our Useful Links section (http://dhs.wisconsin.gov/managedltc/).

The state law that created Family Care also created Self-Directed Supports within it, with the following language: “Each person may arrange for, manage and monitor his or her family care benefit directly, or with the assistance of another person.” That short sentence is one of the most powerful and empowering pieces of long-term care legislation found anywhere in the country.

The Family Care Partnership Program, formerly known as Wisconsin Partnership Program, is an option within some counties. It adds health care to the Family Care long-term care benefit. it also offers the option of Self-Directed Supports for the long-term care services and supports it offers.

IRIS is the new kid on the SDS block. It is a “Waiver Program” like CIP and COP, but it has at least two unique features: 1) it is available only in counties in which Family Care has arrived, and 2) it is totally and solely created to enable people to use Self-Directed Supports. IRIS just started on July 1, 2008. As noted in our Useful Links section, more information about IRIS can be found at http://dhs.wisconsin.gov/bdds/IRIS/index.htm/   

The Individual Consultant Agency (ICA) is available only through IRIS. The ICA provides what is typically viewed as case management or care management services to help participants plan and obtain supports and services. They play a critical role in supporting people who choose IRIS. More information can be obtained by contacting them directly at 888-515-4747 or at their web site: http://www.wisconsin-iris.com .

Aging and Disability Resource Centers (ADRCs) are service centers that provide a place for the public to get accurate, unbiased information on all aspects of life related to aging or living with a disability. Every county must have an ADRC in place before they can be covered by Family Care and IRIS.

Financial Management seems like a phrase we all understand; however, it gets a bit more challenging when it is used within Family Care, IRIS, Partnership and Self-Directed Supports.  Here is an overview of financial management and employer related supports as they relate to self directed support programs. Updates being added.

A Support Broker is personal ally hired by an adult with a disability to help create and implement life plans, manage budgets, supervise support staff, negotiate rates for supports, network within the community, and expand the circle of friends and other allies in the community. The ideal Support Broker is a creative, multi-talented, well-connected individual with the skills to support and promote the rights, needs, and talents of individuals with disabilities. The Support Broker's role is uniquely defined by each adult for whom they work.

Support Brokerage is not a standardized or fixed service delivered equally to each person with a disability. Instead, the role of the Support Broker is to assist each individual to live the life they choose. In other words, the "job description" for a Support Broker will vary depending on the needs and desires of each individual employer. It is the adult with a disability and his circle of support that determine the specifics of a Support Broker's responsibilities.