Self-Determination Services

What is Self-Determination?

In a Self-Determination arrangement, you can hire your own workers and manage your services within a set budget determined by LifeWays according to your level of need:

  • You have choice and control over services
  • Your Case Manager or Supports Coordinator supports you to self-direct the services you choose
  • You are the employer of record with a Fiscal Intermediary paying your worker(s) for services
  • You directly hire, fire, and supervise your workers
  • You set your worker’s schedule
  • You set the wage for your workers within the approved budget

How Does Self-Determination Work?

  • You make choices about the goals you would like to work on when creating your Individual Plan of Service.
  • You determine who you want to help you reach your goals.
  • Your family and friends can help you with decisions to make sure that your health and safety needs are met.
  • After you have a plan for what you need, a budget is developed based on those services.
  • You manage your individual budget (with help from your Case Manager or Supports Coordinator and Fiscal Intermediary).

How Do I Begin Self-Determination?

It starts with your Individual Plan of Service! At your next Individual Plan of Service meeting, tell your Case Manager or Supports Coordinator that you are interested in Self-Determination and they can give you more information or help you begin the process.

Important Things to Know

Medicaid rules still apply under Self-Determination. That means:

  • Services must be medically necessary
  • The type (what kind), amount (how much and how often), and length of service (for how long)must be supported by your condition
  • Your condition would worsen without the services
  • All other natural and community supports must be used before Medicaid will pay for a service
  • Services must be supported by documentation

Referral Process 

Consumers can request to receive services via a self-determined arrangement upon entry into services or at any time during the course of treatment. If a new consumer is interested in self-determination, the LifeWays Access Center will follow the normal procedures for eligibility and service referral and specify self-determination. For current consumers, LifeWays Network Providers shall, at the time of person-centered planning or when interest is expressed by the consumer, assist the consumer in making an informed decision to receive services through a self-determined arrangement.

Self-Determination Resources

Training Requirements

Consumer/guardians as employers and their employees must receive certain trainings that are required by LifeWays and the Michigan Department of Health and Human Services' Medicaid rules.  Consumers can hire any willing and qualified provider, which is defined as an individual that meets the following:

  1. Not been excluded from participation in Federal Healthcare Programs and does not appear on either the Office of the Inspector General’s Exclusions Database; or the Michigan Department of Health and Human Services' List of Sanctioned Providers.
  2. At least 18 years of age at the time of hire.
  3. Citizen of the United States or lawful resident.
  4. Able to prevent transmission of communicable disease.
  5. Able to communicate expressively and receptively in order to follow individual plan requirements and beneficiary-specific emergency procedures, and report on activities performed.
  6. In good standing with the law. For workers serving adults, the person may not be a fugitive from justice, a convicted felon who is either under jurisdiction or whose felony relates to the kind of duty to be performed, or an illegal alien. For workers serving children, the person may not be a fugitive from justice, a convicted felon or an illegal alien. Criminal background checks must also be completed annually after hire.
  7. Able to perform basic first aid procedures.
  8. Has a valid driver’s license and appropriate insurance to operate motor vehicles used to provide     transportation for individual(s) as applicable.
  9. Must complete all training required by LifeWays within the time-frames and at the frequency defined by LifeWays
  10. Knowledgeable of the individualized service plan for the consumer and provides support to the consumer according to the service plan.

Self-Determination Principles

Self-determination embodies the values of person-centered planning and is based on the following four guiding principles that should apply to people with disabilities:

  1. The freedom to choose where to live, with whom and the development of a personal lifestyle
  2. The authority to control the supports provided and the money that is spent on the individual's behalf
  3. The support to develop a life dream and reach toward that dream
  4. The responsibility to use public funds efficiently and to contribute to the community through the expression of responsible citizenship

Fiscal Intermediary

All consumers choosing self-determination must have a Fiscal Intermediary (FI). An FI is an accountant. For a fee, the FI handles payroll responsibilities for the consumer-employer (pays providers, handles Worker's Compensation and payroll taxes, supplies employee payroll forms, etc.) The FI is responsible for paying consumer providers based on the Employment Agreement signed by the consumer and provider and time sheets submitted by the provider. The Fiscal Intermediary also provides each self-determined consumer with a monthly budget status report.

The self-determined consumer (and guardian if there is one) meet with their Fiscal Intermediary at the start. At this meeting, the consumer/guardian will review and sign needed paperwork. The Fiscal Intermediary will explain the services they provide and how much those services cost. The Fiscal Intermediary can help the consumer negotiate service rates with their providers. Lower rates allow the consumer to make the most of their service benefit using available budget dollars.

LifeWays's Fiscal Intermediary:

Community Alliance
301 West Michigan Ave, Suite 102 
Ypsilanti, MI