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Required Member

Care Manager

Care Management comes first

  • provide linkage and referral to services  
  • monitor health and safety
  • perform needs assessment
  • complete level of care documentation
  • develop and update the life plan

Required Member

Fiscal Intermediary (FI)

Choose an FI

  • employer of record for self hired staff
  • trains staff
  • manages payroll and employer taxes
  • reviews budgets and staff action plans
  • processes reimbursements 
  • pays vendors
  • provides an expenditure report
  • audit support

Required Member

Support Broker

Choose a Broker 

  • help build and manage a circle of support
  • build and update the budget for services
  • help you recruit, supervise, and schedule staff
  • write and update the staff action plan 
  • monitor staff notes 
  • monitor expenditures
  • research supportive goods and services
  • provide education to the team

The Circle of support

Individual Receiving Services

The person receiving the services is the leader of the circle of support. They must be at all circle meetings.

Advocates

Parents and advocates are often essential members of a circle of support.  

Friends and Family

The person receiving services is encouraged to invite any person that is important in their life to participate in their circle of support if they feel they are valuable for planning.

Providers

The person receiving services may wish to include other service providers in a circle of support. Other providers may include school staff, support professionals, job coach, life coach, clinical provider

Self Direction Team

The care manager, Broker and FI are required members of the circle of support.

Recommended FI Interview Questions

There are several FIs in each Region.  Each one will have their own policies and procedures which will impact how their Self Direction Services are delivered.  Here are some interview questions to get your conversation started.

The Fringe Rate is a percentage added to the hourly rate of your staff when it is drawn from the budget.  This fee covers employer expenses such as training, paid time off, employer taxes, worker's comp, unemployment insurance, and other benefits.  The benefit options will vary by FI.


You will want to ask if the agency has a deadline for when invoices must be submitted and when they will pay for those invoices. This could vary widely between FI.


Each agency sets a limit on how much a staff in each role can be paid. 


Some agencies use electronic systems for staff punching and data collections.  Some will also use electronic systems for your interface with the agency.


If you want to access job coaching with your self-hired staff will want to make sure that your FI allows this option. 


Live-in-Caregiver is a service that provides a live in support person.  It is not common and may not be supported by every FI.  If this is something you may use, you will want to ask.


Recommended Support broker Interview Questions

You will likely have more contact with your broker than the other members of the self direction team.  It is important that you and your broker understand each other and have good communication.  

Brokers come in all shapes and sizes...some are part time, some full time.  You will want to know if you are hiring someone with a day job and what their availability will be.


Most Independent  Brokers work alone.  If you are hiring an independent broker over an agency broker you may wish to ask what the back up is if something happens and they discontinue their services.


You are entitled to have in-person services if you want them.  You will want to make sure that you are hiring a Broker that can accommodate that.  Travel time and mileage are not paid to a Broker, many independent brokers are not able to travel for in-person services as a result.  If this is important for your service delivery, you will want to establish this up front.


This is not an automatic service from every Broker, it is requested. 


Completing a housing packet takes team work and attention to detail.  Most brokers can do it but not all are comfortable with it.  If you anticipate requesting help with a housing payment you will want to make sure your broker is versed in the process.


Supported Employment is an enhanced service providing support in and around the work place.  Qualifying for the service is not a linear process.  Using Self Hired SEMP will mean that your broker must be comfortable with service types and writing a staff action plan for work related goals. 


Live-in-Caregiver is not common and many Brokers have not interacted with the service.  If this is something you may use, you will want to ask.


The FI pays the Broker Invoices.  You will want to make sure that you are hiring a Broker that is contracted with your chosen FI or is able/willing to be cleared by the agency.



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