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Developing and Implementing Self-Direction Programs and Policies: A Handbook


This handbook, from the national Cash & Counseling program, provides information for State staff, policymakers, service providers, program participants, and other stakeholders about self-direction programs and policies. It can be used to explain how States can increase program participants’ choice of and control over their services and supports. It also can help expand self-direction options in programs already providing home and community services and supports and develop new self-direction programs.

Topics covered are:
  • Chapter 1 – Self-direction: An overview
  • Chapter 2 – Legal authority
  • Chapter 3 – Involving participants in program design, implementation, and evaluation
  • Chapter 4 – Enrollment
  • Chapter 5 – Individual budgeting
  • Chapter 6 – Counseling
  • Chapter 7 – Fiscal/employer agent services
  • Chapter 8 – Quality management in self-direction programs
  • Chapter 9 – Self-direction and health care
  • Chapter 10 – Looking ahead
  • Appendices
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Administration on Aging; National Resource Center for Participant-Directed Services; U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation

Funding Sources

Robert Wood Johnson Foundation

QualityTool Topic



  • Release Date: 02/2009
  • Original Summary: 09/2009
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Last updated: May 16, 2012.