Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Furnishing Assistance to Individuals in Managing and Directing Services


Participants who are interested in directing their services may need or want assistance to do so. The §1915(c) HCBS waiver authority and the §1915(j) State Plan authority require states to furnish two support services to participants directing their services: (1) information and assistance, and (2) financial management services. (The proposed rule for §1915(i) also addresses the provision of these two support services. However, it is not included here because at the time of publication, it had not yet been finalized.)

These support services are necessary to ensure that individuals have a support system to ensure they are able to manage their services and budgets. The extent to which such supports are utilized depends on the capacity, preferences, and needs of each individual and may vary in scope and timing. While their main purpose is to facilitate participant direction, these supports also provide important protections and safeguards for those directing their own services. Financial management services also provide fiscal accountability for state budget staff, by helping participants to manage the individual budget and by issuing payments on behalf of the state.

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