Consumer Directed Services

COMMUNITY AND CHOICE

Americans are a diverse group of people.  We share the belief that all people have a right to life, liberty, and the pursuit of happiness. 

Many people need help in order to enjoy these rights. One of every five Americans has a condition that affects the way they live and enjoy everyday activities. Most of us will experience a disability some day.  This is a natural part of life.

The Americans with Disabilities Act (ADA) is a law to protect these rights.  It gives us a new way to think about public policies and programs. The goals of the ADA are:

Opportunity

People with disabilities have the same right as everyone else to pursue their dreams. Having a disability should not keep anyone from living, working, or having relationships in the community.

Participation

People of all ages with disabilities have the right to participate in decisions that affect their lives. They want to plan for their own needs and decide for themselves what services are best for them. People with disabilities, their families and advocates need to have a voice in shaping public policies.

Independence

Everyone has the right to control his or her life. This includes choosing to live and take part in the community.  Independence does not mean isolation.  As humans we are all interdependent. Each of us does best when we receive support from other people.

Financial Security

Everyone needs enough income to meet basic needs. Everyone has the right to work, to go to school, or to join community activities. Public programs can encourage individuals of all ages to live outside of institutions. To do this, people need resources to meet expenses.  They also need programs that provide assistance and opportunities to work.  

Public programs need to listen to what people want and help them reach their goals.  Federal and state policy makers need to talk with people with disabilities.  That’s the only way to know their point of view. Families, advocates and providers can play a valuable role in the discussion.  Together we can assure that programs respect the rights of all people to control decisions that affect their lives.

Understanding Consumer Choice and Consumer Direction 

Many programs offer services and other supports to help people with disabilities to live in the community.  These home and community based services offer a variety of choices to meet needs of consumers.  Expanding the range of service choices is one of the first steps that states take as they move to expand consumer choice.  Having more choices is good for consumers.  But it is important to know how much choice consumers truly have.  Consumers may have a wide range of service choices but not be able to decide when, where and how they will receive them.

The term consumer direction describes programs that offer maximum choice and control for people who use services or other supports to help with daily activities.  In consumer directed programs, people with disabilities can choose to select, manage, and dismiss their workers.  They can receive services wherever they live.  They can decide which services to use, which workers to hire, and what time of day they will come and leave. They can decide whether to hire family members and whether to spend the available funds on things other than services.

Consumer direction may also be called “self-determination” or independent living.”  When people say they want to be “independent” or they want “autonomy” or self-direction,” they are talking about consumer direction too.  All of these terms are about individual choice and control. 

Of course, all of us must learn to live within our means.  Consumer direction does not mean that there are no limits on funding.  Having responsibility over funding decisions means that the person is accountable for the decisions he or she makes.  But more and more states are finding that consumers who have control do make reasonable purchases.