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Tip Sheet: Principles for Consumer-Directed Services   

People use the words “Consumer-Directed Services,” but that doesn’t always mean the same thing to everyone. Here’s a definition and some guidelines that you may find useful.

The National Institute on Consumer-Directed Long-Term Services offers this definition for “consumer direction”:

  • Consumer direction is a philosophy and orientation to the delivery of home and community-based services whereby informed consumers make choices about the services they receive. They can assess their own needs, determine how and by whom these needs should be met, and monitor the quality of services they received.

  • Consumer direction may exist in differing degrees and may span many types of services. It ranges from the individual independently making all decisions and managing services directly, to an individual using a representative to manage needed services. The unifying force in the range of consumer-directed and consumer choice models is that individuals have the primary authority to make choices that work best for them, regardless of the nature or extent of their disability or the source of payment for services.

Here are some guidelines for consumer direction from this definition and other sources:

  1. Consumers are the experts on their service needs.
  2. Consumers participate in all of their home and community based services including:
    • the design
    • the development
    • the operation
    • the evaluation
  3. Different types of services need different levels of providers. With more complex services, a consumer may want professional expertise to get the services they need. The consumer participates in assessing needs. A consumer decides which service is best. The consumer also decides how to get services and if the services are right for them.
  4. Consumer direction means that there are different service types, different providers, and delivery methods to choose from. Information about these services needs to be accessible.
  5. Consumers have the right to choose, manage, and fire their workers. Managing a worker means the consumer decides what, when and how things are done. Consumers decide how much control to have over services.

    A consumer can do the following:
    • select,
    • manage, or
    • dismiss workers with assistance
    The consumer has the right to make final decisions. If he/she wants to, a consumer can participate in an agency-based program.
  6. A consumer can decide to have a family member (or someone else they choose) make decisions for them. If it is the consumer’s choice, this can be consumer-directed.

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Source: The National Institute on Consumer-Directed Long-Term Services