Through creative examples, the early pioneers of self-determination showed us how people with intellectual disabilities could make heir lives better by assuming greater control and responsibility for their individual budgets and by self-directing their support services. We appreciate their efforts. We are pleased to offer Understanding the Connecticut ADS Home and Community Based Services Waivers: An Introduction to Your Hiring Choices to the people served by the CT Department of Developmental Services.

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We hope that this guide will help many more individuals with intellectual disabilities to experience the pride, accomplishment, and growth that can occur through the provision of self-directed services. Acknowledgements We would like to thank the following individuals for their assistance in developing the first edition of this guide. Their assistance was invaluable.

The update of this document has been funded through a Connect-Ability-systems change grant provided by The Centers for Medicare and Medicaid Services. Dear Consumers & Family Members On behalf of ADS, it is my pleasure to share with you the update to the manual for consumers and families: Understanding the Connecticut ADS Home and Community Based services waivers: An Introduction to Your Hilling consoles. Everyday we live our lives and are part of a community. But what does that really mean to us and to the people we serve? Everyone defines it differently.

In general I think - We all want to be loved and have meaningful relationships e want to live in our own home with people hectare about W who care about We want to be treated fairly in all aspects of our lives We want to work in Jobs where wear respected e want to make enough money to pay our bills and have a little W left over to have some fun make choices that are right forth wear and who W we want to be e want to feel in control of our lives and know wear part of W the rater community of life e want to be part of our own communities and have a sense W belonging e want to leave this earth knowing we have made difference W by being We want to live life! This manual is a starting point to assist you to begin taking control and living your own life by hiring and managing your own staff. This guide will assist you to explore self directed supports and give you "An Introduction to Your Hiring Choices".

This guidebook is the second of a series of waiver guides to be developed by the Department of Developmental Services (ADS). The first guidebook titled, Understanding the Connecticut ADS Home and Community Based Services Waivers: A Guidebook foreclosures and Their Families explains the department's new Medicaid Waiver System. The first guide provides an overview of the supports and services that are available from the department and identifies the processes that are used to assist individuals to get needed supports and services.

We urge you to read A Guidebook foreclosures and Their Families before reading this second guide. This second guide, Understanding the Connecticut ADS Home and Community Based Services Waivers: An Introduction to Your Hiring Choices explains the choices you have for hiring individuals or agencies to provide waiver services for you. It also provides a brief summary of the choices, actions, and activities that take place when you decide to hire and manage your own employees. The purpose of this second guide is to help you to make informed decisions about your waiver services and to assistantship you who choose to self-direct your services to become confident and effective employers.

Traditional Provider Agencies A Combination of Approaches Once you've become eligible for waiver services, have been allocated funds for an individual budget through the Level of Need (LOON) tool, and have identified the services that will best meet your needs, you and your family can choose who you want to hire to provide services to you and how you want to be involved in the management of your services. If you're still unsure about what supports and services are best for you, we encourage you to read our first waiver guide titled, "Understanding the Connecticut ADS Home and Community Based Services Waivers: A Guidebook for Consumers and Their Families," or you can request assistance from your case manager to help you make informed decisions about your waiver services. You will need to decide what type of services are right for you, before you can consider who you will hire to provide services and how these services will be managed.

You can choose from among a number of different hiring and management options, including: ELF DIRECTION: If you select this S option, you become the employer of the people you choose to hire to provide supports for you. As the employer, you are responsible for the training, supervision, and management f the people you hire. This option gives you the most control and responsibility over your supports. You are able to choose your own employees and have direct control over who works with you, their schedules, and their routines. In this model, you also decide how much to pay your employees and what benefits, (e. G. Health insurance) they receive.

If you choose this option, you can also use a portion of your budget as defined by ADS, to purchase non-waiver supports. An Agency A With Choice is an agency that agrees to hire the individual you choose to provide services for you. This individual becomes an employee of the agency and the agency agrees to help you train and manage your staff. The agency may also agree to negotiate the rate to be paid for the service or the wage to be paid to the person you want to hire. When you choose to use an Agency With Choice you agree to work as a partner with the agency in setting the employee's schedule and routines and in training and supervising the individual.

However, the agency ultimately retains the final say in decisions about the employee, since the agency retains the responsibility of being the individual's employer. Ђ REVIVER: A provider is a traditional P agency that is the employer of the individuals that will provide services for you. ADS will use the funds that are allocated to you in your individual budget to pay the provider agency at the established rates for service. The provider agency is responsible for hiring, training and managing the employees that support you. Provider agencies typically have set hours when they can provide services to you and are not required to give you a choice of which employee will work with you. Or, you can use a combination of the above approaches to meet your individual needs.

For example, you may choose to use some of your allocated funds to purchase employment waiver services you need from a traditional provider agency, and use other funds in your budget to hire your own staff, or have an Agency With Choice provide other waiver services to you. It is important that you think carefully about these hiring options. Each option provides you with a different amount of control, authority and self-determination. More choices "It's not always easy managing staff, but I love being the boss! " JOYCE RIVERS, Consumer 3 Your Hiring Choices, It is important that you think carefully about these hiring options. Each option provides you with a different amount of control, authority and self-determination. It is especially important to carefully select who will help you find and keep a real Job for real pay. You are the expert and know what hiring option will work best for you.

Feel free to ask questions, request additional information, take the time to talk to others who have chosen different hiring options than those you are familiar with, and do whatever you need to do to get the help you need to make an informed choice about this important decision! Keep in mind that you can also change the way you arrange our services Ana won Lovers teen at any time . I mere Is no need to Tell concerned that your decision might be the right one for now, but you may change your mind some time in the future. "l like to have the freedom of choice to pick my own support staff. It makes me feel important and feel in control of my life. I have always been told I couldn't do things because I have disabilities, that I was too slow.

Now that I have a good Job and hire my own support I feel I am respected by others and my family. " JESSIE TORTES, Remember ... Your funds are portable! You can always change your mind ! 4 Supports for Self-Direction SECTION 2 This section of the guide describes the supports that are available to you when you choose Self-Direction: Direct Hire and Management of Employees. ADS Support Brokers Independent Support Broker Individual Goods & Services Supervisor Fiscal Intermediary Services 5 So, you've looked at all of your hiring choices and have made a decision to hire and manage your own employees, or to use an Agency With Choice. Congratulations on choosing to self-direct your supports and services!

You've identified the services that will best meet your needs, and thought about all the different ways that you can manage these services. You've learned about how traditional provider agencies manage the services they provide and considered the Agency With Choice model. You've also thought about using a combination of different approaches. After thinking it over, you may have decided that you want greater freedom and flexibility in the way your services are provided and feel ready to take on more responsibility in your life. You may have decided that hiring and managing your own staff is the right step for you! Hiring and managing your own employees is a big step. Listed below are some supports to help you in your new role.

ADS SUPPORT BROKERS: You can choose o have a ADS support broker or purchase an independent broker service to help manage the services and supports you receive. You can also purchase the services of individual goods and services supervisor. A ADS support broker is a case manager who has a smaller size caseload, so that he or she has the time to provide you with Don case management services Ana AAA t 01 IANAL assailants name to Nile Ana manage your supports. INDEPENDENT SUPPORT BROKERS: An independent broker is a person that you hire directly, or a service you hire from a qualified vendor to help you to recruit and supervise employees. This service is available under the ADS HESS Waivers.

You may use this service for a short period of time to assist you in setting up your new supports, or it can be an ongoing service that you purchase to help coordinate your supports and assist you in your new role of hiring and managing your own employees. If you purchase SIB services, you will keep your ADS case manager. Your ADS case manager will provide case management services including assistance to develop and implement your individual plan. However, your case manager generally will not be able to dedicate the time to assist you to hire and engage your employees.

Examples of acceptable activities be implemented by the Individual Goods and Services supervisor may include the following: Assistance with day-to-day supervision of staff to meet the outcomes outlined in the Individual Plan Training and assistance with daily oversight of staff including the completion of timeshares and documentation of services provided Training and assistance with implementing an emergency back- up plan Training and assistance with accessing community services and day-to-day coordination of approved services Not everyone may need to hire a person to be a supervisor. If there is a need and you have the funds available in your Individual Budget you may want to consider hiring an Individual Goods and Services supervisor. 7 Supports for Self-Direction,When you hire your own employees you are required to use Fiscal Intermediary (F').

This service helps both you and ADS to manage individual budgets and helps you to manage all of the financial responsibilities of being an employer. You can choose which Fl you want to help you pay employees, manage taxes and complete additional employer responsibilities. Your case manager can provide you with information about the available Flu's. The ADS broker and Fl services are provided by ADS at no cost to you, but you will need to use funds from your individual budget if you decide to purchase services Trot an Independent Drover or Uninominal s Ana services supervisor.