Self-Direction Enrollment Procedure Manual 2025

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Self-directed Medicaid services means that participants, or their representatives if applicable, have decision-making authority over certain services and take direct responsibility to manage their services with the assistance of a system of available supports.
Self-directed support (SDS) Typically, direct payments have been understood as a route to employing a personal assistant*. However, a direct payment can also be used to purchaser a wide range of things. For instance: a service from the local authority or from another local authority.
Self-direction is a service model for Ohioans served by certain Medicaid waivers that empowers their individual choice and control over the long-term services and support needed to live at home.
Examples of self-directed supports include, but are not limited to: information regarding how a self-directed care program works; individual rights and responsibilities; and available resources; counseling; training; assistance, such as the use of a supports broker/consultant and financial management services (FMS);
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Often, states also include options to purchase goods and services that can reduce the individuals need for ongoing services. For example, a participant who uses a wheelchair might choose to purchase a front-facing washing machine and dryer, which would reduce their ongoing need for a worker to assist with laundry.

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