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Self-Directed Services

What are Self-Directed Services?
Self-Directed services are available through the Intellectual Disability (ID), Living at Home (LAH), and the Community Waiver Program (CWP).  Self-Directed Services allow the individual to have someone in their support system enroll as the employer. This provides the individual and the appointed Employer of Records (EOR) the freedom to find, train, and hire staff that they prefer and that best meets the needs of the individual. 

What are the responsibilities of the Employer of Record (EOR)?
The EOR is responsible for performing the responsibilities of the employer. This may include submitting and approving time sheets, submitting employee application information, ensuring that staff are meeting the needs as defined by the individual, etc. The EOR submits the documentation to the Fiscal Management Agency (FMSA) of the individual's choosing from the certified providers.

What are the responsibilities of the Financial Management Agency (FMSA)?
The FMSA is responsible for issuing payment to the employee and ensuring that appropriate payroll taxes are deducted and paid. The Department of Mental Health is billed for the services by the FMSA. This means that the service is at no cost to the individual, their family, or their EOR. 

What are the benefits to Self-Directing Services?
There are many benefits to choosing to self-direct services.
1) It allows the individual and their support system to identify and hire employees that they choose and that meet their needs.
2) It allows more flexibility in meeting the individual's needs by removing any barriers to choosing their preferred time to receive services.
3) Self-Directed services have a higher maximum rate of pay than those through a DMH provider, allowing the EOR to pay more and potentially find a higher quality of staff.
4) It allows the individual access to a goods and services account. The goods and services account is created once the individual is enrolled in self-directed services. The funding from this account comes from the difference from the maximum rate of pay and what the EOR/individual choose to pay their employees. Maximum rates of pay are provided by the FMSA and vary by individual. This means that if you are informed your maximum rate of pay is $21.00/hour and you choose to pay staff $15.00/hour, you will "bank" $6.00/hour in the goods and services account. The Goods and Services account can be accessed through the support coordinator to purchase or reimburse items or activities that meet the needs of the individual and are not covered by Medicaid. Some examples may include: A gym membership, paying for a private pay day program, dental costs, etc.

Services that can be Self-Directed by waiver:

Intellectual Disability Waiver (ID) and Living at Home Waiver (LAH):
Personal Care
Personal Care Transportation
Adult Companion Care
Environmental Accessibility Adaptations
Personal Emergency Response System (PERS)
Skilled Nursing- RN and LPN
Specialized Medical Supplies
In home Respite
Out of home Respite
Assistive Technology

Community Waiver Program (CWP):
Personal Assistance- Home
Personal Assistance- Community
Skilled Nursing
Community Transportation
Breaks and Opportunities (Respite)
Employment Supports- (Individual Employment Support - Exploration, Discovery, Job Development plan, Job Development, Job Coaching Career Development)
Community Integration Connections and Skills Training
Independent Living Skills
Natural Support or Caregiver Education and Training

For more information on self-directed services, please visit the link at the Alabama Department of Mental Health's (ADMH) website: 

More information regarding Self-Directed Services can be found at the links below:

If you are interested in self-directed services and are currently enrolled in the ID, LAH, or CWP waiver,
please contact your support coordinator. They will assist you in accessing the services. 

Important Contacts for Self-Directed Services:

Self-Directed Liaison for Madison County
Lori Scruggs
Phone: (256) 898-2829

DDD Director of Support Coordination
Francilla Allen
Phone: (251) 283-6220


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