Introduction to Self-Directed Supports

1. To get started with Self-Directed Supports, you must first be found eligible for adult services by the Division of Developmental Disabilities (DDD), Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH). It is recommended that you apply to DDD/BHDDH by age 17 or two years before you need adult services.
2. You will complete the Supports Intensity Scale (SIS) and receive a funding level.
3. You will be assigned a Conflict Free Case Manager (CFCM).
4. You will create your plan with the CFCM and submit it to DDD/BHDDDH for approval before starting services.
5. You will choose an agency to be your fiscal intermediary. Your fiscal intermediary will set you up as an employer and will manage the dollars approved for your services.
6. Once you have an approval in writing, the next step is to find and hire staff. 
    

You will find information to help with each of these steps at Fiscal Intermediaries and Resources. 

The benefits of choosing Self-Directed Supports are that you decide what you want to do, what help you will need and who will support you. When using Self-Directed Supports, you, along with family or others you trust, will:  

1. Set your own goals.
2. Decide your own schedule and activities.
3. Choose the people and agencies that will support you.  

You will create a Plan to help you think about your activities, schedule and how you will use your dollars to reach your goals. Participating in person-centered planning activities with family and people can be a good way to gather ideas, list your strengths and to talk about your interests and the supports that work best for you. Go to the Fiscal Intermediaries and Resources page for information and tools to help create a good plan.  

It is your responsibility to hire, train and supervise your staff – and fire them if you need to! If an employee quits or does not show up, you will need a backup plan. You decide how much to pay your staff based on your budget. You will sign time sheets and submit them to the fiscal intermediary for payment. A family member or trusted person you know can help you as needed. 

You can also choose to use some of your dollars to get services from a DDD/BHDDH agency or another agency that can help you to meet your goals.  

• The fiscal intermediary (FI) you choose will set you up as an employer. The FI is primarily responsible for managing your authorized or approved budget for DDD/BHDDH services.
• You can ask family or friends to help design or write your plan.
• Family or friends can also help recruit and supervise your staff, or you can use your dollars to hire someone to coordinate your staff schedule and supports.
• Others using Self-Directed Supports can help answer questions and share resources. Consider attending SDS network meetings or joining the SDS online community to connect with them.
• Some people pay a fee for support brokerage services to help with planning, budgeting and managing staff. These services are available from the following agencies:

Lazo Rhode Island 

BestLife RI

RI Self-Directed Coalition

• To learn how to find, choose, and train Direct Support Professionals (DSPs), visit the Sherlock Center employer resources page.
• Visit the DSP Recruitment Resources page. 
  • You can use these flyers and social media posts to make your own.
  • You can also use the short videos called public service announcements (PSAs).
• You can look for DSPs on websites like Indeed, Care.com, RewardingWork or Craigslist.
• You can post in places that match your interests. For example, if you love animals, you can post your ad at an animal shelter.
• You can ask local colleges or universities to share your ad. Try reaching out to departments like nursing or social work.
• You can place your ad in spots you visit often. This can include coffee shops, grocery stores, churches and other places of worship.
• Be creative! Tell people what the job pays, where it is and what you need help with.
   

Getting started

• Get all forms and information from your fiscal intermediary (FI).
• Make sure you understand the FI’s application process.
• Start with a phone interview. This helps you see if the person understands the job and can work the days and times you need.
• You can meet in person at a safe public place, like a coffee shop, to talk more. If the meeting goes well, explain what will happen next in the hiring process.

How to interview

Write down some good interview questions before you meet. Make sure the questions fit your needs and the kind of help you want.

• Think about whether you want staff who can work when others are out.
• If you have pets, make sure the person is not allergic.
• Talk about what happens if you get sick or if it snows.
• Say if you ever need someone to work overnight or be on call.
• If you need help with transportation, make sure they have reliable transportation that meets your needs.
• You can ask a problem-solving question. For example:
  • “If you are running late, what would you do?”
  • Compare their answer to what you would expect.

Steps before hiring

• Develop a job description for the tasks or goals you want the staff to work on with you.
  • You and the staff can both sign it and use it later if something doesn’t work out.
• Start the application process in small steps.
  • Ask the person to get a BCI (background check) and tell them where to go.
  • Some FIs may also ask for a driver’s record.
  • If the person doesn’t have a check, they will need a bank letter for payroll.
  • Ask each applicant for references from past employers, or from teachers or other adults who know them. If they can’t give any, ask why and use caution. Call the references to learn about their skills and what kind of worker they are.
  • Always check what your FI needs.
• BCI Information:
  • They should go to the Attorney General's Office in Cranston.
  • They must have a valid state-issued driver’s license, ID card or U.S. passport.
  • They can also go to their local police station, but it might take longer.
• After they finish those steps, you can meet again to complete the rest of the application. You can do this at home if you feel comfortable.

Training and checking in

• Make a plan for training. Decide when and who will help train the new worker. If the timesheet clearly shows it, two DSPs can receive payment at the same time for training purposes.
• Plan to check in after they start working, after 3 months and/or 6 months. Talk about how things are going.
• Is there something they can do better?
  • Do you both feel it’s a good fit?
  • Decide what to do next.
• Always inform the FI about any staff changes. This includes names, addresses, and more. Do this task as soon as possible.
   

• Division of Developmental Disabilities (DDD): The division of Rhode Island's Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) that is responsible for planning, administering and providing supports and services for adults with developmental disabilities.  
• Conflict Free Case Manager (CFCM): They help people get the services and supports they need with guidance from someone who is separate from the organizations delivering those services.
• Support Intensity Scale (SIS): You will answer questions about how much help you need to be as independent as possible as an adult. After this interview, DD will let you know how much money they approve to pay for your supports or services.
• Fiscal Intermediary:  A fiscal intermediary is an agency that manages the money approved by DDD. You do not receive any money directly from DDD. Your money is given to your fiscal intermediary, who will pay your staff wages and other bills.
• Plan: A written plan is submitted to DDD for approval annually. The plan should include an overview of your current situation and your desired future, specific goals and support needs, the resources required to achieve your personal goals, and a budget outlining exactly how you will spend your DDD funds.
• Support Brokerage: A support broker is hired by you and takes all directions from you. A broker is a liaison between you and the agency or staff providing services. They help identify your needs, special requirements and resources. They also help to implement, monitor and support the goals in your Individualized Service Plan (ISP). This is an optional service paid for with your budget.