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What are consumer-directed services?
When a person with a disability employs a personal assistant rather than arranging for a worker through an agency, they are participating in consumer-directed or self-directed personal assistance services. In consumer-directed services, the person with a disability is called the “employer” or “consumer” and is responsible for hiring, supervising, training, paying and firing the personal assistant. Services are paid for by the employer from their own money or through a federal or state program. Why are consumer-directed services so important?
Consumer direction gives people maximum control over their support services. The benefits of consumer direction for the employer include independence and more flexibility with their services, the ability to hire providers they feel will do the best job, and the ability to pay family members or friends who provide assistance. The benefits for personal assistants include working with just one or two employers for a longer time each week. This enables longer lasting work relationships and allows employers and assistants to work together, get to know each other better, and communicate directly with one another. Scheduling is usually more flexible because providers aren’t following agency time guidelines. Employers have more of a sense of control because the personal assistant is not accountable to an agency, but rather to the employer. Some of the drawbacks to working in consumer-directed personal assistance services include lack of benefits like paid leave, health insurance and overtime. How are consumer-directed services paid for?
Depending on the employer’s income and assistance needs, a personal assistant’s services may be paid for by MaineCare (Medicaid) or another state or federal program. Independent living agencies like Alpha One help eligible consumers who are organizing their own services and directing their assistants. Alpha One also provides some education, training and equipment for people with disabilities who are directing their own services. Who is eligible for MaineCare-funded consumer-directed services?
Maine has set certain standards people have to meet to qualify for MaineCare-funded consumer-directed services. Employers must meet the income guidelines defined by MaineCare. Consumers 65 and older must meet the state standards for eligibility for a nursing facility. Those 64 and under must meet the state’s definition of disabled. (Explanations of these standards are available from the Maine Department of Health & Human Services. Their contact information is listed below.) Personal assistants can be any family member (except the employer’s spouse or parent of a minor child), friends or community members, or people who apply for the job and are hired by the consumer. Maine doesn’t require providers to have formal training though some employers do. Some services, such as physical therapy and medication management, may have to be provided by trained individuals. How do personal assistants get paid in consumer-directed services?
An individual who hires a personal assistant is responsible for paying the assistant. The individual also has to withhold payroll taxes and workers compensation premiums. Sometimes, the individual will use a payroll service to withhold these amounts and write the check to the personal assistant. Alpha One Center for Independent Living provides payroll services for people who use some MaineCare consumer-directed services. Home Resources of Maine provides payroll services for people who use Maine’s Home Based Care consumer-directed homemaker services. (Contact information is below.) Where can I get more information about consumer-directed services?
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Worker Info 
