EXPERTS IN SELF-DIRECTION

EXPERTS IN SELF-DIRECTION

People are happiest when they have control over their care.

Self-direction is at the heart of all the services we provide.
 

From Medicaid waiver programs to state-specific services, we are a solutions-oriented partner for states and health plans to provide the most efficient self-directed program options for home and community-based services.

Our members and caregivers have taught us that every service and support we offer directly impacts a life.

Our job is to empower clients to have choice and control over their services and supports.

Consumer Direct Care Network Brochure
PDF – 3.32 MB
Medicaid Model Comparison Brochure
PDF – 1.66 MB

State Health Plans and Managed Care Organizations

We believe your members deserve to live the healthiest and happiest lives they can.  

For over three decades and across the country, Consumer Direct Care Network has provided Managed Long Term Services and Supports (MLTSS). Our focus is finding solutions for our Managed Care Organization and state partners to better help people get the care they need.

Whether you are looking for Agency with Choice (AWC), Fiscal Employer Agent (F/EA), or Support Broker Services (SBS), Consumer Direct Care Network is here to build the right program for you and your members.

We are here to support your members no matter where they are in the self-direction journey.

Agency with Choice is a co-employment option where your member is in control of who provides their care and services.
  • Your member is the Managing Employer, meaning they recruit, hire, train, and schedule their own caregivers.
  • We are the Employer of Record and manage all administrative and payroll-related tasks.

Fiscal/Employer Agent (F/EA) provides your member the most control over their in-home care.

  • Your member is both the Managing Employer and the Employer of Record for their caregivers. Meaning they recruit, hire, train, and schedule their own caregivers, in addition to being the Employer of Record.
  • We act as the Fiscal/Employer Agent and take care of the payroll and administrative functions for them.

As the Fiscal/Employer Agent, we make sure workers are paid on time and employment taxes are withheld correctly. Additionally, to fully protect your member from financial risk, we take on full liability for each member-employer’s tax responsibilities related to a self-direction program.

Support Broker Services assist your members with questions and help them achieve success with their self-directed goals. Our job is to take away the stress and worry. We can answer questions and help your member understand paperwork and program requirements. Our Support Brokers walk side-by-side with your member to ensure they are successful in achieving their goals.

With a commitment to collaborative partnerships, person-centered thinking, and the advancement of self-direction, we work with you to develop solutions that meet your unique needs.

Experts in Self-Direction

From our headquarters in Missoula, Montana, to every program across the country, our staff live in the communities where they work and understand the unique needs of members and their caregivers.

Our tools, technology, and services are designed with people in mind. We serve members and caregivers through Medicaid programs across the United States. We work with managed care organizations, state agencies, and other payors.

Click on a state to learn more about our current programs.

What Sets Us Apart

Experienced leadership 

We are led by an executive team that brings a combined 100+ years working collaboratively with state agencies and managed care organizations to provide exceptional support to members and their caregivers.

Leadership

Skilled local staff  

Our community-based offices are staffed with local program personnel who understand the area’s culture and blend their knowledge with determination to provide exceptional support statewide.

Locations

Proven expertise and collaboration

We have 30+ years of experience providing home- and community-based services and support all self-directed service models. We have proven expertise implementing programs, collaborating through innovative partnerships, meeting unique program requirements, and ensuring compliance.

Services

Certified Employee Owned

As a Certified Employee Owned company, our ownership structure recognizes caregivers as essential partners and protects the mission and integrity of care by ensuring that company decisions remain focused on people over profit.

Large or Small, Our Tools Fit Your Needs

Web Portal
Our secure, user-friendly web portal provides role-based access to on-demand reports and other useful information.
Electronic Visit Verification (EVV)
We are a flexible partner and can integrate any time capture portal or EVV system into our platform.
Universal Time and Expense Tracking
Our enterprise payroll and billing system ensures accurate and prompt payroll while preventing timesheet and billing errors.
Customer Support Systems
Our customer support systems track all communications, enabling efficient issue resolution and high-quality customer support.
Multi-Channel Communications
Call, text, chat, email, and mail communication channels are available, providing regular ongoing communication with members and their caregivers.
Provider Directory
The Provider Directory is an online platform that helps match members and caregivers in their region, whether rural or urban.
Training Resources
Training resources are provided in a variety of ways, from in-person to online. Resources are structured for new hires, continuing education, and other member needs.
Fraud Prevention Program
Our fraud prevention strategy is comprehensive, focusing on education, detection, and reporting to maintain the integrity of self-directed services.

Care by the Numbers

Caregiver Shifts Annually

0 M+

Clients Served*

0 k+

Employed Caregivers*

0 k+

Annual Payroll

$ 0 B+
*Numbers reflect a 12-month time period ending December 31, 2025

Why Self-Direction Works: Explore the Evidence

Don’t just take our word for it—see what the research says. These peer-reviewed studies and policy briefs highlight why self-direction is a proven, effective approach for home and community-based services. Explore these resources to learn how self-direction improves quality of life, empowers individuals, and strengthens care systems.

Select Topic +

Why Self-Direction Wins

Self-direction gives people the ability to remain in their homes and make choices about their care, which research shows improves independence and quality of life. Studies also link self-direction to better health outcomes and fewer avoidable hospital visits.

Citation: Institute on Community Integration. (2020). Evaluation of experiences with self-direction in New York State: A focus on sustainability. University of Minnesota. https://ici.umn.edu/products/LaP49B5GQnCk5nTrgIX2SQ 

Summary: This report evaluates self-direction programs in New York State, focusing on their long-term sustainability. It examines participant experiences, program outcomes, and challenges in maintaining self-directed services. The study provides insights into how state-level policies and infrastructure support or hinder the effectiveness of self-direction models for individuals with disabilities. 

Citation: DeCarlo, M. P., Bogenschutz, M. D., Hall-Lande, J. A., & Hewitt, A. S. (2019). Implementation of self-directed supports for people with intellectual and developmental disabilities in the United States. Journal of Disability Policy Studies, 30(1), 15–21. https://journals.sagepub.com/doi/abs/10.1177/1044207318790061 

 

Summary: This article examines the national landscape of self-directed support implementation for individuals with intellectual and developmental disabilities across the United States. The authors analyze state-level variations in program design, funding mechanisms, and administrative structures. The study identifies best practices and barriers to implementation, providing a comprehensive overview of how different states have adopted and adapted self-direction models. 

Citation: Yuan, Y., Thomas, K. S., Van Houtven, C. H., Price, M. C., Pizer, S. D., Frakt, A. B., & Garrido, M. M. (2022). Fewer potentially avoidable health care events in rural veterans with self-directed care versus other personal care services. Journal of the American Geriatrics Society, 70(5), 1498–1508. https://doi.org/10.1111/jgs.17656  

Summary: This study compares adverse event rates among rural veterans receiving home-based primary care in self-directed versus traditional agency-based models. The research analyzes safety outcomes, healthcare utilization, and quality indicators. The findings contribute to understanding the comparative safety and effectiveness of different home care delivery models for vulnerable populations in rural settings. 

Programs that support self-direction consistently cost less than institutional care, saving states and managed care organizations significant resources. Evidence shows these models are scalable and help rebalance long-term services toward more efficient, person-centered care.

Citation: Centers for Rehabilitation Research. (2025). The value of rebalancing long-term services and supports: Policy brief. Shirley Ryan AbilityLab. https://www.sralab.org/research/labs/cror/news/policy-brief-value-rebalancing-long-term-services-and-supports 

Summary: This policy brief makes the case for rebalancing long-term services and supports away from institutional care toward home and community-based services, including self-direction. It presents evidence on cost-effectiveness, participant outcomes, and quality of life improvements associated with community-based care. The brief provides policy recommendations for accelerating the rebalancing of LTSS systems at state and federal levels. 

Citation: Centers for Medicare & Medicaid Services. (2021, September). 1915(c) HCBS waiver payments and financing trends. U.S. Department of Health and Human Services. https://www.medicaid.gov/medicaid/downloads/hcbs-wavr-paymnts-financng-trnds-sept-2021.pdf 

Summary: The Centers for Medicare and Medicaid Services identify waiver payment trends finding that “Medicaid 1915(c) waiver costs were approximately $100,000 less per year per person than institutionalized care, projecting waiver costs to be 62% lower.” 

Edwards-Orr, M., & Ulyari, K. (2018). Long-term services and supports scorecard innovative and promising practices: Taking it to the next level: Using innovative strategies to expand options for self-direction. AARP Public Policy Institute. https://www.aarp.org/pri/topics/ltss/home-community-services/taking-it-to-the-next-level-using-innovative-strategies-to-expand-options-for-self-direction/?msockid=10e9bb4e66c866df3944ad6c674367cf 

Summary: This AARP report highlights innovative and promising practices in long-term services and supports expanding self-direction options. It provides case studies of successful programs and identifies strategies states can use to enhance participant’s choice and control. The scorecard assesses different approaches to self-direction implementation and offers recommendations for scaling effective practices. 

Self-direction programs may create paid opportunities for some family members and direct support workers, turning caregiving into a sustainable career. It also strengthens personal connections between caregivers and those they support, improving satisfaction for both.

Citation: Applied Self-Direction. (2023). Bridging the gap: Insights into strengthening the self-directed workforce. https://pb.appliedselfdirection.com/api/files/xdr1oqesscyfjmm/m63hpjgrontcirv/Self-Directed%20Workforce%20Report%202023.pdf 

Summary: This report addresses critical workforce challenges in self-directed services, examining recruitment, retention, and training of direct support workers. It analyzes barriers to building a stable workforce and identifies promising practices for workforce development. The report provides recommendations for policymakers and program administrators to strengthen the self-directed workforce through improved compensation, training, and support systems. 

Citation: Wendel, C. L., LaPierre, T. A., Sullivan, D. L., Babitzke, J., Swartzendruber, L., Barta, T., & Olds, D. M. (2023). “Anything that Benefits the Workers Should Benefit the Client”: Opportunities and Constraints in Self-Directed Care During the COVID-19 Pandemic. Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society, 42(4), 524–535. https://doi.org/10.1177/07334648221143604  

Summary: This qualitative study explores the perspectives of workers and clients in self-directed care arrangements. Through interviews, the authors identify opportunities for improving worker conditions and compensation while maintaining program flexibility and client autonomy. The research highlights the interdependence of worker satisfaction and client outcomes, arguing that investments in the direct-care workforce benefit both parties in self-directed relationships. 

Citation: Wolf, D. A. (2025). Public health’s roles in sustaining informal and family caregivers. Trust for America’s Health. https://www.tfah.org/wp-content/uploads/2025/09/TFAH-Caregiving-Brief-FINAL-1.pdf  

Summary: This policy brief outlines public health’s role in supporting informal and family caregivers. It identifies evidence-based interventions, policy approaches, and public health strategies that can strengthen caregiver capacity and prevent caregiver burnout.  

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