Learn more about our Homes with Heart capital campaign at HCSHeart.org

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We’re entering a time when Medicaid itself is being redesigned, meaning how services are coordinated – and what it will pay for – continues to change. Heritage Christian Services is adapting and innovating so it can always provide services to people in need.

Self Directed Services

HCS is a leading community services agency providing greater choice and flexibility in things like respite, supporting people in meaningful day activities and in their home and community life.

As Medicaid continues to change, people will have the option of choosing what supports are most important and which agency they would like to work with. HCS has already built the infrastructure for the new way Medicaid will be doing business with agencies. In fact, HCS supports more than 1,600 people with self directed plans/budgets, with more than 1,200 self-hire employees. We employ the only Master Broker trainer for the Finger Lakes region.

For people exploring options other than a traditional group home or day habilitation setting, the agency offers customized options where people choose who they would like to live with – if anyone – and select the supports they would like to have in their home.

In the graphic below, we’ve outlined the route a person can take to receive traditional services, if there are opportunities available, and the route to creating a self-directed or individualized plan.


Our work in practice

One woman lives at home with her family but could not find a nearby day program that would support her physical needs and provide the kind of intellectual stimulation that she craves. Through her individualized plan, she has direct care staff for 40 hours a week so she can travel to see occupational and physical therapists, swim at a community pool and visit the library.

One gentleman lives in an apartment where staff is on call when he needs them. He meets with someone one time each week to work on building social skills, attends a day program two times a week to work on technology skills, is learning to use public transportation and is taking adult education classes, where he can learn more about some of his hobbies. Health and fitness are important to him, so he uses a portion of his budget for a gym membership.

Self Direction Q&A

What are the roles of a broker and a fiscal intermediary?

A broker engages in person-centered planning and supports families in creating a self-directed plan to meet the annual needs of their loved ones. The broker works in conjunction with a care coordinator and the person’s circle of support. The broker works closely with what’s called a fiscal intermediary. A fiscal intermediary helps manage the Medicaid money that’s associated with a person’s self-directed plan/budget and supports individuals to recruit and hire their own staff. Once the self-directed plan/budget is approved, the broker is charged with helping carry out the plan and with making modifications as needed.

How will that be different than what I’m used to?

People with disabilities, along with their circles of support or planning teams, will be in the driver’s seat, actively making decisions for their lives and directing their services. Heritage Christian has always worked toward treating people with dignity and encouraged as much independence as possible. This process helps standardize that.

Why would I choose self direction?

In addition to giving you greater choice and control, a self-directed plan may include unique options such as:

  • Gym memberships
  • A wide range of classes
  • Camps accredited through the Department of Health
  • Hiring your own staff
  • Rent subsidies and housing supports
  • Computer software
  • Therapies such as art, music and massage
  • Reimbursement for internet and cell phone
  • Other items that may help increase independence

How do I get started?

Contact your care coordinator. The care coordinator will complete a referral for you. Once the referral is approved, you will be given a list of brokers and fiscal intermediary providers to choose from and partner with to begin your customized plan.

If you’re not sure what services you’re interested in, fill out this form to contact our resource adviser.

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If you have questions that have not yet been answered, please contact us at info@heritagechristianservices.org.