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We work with stakeholders to support self-direction programs across the country. Our consulting clients include federal, state, and local government agencies, Medicaid Home and Community-Based Services (HCBS) providers, and advocacy organizations. We also regularly partner with other consultancies to provide subject matter expertise on self-direction.

Services we provide

Program Design
Policy Analysis
Readiness Reviews
Waiver Reviews
Focus Groups
Environmental Scans
Handbooks and Toolkits

Expert guidance tailored for

State Agencies & Managed Care Organizations

Our team has decades of experience providing technical assistance to states on program design and implementation, including:

  • Designing self-directed services in a 1915(c) waiver or other Medicaid context
  • Presenting educational sessions on best practices from other programs
  • Facilitating stakeholder engagement and focus groups to identify programmatic strengths and weaknesses
  • Developing program documentation, such as participant handbooks and policy manuals
  • Creating training curriculums for case managers, support brokers, and participants
  • Drafting Scope of Work requirements for Financial Management Services and Information and Assistance to align with payer needs, compliance obligations, and nationally recognized best practices

Financial Management Services (FMS) Entities

Our customized consultations and trainings facilitate professional development and help organizations deliver quality assistance. Frequently requested topics include:

  • Federal and state tax compliance
  • FMS readiness reviews
  • Development of budget and spending plan templates
  • Support with program and vendor transitions
  • Analyzing new governmental policies for impact on FMS compliance obligations


Our work with key players includes projects for national membership organizations, community-based agencies, research centers, federal agencies, and advocacy groups. Sample projects include:

  • Designing self-direction training for people and families who self-direct
  • Convening national executive roundtables to inform policy recommendations
  • Creating guidebooks featuring case studies of different program structures
  • Facilitating focus groups to connect and engage families with lived experience
  • Presenting research findings to national advisory boards
  • Partnering with other consultancies to support states with redesigning self-directed services

Applied Self-Direction can help!