Self-Direction or Agency Services? Questions to Help Your Family Decide

Once someone is eligible for OPWDD services, one of the first real choices is how those services will be delivered. There are two broad paths, and many families end up with a combination of both.

The two paths, briefly

Agency services. A provider agency delivers the service. They hire, train, and schedule staff, run the day program, and handle the paperwork. You choose the agency and help shape the plan, but they run the day-to-day.

Self-Direction. You, or a family member acting for you, decide which supports to buy and who provides them. With employer authority, you recruit, hire, and supervise your own staff. With budget authority, you decide how your approved budget is spent. A Support Broker helps build the plan, and a Fiscal Intermediary handles payroll.

There is also a middle option: Agency-Supported Self-Direction, where you choose the staff but an agency handles more of the employer paperwork.

Questions to ask yourselves

1. Do you already know someone you'd want as staff?

This is often the deciding factor. If there is a neighbor, family friend, or former aide who already understands your family member, Self-Direction may let you hire them. Agencies hire their own staff. There are rules about which relatives can be paid; our FAQ covers the main ones.

2. How much flexibility does your family member need?

Agency schedules work well for people who do best with a set routine at a set place. Self-Direction can build a week around a person: a morning job, an afternoon class, a gym session with a staff member they trust.

3. Who will handle the management?

Self-Direction is real work. Someone reviews timesheets, finds a replacement when staff call out, and keeps the plan up to date. A good Support Broker lightens that load a lot, but it doesn't disappear. Be honest about how much time and energy your family has.

4. What happens when staff quit?

Staff turnover is a fact of life in this field. An agency covers gaps with other employees. In Self-Direction, you need a backup plan: a second staff member, family coverage, or respite. Families who plan for this in advance have a much easier time.

5. Are there programs you want that only agencies offer?

Some supports, like structured day programs or certified residential homes, are agency-run. A self-direction budget can include some provider-delivered services alongside self-hired staff, so this doesn't always mean choosing one path entirely.

You can change your mind

This isn't a permanent decision. Families move from agency services to Self-Direction, and back, as needs and circumstances change. Many start with one service self-directed and expand from there.

Where to start

Talk with your Care Manager about both options. If Self-Direction interests you, read our step-by-step guide and our page on what a Support Broker does.

Sources: OPWDD, Self-Direction; OPWDD Self-Direction Guidance (March 2022).