Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

M. P. DeCarlo, M. D. Bogenschutz, J. A. Hall-Lande, A. S. Hewitt

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Self-direction is an approach to human service delivery within long-term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with intellectual and developmental disabilities. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships, as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

Original languageEnglish (US)
Pages (from-to)11-21
Number of pages11
JournalJournal of Disability Policy Studies
Issue number1
StateAccepted/In press - Jan 1 2018

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Development of this article was supported by Grant #90RT5019-01-01 to the Research and Training Center for Community Living from the National Institute on Disability Independent Living and Rehabilitation Research, U.S. Department of Health and Human Services. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not therefore necessarily represent official National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) policy.


  • consumer direction
  • HCBS waiver services
  • intellectual and developmental disability
  • qualitative research
  • self-direction

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