Are Traditional or Self-Directed Services right for you?

Are Traditional or Self-Directed Services right for you?

PICS wants you to choose the service option that’s best for you based on your personal situation. While there are similarities between Individualized Home Supports* (traditional services) and CDCS/CSG (self-directed services), there are some key differences that may make one a better choice for you.

*Formerly Personal Supports & Respite

Service Similarities

Both services follow the same assessment, require Medical Assistance (MA) eligibility with the county, and offer the following:

  • Access to PICS portal, processes and service-forward philosophy
  • Sick & Safe leave benefits (where applicable)

Service Differences

Understanding the differences between Individualized Home Supports and Consumer-Directed Community Supports / Consumer Support Grant (CDCS/CSG) in the chart below is key to making the best decision for you and your family.

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Your Allocation, Services & Fees

Individualized Home Supports
(traditional services)

You receive the total allocation for services. Fees are built into the service (see below).

Vocational services (such as day support services) are paid through a separate funding source.


Fees are built into the service.

PICS sets wage rates so that fees are already covered. This means your full allocation of units can be used for staffing.

Authorized services.

You are issued a set amount of units for staffing for the year that must be monitored closely.

Services are issued in units of 15-minute increments. Although you have less flexibility in how much you can pay staff, you might have more staffing hours.

(self-directed services)

Your service allocation is calculated by using a formula developed by the state, according to federal waiver authority for each program. This is the total amount available to you to purchase eligible goods and services, including the costs of all waiver services and MA home care services.

A percentage of your budget, tied to wages, pays for service fees and employer costs.


Flexible spending.

You can choose how and when to use your allocation within program guidelines and approval from your case manager.

Services are issued in dollar amounts.

This results in more flexibility regarding wage rates, but it might mean fewer total staffing hours.

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Developing Your Plan

Individualized Home Supports
(traditional services)

You work directly with PICS Service Coordinator during annual service planning meetings at your home to ensure you are getting the services that are right for you.


(self-directed services)

You develop your plan to set services for the year, either by yourself or with a support planner. When complete, you submit your plan to your case manager, who sends the approved plan to PICS. Your PICS Service Coordinator then creates a budget for the approved plan to fit your annual allocation, usually working with you online, via email or by phone.

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For Your Employees

Individualized Home Supports
(traditional services)

PICS is the employer and provides the following for all workers: 

  • Contributes to Social Security
  • Pays Employer Federal/State taxes
  • Covers Workers Compensation insurance

Eligible for federal and state unemployment


Fixed pay rate.

PICS sets the pay rate.

Full time employees are eligible for health benefits through PICS, including an HSA program.

PICS provides required training. Workers are paid to complete required training.

Workers do not accumulate Paid Time Off (PTO).

(self-directed services)

The participant is the employer, and employment benefits are paid through the annual budget. Parents and spouses providing services are exempt from the following benefits due to the relationship with the Participant:

  • Social Security
  • Federal and State Unemployment Workers Compensation (option to purchase)

Flexible pay rate.

Managing party chooses the wage rate, within program guidelines.

No medical benefits are available through PICS.


Training is handled by the Authorized Representative and can be paid for through the annual budget.

Workers accumulate Paid Time Off (PTO).


Contact us to discuss your specific needs.

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