Participant-Direction in Health Payer Contracting for Centers for Independent Living

Participant direction (self-direction) allows people with disabilities to be in control of the services they receive by managing and hiring personal assistance service providers of their choice. Centers for Independent Living (CILs) are uniquely positioned to provide participant-directed services. Participant-direction is a natural fit for disability-led organizations such as CILs that support community independence and full participation. Health care payers are adopting self-direction to allow people with disabilities to direct services that address unmet service needs, creating resource development opportunities for CILs.

This technical assistance webinar will foster CIL operation of participant-directed service programs funded through Medicaid managed care organizations (MMCOs), accountable care organizations (ACOs), and other health payers. In this webinar, CIL leaders and staff will learn how they can work with managed care organizations (MCOs) and other health care entities to provide participant-directed services, as well as learn how to approach and negotiate with health payers to form these partnerships. Participants will know the following upon completion of the webinar:

  • Definition and Description of Participant-Direction: Webinar attendees will understand what self-direction is, the services typically offered, how individuals determine the services they receive, and how they hire and manage those who provide their services.
  • Self-Direction in CILs: How self-direction succeeds in the consumer-directed, disability-led operation of CILs.
  • Financial Management Arrangements: Attendees will understand the approaches most often used to arrange self-directed services to ensure the individual receiving services has control of how and by whom services are provided. Examples include the fiscal employer agent (FEA) and agency with choice models.
  • Services Purchased by Health Payers: Specific examples of services provided and contracted in CILs by payers.


  • Molly Morris, Vice President, Applied Self-Direction
  • Suzanne Crisp, Senior Advisor, Public Partnerships Group, LLC
  • Amber O’Haver, Chief Revolutionary Officer / Owner, Disability Revolution   
  • Moderator Richard Petty, Director, IL-NET National Training and Technical Assistance Center for CILs and SILCs


Resource: Slides

Resource: Transcript

Resource: Recording