Self Direction

Self direction person holding house icon

Self Direction

Choice and control for people living with disabilities

  • Participant Direction
  • Consumer Directed Services
  • Community Living Program
  • Veterans-Directed Home and Community Based Services
  • Consumer Direction
  • Consumer Direction Option

What is Self Direction?

Self direction is a model of long-term care service delivery that expands individual choice and control. Participants in self direction programs regularly hire their own workers and make decisions about how to use individually budgeted funds for long-term care services and supports. You may know of self direction by a different name, such as:

Self direction offers participants choice of and control over their long-­term services and supports. As choice and control increase, so do certain fiduciary responsibilities, including those associated with being an employer, managing funds for services, and handling payroll and employer-­related taxes and insurance.

Financial Management Services

Self direction programs use Financial Management Services (FMS) to support regulation, tax, and budget compliance. FMS is focused on ensuring tax compliance and upholding program rules so participants can focus on managing their long-term care supports. Depending on the FMS model used, an FMS provider may be called a Fiscal/Employer Agent, Agency with Choice, Consumer-Directed Services Agency, Fiscal Intermediary or Fiscal Support Entity. These are our clients and they know FMS is complex work.
is used for FMS providers to perform their daily operations with streamlined accuracy.
provides FMS providers a leg up on the best policies, procedures and internal controls for their Fiscal/Employer Agent services.
subscribers enjoy regular tax, labor and best practice updates and consulting help specific to FMS in participant direction.
prepares Schedule R for Forms 940 and 941 easily and for free.




Annkissam is proud of our experience with self direction and Financial Management Services (FMS). Mollie Murphy, CEO of Annkissam, has been honored to work with the National Resource Center for Participant-Directed Services (NRCPDS) since 2008. NRCPDS and Mollie put on the National Financial Management Services Conference in 2009, 2011, 2013 and another is planned for 2015. Working with federal agencies that support participant direction, the Internal Revenue Service and the Department of Labor, Mollie and Annkissam have developed deep expertise in FMS.

How can we help your FMS operations? Let us know at