California Participant Directed Services: What To Know Before You Enroll

Participant Directed Services is a model of care available through California’s Regional Center system for people with developmental disabilities.

The word “participant” refers to you, the person receiving services. And “directed” means exactly what it sounds like: you direct (or make decisions for) your own care.

In a traditional care model, a provider agency usually decides which worker comes to your home and when.

With PDS, those decisions belong to you. You choose who provides your support, you set the schedule that works for your life, and you supervise the people working with you.

Anyone who receives services through a California Regional Center is eligible for this program. If you’re already connected to your Regional Center, you can explore whether PDS is the right fit for you.

California allows several types of Individual Program Plan (IPP) services to be provided through the PDS model.

Respite provides family caregivers with a break from their caregiving responsibilities. It can be provided in the family home by a qualified person you trust, such as a family member or friend. This is especially helpful for families who need occasional relief without disrupting the routine and comfort of their loved one.

Day care covers care for a child while a parent is working. It can be provided by a family member, friend, or other qualified individual. PDS gives families the flexibility to use someone they already know and trust rather than relying solely on a formal day care setting.

Non-medical transportation helps you get to services listed in your IPP. This could include rides to therapy, appointments, or other program-related activities. The person providing transportation must have a valid California driver’s license and the insurance coverage required by your Regional Center.

Skilled nursing refers to services provided by a Registered Nurse or Licensed Vocational Nurse. When a Licensed Vocational Nurse is used, the care plan must be developed by a physician or Registered Nurse. Before using participant-directed nursing services, you must first use available generic services, including those covered through Medi-Cal.

Day services are individually designed services that support employment goals, volunteer activities, or post-secondary education in community settings. These services are built around your personal goals and are intended to be provided out in the community, not at home.

Your service coordinator at the Regional Center can help you understand which of your IPP services may be available through the Patient-Directed Services (PDS) model.

One of the biggest benefits of Patient Directed Services is the freedom to hire people who already know you and who you feel comfortable with. Here are some examples of people you may be able to hire:

A sibling, aunt, uncle, cousin, or another relative who you trust and who has the skills to support you can be hired as your worker. Note that a spouse or parent generally cannot provide certain services, such as respite or day care, so check with your service coordinator about the specific rules for each service type.

Someone you already have a relationship with and who understands your needs and routines can make an excellent care worker.

A trusted neighbor who is willing and qualified to provide support is also an option.

Anyone else who meets the program requirements can be hired, even if you don’t have an existing relationship with them. They do not need to be a registered Regional Center vendor.

There are a few requirements that apply to anyone you hire, regardless of who they are.

• They must be at least 18 years old
• They must be eligible to work in the United States
• They must have the skills, training, or experience needed for the specific service they will be providing

For example, if you are hiring someone to provide in-home respite, they are required to have CPR and first aid certification. This can be completed within 30 days of starting work, but it must be done.

Your service coordinator can help you understand the specific requirements for each service type before you make any hiring decisions.

Before a worker can start or be paid, they’ll need to submit several required documents to your Financial Management Services (FMS) agency for review and approval. This includes, but is not limited to: verification of age, proof of qualifications, and eligibility for employment. Your worker cannot begin providing services or receive payment until all required documentation has been reviewed and approved by your FMS agency.

When you participate in PDS, you take on the role of employer for the workers you hire. That comes with real responsibilities like processing payroll, withholding taxes, and managing employment paperwork. A Financial Management Services (FMS) agency supports you in that role so you don’t have to navigate it alone.

Working with an FMS agency is a required part of participating in PDS. They will help you with all of the following:

• Enrolling you and your workers in the program
• Training you to understand your responsibilities as an employer
• Processing payroll using your authorized budget
• Handling all employment-related taxes (federal, state, local, and unemployment)
• Coordinating required background checks and worker verifications
• Providing regular reports so you always know how many authorized hours you’ve used and how many remain

Your Regional Center has information about how to identify and connect with an FMS agency. The FMS agency must be approved and work in coordination with your Regional Center to authorize services before anyone can start work or receive payment.

Getting started with PDS is more straightforward than it might seem. Here’s how the process typically works.

Reach out to your service coordinator at your Regional Center and let them know you’re interested in Participant Directed Services. They’ll discuss which IPP services can be participant-directed for your situation and help you identify an FMS agency.

Once you decide to move forward, the Regional Center will send your information to your FMS agency to get the process started.

Your FMS agency will reach out to schedule an enrollment call for you and your workers and send you the necessary forms to complete.

The FMS agency assists in getting your workers (or your preferred vendor or business) into the system and ready to be paid.

Your FMS agency will walk you through the tools and processes you’ll use so the transition into PDS goes smoothly.

Your service coordinator creates a Purchase of Services (POS) and sends it to your FMS agency before your services can officially begin.

Once everything is in place, your FMS agency will confirm that you and your workers are cleared to begin. Services and payment for workers cannot start before this status is issued.

Once you’re enrolled, staying organized is key. Most FMS agencies provide digital tools to help you and your workers manage timesheets, track authorized hours, and stay on top of your budget. Electronic Visit Verification (EVV) is required by the California Department of Developmental Services (DDS) for most employees. EVV is typically handled through a mobile app that logs your worker’s time and confirms the visit took place. Your FMS agency will walk you through how EVV works and what’s expected.

You’ll also receive regular utilization reports showing how many authorized hours have been used and how many remain. Keeping an eye on these is important because workers cannot be paid for hours worked beyond what has been authorized.

Participant Directed Services is designed to give you real control over your care, and the good news is you don’t have to figure it out on your own. Your Regional Center service coordinator is your first call, and your FMS agency will be there to guide you through enrollment and beyond.

View the DDS Regional Center Directory to at https://www.dds.ca.gov/rc/listings/ to find yours.

If you’re in California and ready to explore PDS, Public Partnerships (PPL) is an FMS agency vendored with all 21 California Regional Centers. Our team is available Monday through Friday, 8:00 a.m. to 5:00 p.m. PT and supports participants in multiple languages.

Phone: 1-833-202-6175 TTY: 1-800-360-5899 Email: capds-cs@pplfirst.com

You can also visit the PPL website to fill out the CA PDS Referral Form and get the process started today.

PDS stands for Participant Directed Services, a model of care that allows individuals with disabilities to choose, hire, and supervise their own support workers rather than having a provider assigned to them. It is available through state Medicaid programs and, in California, is administered through the Regional Center system.

Participant Directed Services programs exist across the United States, though the program name, structure, and available services vary by state. In California, PDS is available through the Regional Center system for individuals with developmental disabilities.

Also on the PPL Blog: California Self-Determination Program (SDP): What It Is, Who Qualifies, and How To Enroll