How To Build Amazing Self Direction Programs That Actually Work (with guest Melody Wray)

This episode of Home Care Heroes and Day Service Stars features Melody Ray, Executive Director of ReSOARces, a nonprofit in Kentucky.  Melody discusses self-direction programs for individuals with intellectual and developmental disabilities. These programs enable participants to direct their care and lead more fulfilling lives.

The episode begins with host Ken Accardi providing a historical perspective on disability services, highlighting the shift from institutional care to programs that support individuals in their homes and communities. Self-direction programs represent a significant evolution, allowing participants or their authorized representatives to manage their care and services according to personal preferences.

Melody explains that self-direction, referred to as "participant-directed services" in Kentucky, is a Medicaid waiver program aimed at enabling individuals with disabilities to live independently. Participants can hire and manage their own caregivers, providing greater consistency and choice in their care. However, the complexity of managing these programs, which requires participants to take on responsibilities similar to running a small business, presents challenges.

The conversation highlights the administrative burdens faced by participants, such as hiring and vetting caregivers, conducting background checks, managing compliance with Medicaid regulations, and maintaining essential records. Case managers often struggle to support self-directed participants due to the extensive administrative work involved, leading some agencies to turn away potential participants.

Melody describes how ReSOARces addresses these challenges through its "community guide" service. Community guides assist participants by handling administrative tasks such as recruiting and training caregivers, managing compliance, and ensuring timely submission of required documents. This support streamlines the process, allowing participants to focus on their quality of life. ReSOARces also developed tailored processes to accommodate variations in requirements across different fiscal management agencies (FMAs).

The conversation underscores the benefits of self-direction programs, such as personalized care and greater independence, while acknowledging the difficulties in implementation. Melody emphasizes the importance of community guides in overcoming these barriers and enabling participants to succeed in self-directed care.

Ken and Melody discuss the broader implications of self-direction programs, noting their availability in various states and the growing demand for disability services. They also highlight the financial viability of these programs, citing reimbursement rates and the potential for organizations to "do well by doing good."

The episode concludes with Melody sharing insights on the growth of ReSOARces, which now supports over 60 participants with a team of dedicated community guides. She encourages listeners to persevere through challenges, emphasizing that impactful work will naturally lead to growth and recognition.

For those interested in learning more about Resources or the self-direction model, Melody provides contact details and invites engagement through their website and social media.

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