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Self-Determination and Self-Directed Supports in Wisconsin's Long-Term Care Programs

Although the terms self-determination and self-directed supports (SDS) are often used interchangeably, they are actually two distinct concepts with unique implications.

Self-determination, being the broader of the two elements, refers to the individual having control over all aspects of his or her life, and exercising basic rights such as citizenship, liberty, and the pursuit of happiness. This definition impacts activities beyond the scope of long-term care services.

Core Values of Self-Determination

Self-directed supports (also referred to as "consumer-directed" supports) are a facet of the larger self-determination philosophy. Stated simply, participants in long-term care programs actively direct the supports and services being provided. The term self-directed supports refers to a wide range of approaches designed to maximize choice and control for people who use long-term care services and supports. People who self-direct are able to hire, supervise, and dismiss their own direct care workers. SDS involves many other elements as well, including control of one’s own budget for services, choice of services and supports, and decision-making authority. Though frequently used for in-home care, SDS can be used outside of the home as well for services such as transportation and supported employment.

Wisconsin has several programs available to people who want to self-direct their own services and supports.

Last revised April 13, 2023