Consumer Directed Services (CDS) gives individuals more control over how their in-home care is arranged and delivered. Instead of services being fully managed by an agency, the individual or their designated representative can decide what services are needed, when they are provided, and who delivers them. This option is designed for those who are able and willing to take on responsibilities such as hiring, training, and supervising their caregiver, while still receiving administrative support for payroll and program requirements.
Getting Started
- Step 1: Choose a Financial Management Services Agency (FMSA) to support payroll and administrative requirements.
- Step 2: Complete an initial meeting with the FMSA to review program rules, required forms, and employer responsibilities.
- Step 3: Recruit and hire a caregiver of your choice, including a family member or trusted individual, if allowed.
- Step 4: Set a work schedule based on your approved service plan and authorized hours.
- Step 5: Train your caregiver on your specific care needs and daily routines.
- Step 6: Submit timesheets and required documents to the FMSA for payroll processing.
- Step 7: Stay in contact with your service coordinator or case manager for ongoing support and required reviews.
Support Advisor
- A support advisor may be available to help explain employer responsibilities and program requirements
- This support is only offered under certain programs
- A list of qualified support advisors can be accessed through the appropriate state resources
Responsibilities of a Financial Management Services Agency (FMSA)
- Provide payroll and financial management services for the employer or designated representative
- Offer initial orientation and ongoing administrative guidance
- Verify basic caregiver qualifications before services begin
- Process timesheets, payroll, and required tax withholdings
- Track service budgets based on the approved care plan
- Maintain compliance with state and program requirements
How the Consumer Directed Services Option Works
The Choices
Texas offers different ways to receive home and community-based services depending on how much involvement you want in managing care. Individuals can choose between directing their own services or having an agency manage them.
Available options include:
- Consumer Directed Services (self-managed)
- Agency-managed services
Each option carries a different level of responsibility. The CDS option places more day-to-day management on the individual or their representative, while agency-managed care shifts those responsibilities to the provider.
Key Responsibilities Under CDS
When choosing CDS, the individual or designated representative is responsible for:
- Recruiting, hiring, and training caregivers, including backup workers if needed
- Setting schedules based on approved service hours
- Determining pay rates within program limits
- Managing day-to-day supervision and resolving workplace issues
- Keeping required employment records
- Arranging backup care when the primary caregiver is unavailable
Role of the FMSA in CDS
The selected FMSA supports the process by:
- Processing payroll and timesheets
- Handling required tax payments and filings
- Managing receipts, invoices, and budget tracking
- Acting as the employer’s agent for required financial functions
Consumer Directed Services (CDS) Option Details
- The FMSA provides guidance on how to hire and manage caregivers within program rules
- Budget amounts are based on the approved service plan and must be followed when setting pay and hours
- Limited funds may be used for employer-related expenses necessary to manage services
- If needed, the individual can appoint a designated representative to help manage responsibilities
Take The Next Step In Care
For more information, contact us to discuss your care needs. Details will be reviewed to determine appropriate services and coverage. Next steps will be provided for care planning.