County Administrator Perspectives on the Implementation of Self-Directed Supports

Self-directed supports are a program or service option in which individuals with Intellectual and Developmental Disabilities (IDD), their families, and their allies directly manage their supports. This study explores the perspectives of county-level administrators in the implementation of one state's self-directed support option for people with IDD. Perspectives of local-level administrators are important as they have key leadership roles concerning policy, program implementation, and program accountability. As the prevalence of self-directed supports increases, it is important to understand both the successes and challenges faced by local administrators as they implement this service option. A qualitative research methodology was used for this study, following a grounded theory analytic approach. In-depth semi-structured telephone interviews were conducted with county directors of Developmental Disability Services as the primary source of data for this study. Analysis of the semi-structured interviews with the county-level administrators and staff revealed both successes and challenges with the self-directed waiver option. Many county administrators cited changes in professional philosophy, improved quality of life, higher staff quality, and lower costs as major sucof the self-directed waiver option. Challenges of the self-directed waiver option consisted of need for clear policy guidelines, program changes, and monitoring of outcomes. The results of this study illuminate both the successes and chalof self-directed service implementation for individuals with IDD from the perspectives of the local adminwho are responsible for the direct management of programs for individuals with IDD. This research presents important implications for the design, implementation, and modification of future self-directed initiatives.