Montana's Self-Directed Personal Assistance Services (SDPAS) Program

Montana's Self-Directed Personal Assistance Services (SDPAS) is a Medicaid program designed for elderly or disabled residents that require in-home care service and wish to select their own personal care provider.   Individuals can receive care services from the state or they can elect to hire and train their own care providers who are then paid by the Provider Agency.  This type of self-directed care program is also referred to as cash and counseling, consumer direction or participant direction. 

One element of the Self-Directed Personal Assistance Program that is attractive to many families is that certain family members can be hired to provide personal care; they can be paid caregivers.  Although spouses, parents and legal guardians are not eligible, the adult children of aging parents and ex-wives or ex-husbands can be paid to provide personal care services.  To be clear, the Montana Medicaid Provider Agency is not obligated to hire family members, however given family members' emotional commitment to the individual in need of care, typically they make good caregivers and the state will hire them. 

During initiation and periodically during active enrollment in the Personal Assistance Program, a health care professional will assess the individual in need of care and determine the types and amount of in-home care they require.  The plan of care is developed or modified and the hired caregiver, their Personal Assistant, must follow this plan of care.

The individual self-directing their care is responsible for approving their Personal Assistant's timesheets.  The Provider Agency is responsible for reviewing the timesheets and making payments to the Personal Assistant.