- Louisiana's self-direction option allows participants in the New Opportunities Waiver program to directly hire, fire, and manage their own support workers. Currently 1.8% of waiver participants use self-direction. - Acumen serves as the fiscal agent, handling payroll, taxes, training tracking and other administrative functions to support self-direction. - Surveys found high satisfaction rates with both self-direction services and Acumen's fiscal management. The state aims to expand self-direction to more waiver programs.

1. NASHP State Health Policy Conference October 2010 Julia Kenny Assistant Secretary Office for Citizens with Developmental Disabilities Louisiana Department of Health and Hospitals