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Understanding Self-Directed Support Enrollment

What You Need to Know as An Employer

Self-Direction. Participant-Direction. Consumer-Direction. Self-Determination.

Regardless of what it is called in your state, these phrases represent a long term-care option for Medicaid eligible individuals and their families that puts them in control.

Self-directing allows you to have control over the support you receive. You get to decide who delivers that support. Now that you have chosen to use self-direction, we must set you up as an employer so you can hire the care/support worker(s) of your choice.

We know that enrollment and the paperwork involved can be confusing and challenging. Our team is here to help you through every step of the enrollment process. In this blog, we address the most common questions and concerns we hear from people receiving self-directed support.

What is Enrollment in Self-Direction?

Enrollment is the process of getting set up with self-direction in your program and with your FMS provider such as PPL. The enrollment process collects, reviews, and verifies all required paperwork and information so you can hire and pay people to provide your care.

An FMS provider, such as PPL, helps you with the following:

  • Prepares you for your role as an employer.
  • Performs background checks on your care/support workers.
  • On your behalf, pays your care/support workers’ payroll taxes.
  • Pays care/support workers and for support services, if applicable.
  • Gives you tools to manage your budget and approve your care/support workers’ time sheets.

Why is Self-Directed Enrollment Important?

The Self-Directed Employer and/or their Representative will be running a small business. The enrollment process gets the business started and the care/support workers working. You will be:

  • Hiring the care/support workers to provide support, who will be employees
  • Supervising the care/support workers
  • Approving timesheets so care/support workers get paid

Why are the Enrollment Forms Required?

The enrollment forms are required because federal and state governments require that certain information is provided to our PPL team so that we can:

  • Get a Federal Employer Identification number for you.
  • Get your care/support workers approved to work.
  • Pay your taxes and do tax reporting on your behalf.
  • Complete care/support worker payroll.
  • Report back to the state on the services you receive.

We know that there are a lot of forms to fill out and that you have to provide a great deal of information. All of this information is required because state and federal funds are used to provide self-direction (sometimes called participant direction) and there are rules relating to how this money is used.

How to Prepare for Self-Directed Care Employer Enrollment

The more prepared you are, the easier and faster this process can be. Remember to read anything given to you by your program or PPL – write down any questions you have and call your PPL representative for answers.

To prepare for self-directed care employer enrollment, we recommend that you:

Identify 1 or 2 care/support workers to help you before you start enrollment:

  • In many cases your enrollment can’t be completed until you have identified a care/support worker or possibly two.

Work with your service coordinator. They can:

  • Help you understand the rules you need to follow.
  • Provide you with documentation that defines what your care/support workers will do. In some states this documentation is called a spending plan, but it may have a different name, such as a support plan or plan of care.
  • Help identify who the Employer will be. The Employer might be you or someone else who is helping you.

Collect key information about yourself, including:

  • Your full legal name, address, Social Security Number, and possibly your Medicaid number.
    If you already have a Federal Employer Identification Number (EIN), look it up and have it ready.
  • Any information your state requires, which your service coordinator can help you with.
  • If someone other than you will be the Employer, they will need to provide information about themselves.


Smiling woman sitting in kitchen on the phone with paperwork


We Work with You to Make Enrollment as Easy as Possible

This list makes it easier for you to have a smooth enrollment experience.

  1. Provide clear documents.

    Please review your documents to make sure they are clear and easy-to-read. We cannot guess at the information on your documents. Unclear documentation requires us to follow-up with you and may require you to resubmit them, causing a delay.

    Do not send documents that are fuzzy, dark, cut off, or warped. As well, do not use whiteout to fix mistakes - documents with whiteout are considered invalid.

  2. Carefully review your documents for errors before you give them to us.

    Take the time to double-check your documents. Make sure every field is completed, the right boxes are marked, and that you have signed and initialed where required. We cannot correct your documents for you. It always helps to ask a trusted family member or friend to review your documents to make sure they are error-free.

  3. Make sure we can contact you.

    If we can’t communicate with you, you may experience a delay in enrollment. 
    • Make sure your phone works and that you have voicemail set up. Make sure your voicemail is not full, that you know the password, and that you check your voicemail daily.
    • If you have an email address, make sure you can check it. Make sure the email address you provide us is correctly spelled.
    • Check your email daily.

How long does the enrollment process take?

On average it can take anywhere from a few days up to 3 weeks for your care/support workers to be approved and for the enrollment process to be completed. It will take longer if you give us documents that are incomplete, hard to read, missing information, or have other errors. We can only start the enrollment process once we have all your required documentation.

How Do I Support My Care/Support workers In Getting Enrolled?

The best way to support your care/support workers in getting enrolled is to remember that you are their hiring supervisor.

Remember that part of our role is to help you get your chosen care/support workers enrolled as employees. Ask us any questions that you have!

Keep in mind that each state or Medicaid program has its own care/support worker enrollment requirements.

Expect your worker to ask you about:

  • The information they need to provide, such as documentation like:
    • Their official identification, such as a driver’s license.
    • Their Social Security Number or birth certificate.
    • Proof of education or other required certification as determined by your program rules.
  • The training and certification required to provide services, if required.
  • Signing their documents that you (or your representative) as the employer need to sign.

What options do I have for filling out this required paperwork?

Now that you have all your required information, you’re ready to enroll in the FMS selected by your self-directed program.

We offer you three ways to enroll with PPL. Please note that your state might not support each PPL enrollment option.

  1. Online enrollment using the Internet.

    Use the BetterOnlineTM or My Account web portal, which gives you a step-by-step process through enrollment. Our online enrollment process ensures we have all the information required from you. Your information is reviewed and validated online, allowing you to make corrections immediately.
    Note: This is available in only select programs and requires access to a computer.

  2. Paper-based enrollment.

    PPL mails you, your representative (if applicable), and care/support worker, the required paperwork. We may meet with you in-person to help you fill in and review these documents, if available in your state. If an in-person meeting is not available, we provide detailed instructions to assist you and as always are happy to help you over the phone.

  3. Phone-based enrollment.

    The phone-based enrollment process is conducted over the phone. If you have a computer, some steps can be done online during this phone call. After the meeting, you either mail or fax us all the required paperwork.

The enrollment process may be delayed by factors outside of our control, such as waiting for the IRS to process paperwork or the completion of background checks.

Our goal is to get you enrolled as quickly and easily as possible. We will contact you with any issues so we can get them resolved and are happy to answer any questions you may have!

What if I have problems with enrollment? What should I do?

Contact us. We are here to support you.

Depending on your program, you may have a Support Broker or Enrollment Specialist from PPL who is working with you. These people are your best resource for assistance.

Customer service agent at a desk with headset on and smiling at the camera Male customer service agent sitting at a desk with a headset on smiling at the camera

Contact us to talk about enrollment and learn how we can help you get enrolled for self-directed care. Our phone numbers and emails can be found here, you can also chat with us online, or reach out on our social media accounts.