Understanding the roles of your Care Manager, Fiscal Intermediary, and Broker

Starting Self-Direction can feel overwhelming—there are many people involved, and it’s not always clear who handles what. This simple guide explains each role and who to contact in different situations.

Self-Direction Broker

Your primary point of contact within Self-Direction.
A good broker guides you through the entire process and supports you continuously. They help you understand the rules, make decisions, and ensure your budget and services actually meet your needs.

They are responsible for:

• Completing the Start-Up process with you
• Creating a personalized Self-Direction budget
• Adjusting the budget when needs change
• Helping you find and hire self-hired staff (Respite, ComHab)
• Identifying appropriate classes, memberships, programs, and activities
• Getting FI approval for services and purchases
• Supporting reimbursements and helping families submit documentation correctly
• Training and supporting you and your Circle of Support
• Assisting with ongoing updates, budget changes, and annual documents

Contact your Broker when:

• You want to explore new services, classes, or activities
• You need help finding, hiring, or scheduling a worker
• You need to adjust your budget or check what is allowable
• You have questions about Self-Direction rules, reimbursements, or next steps
• Anything in your plan or needs changes

Care Manager

Your main point of contact for coordinating services that support the Life Plan.
Care Managers help ensure the Life Plan matches the person’s needs and that all supports—community providers, medical services, benefits, and OPWDD services—are connected correctly. They do not manage Self-Direction; they support the overall care coordination.

They are responsible for:

• Supporting OPWDD eligibility and required assessments
• Creating and updating the Life Plan
• Holding Circle of Support meetings (at least twice a year)
• Making referrals to medical, behavioral, therapy, and housing services
• Assisting with Medicaid, SSI, SNAP, HEAP, TANF, etc.

Contact your Care Manager when:

• You need referrals (medical, therapy, behavioral, housing)
• There are changes to needs, diagnosis, or family situation
• You have questions about Medicaid or government benefits
• You need updates made to the Life Plan

Fiscal Intermediary (FI)

The financial administrator and employer of record for your self-hired staff.
They handle payroll, reimbursements, and make sure spending follows OPWDD rules.

They are responsible for:

• Processing payroll for self-hired staff (Respite, ComHab, SEMP, etc.)
• Reviewing and processing receipts and reimbursements
• Ensuring your budget is used correctly and according to rules
• Overseeing hiring paperwork and background checks for staff

Contact your FI when:

• You want to hire, onboard, replace, or remove a staff member
• There are payroll, timesheet, or payment issues
• You have questions about receipts, documentation, or reimbursement status