Self-Direction and FMS in California

All states: self-direction map

California self-direction at a glance

Last verified against state sources: 2026-10-13.

Which Medicaid programs in California offer self-direction?

California has no single self-direction program. Four programs let a person choose and direct their own workers: In-Home Supportive Services (IHSS), Waiver Personal Care Services (WPCS), the Self-Determination Program (SDP) and Participant-Directed Services for regional center consumers. They are run by three different state departments, and they handle payroll in very different ways. Only the Self-Determination Program gives the participant a budget to manage.

• In-Home Supportive Services (IHSS): serves aged, blind and disabled Medi-Cal beneficiaries of any age, children included, who live in their own home. It is run by the California Department of Social Services (CDSS) with county IHSS offices, and the county assesses need and authorizes hours. IHSS is funded through four subprograms: the Community First Choice Option (CFCO), the Personal Care Services Program (PCSP), the IHSS Plus Option (IPO) and IHSS-Residual (IHSS-R). The recipient has employer authority: the recipient hires, trains, supervises and can fire the provider. The county authorizes hours, not a dollar budget.
• Waiver Personal Care Services (WPCS): a service under the Home and Community-Based Alternatives (HCBA) Waiver, a 1915(c) waiver for adults and minors who would otherwise need facility level care. It is run by the Department of Health Care Services (DHCS) through HCBA Waiver Agencies, or by DHCS directly where there is no Waiver Agency. Hours are authorized by the Waiver Agency care management team. We did not confirm from a DHCS source who is formally the employer of an individual WPCS provider.
• Self-Determination Program (SDP): serves people of any age with intellectual and developmental disabilities who receive regional center services. It is run by the Department of Developmental Services (DDS) through the state's 21 regional centers, under a 1915(c) waiver and Welfare and Institutions Code section 4685.8. It has been open to all eligible regional center consumers since July 1, 2021. The participant has both employer authority and budget authority, with an individual budget and a spending plan.
• Participant-Directed Services: an option for regional center consumers who live in their own or family home and are not in the Self-Determination Program. It is run by DDS through the regional centers. The consumer or family chooses, schedules and supervises the worker. The regional center approves the amount of service and sets the rate, so there is no participant-managed budget. A DDS summary from October 2020 lists respite, day care, non-medical transportation, skilled nursing and day services. We did not confirm the current service list.

Employer authority means the person recruits, hires, schedules and supervises the workers. Budget authority means the person also manages a set amount of money for services. CMS approved a five year renewal of the Self-Determination Program waiver on September 2, 2026, effective July 1, 2026 through June 30, 2031.

Who handles financial management services (FMS) in California?

It depends on the program. IHSS and WPCS have no FMS vendor, because the State issues provider pay. In the Self-Determination Program the participant must use a financial management service (FMS) vendored by a regional center, and chooses one from a DDS list of 29 providers. Participant-Directed Services also require an FMS agency, but we did not find a published vendor list for that option.

An FMS is the organization that handles the money side of self-direction. It pays workers and other providers, withholds and files taxes where there are employees, and keeps the records the program requires.

• IHSS: the recipient is the provider's employer. The State issues provider payments and withholds applicable taxes through its Case Management Information and Payrolling System (CMIPS). Hourly wage rates vary by county, because unions negotiate with the employer of record in each county.
• WPCS: there is no FMS vendor. Individual WPCS providers record their time in the same CDSS timesheet systems that IHSS providers use. We did not confirm the payroll details or the legal employer from a DHCS source, so ask the WPCS Hotline at (916) 552-9214.
• Self-Determination Program: the FMS pays all providers directly. It does not control the individual budget or the spending plan. Since July 1, 2022 the regional center pays the cost of the FMS outside the participant's individual budget.
• Participant-Directed Services: the FMS agency pays the worker and the taxes after the family approves the timesheet. A respite agency can act as the FMS and be the employer of record.

In the Self-Determination Program the participant also picks one of three FMS models, and the model decides who the legal employer is. DDS describes them in its FMS models comparison chart. That chart dates from 2021 and still says the FMS cost comes from the individual budget, which is no longer the case.

• Bill Payer (also called fiscal agent): the FMS pays bills from businesses and vendors. The business or vendor is the employer of the people who deliver the service.
• Co-Employer: the participant and the FMS share the employer role.
• Sole Employer (also called fiscal/employer agent): the participant is the direct employer, and the FMS handles payroll and taxes as the participant's agent.

The DDS FMS contact list named these 29 providers at our last check, grouped here by the models each one offers:

• Bill Payer, Co-Employer and Sole Employer: AAA FMS, AbleRoot, Accura FMS, ACE FMS, Action FMS, AID FMS LLC, Arch FMS, Inc., Balance FMS, Cambrian FMS, C&T Home Care LLC, Dromen FMS, FACT Family, GT Independence, HR Alliance, Ridgeline FMS, Ritz FMS Inc. and Sentinel Four.
• Bill Payer and Sole Employer: Acumen FMS, Blessed FMS Inc., Mains'l, Public Partnerships LLC (PPL) and SequoiaSD.
• Bill Payer and Co-Employer: Aveanna Support Services (formerly Premier Healthcare Services).
• Bill Payer only: Community Interface Services (CIS), Essential Pay (doing business as Casa Fiscal), FMS Pay LLC, Home of Guiding Hands, STRO FMS and TrueCare FMS.

The list is statewide, and not every FMS serves every regional center. Ask the regional center which FMS providers are vendored in its area before choosing.

Who can be a paid caregiver under self-direction in California?

Family members can be paid in every California program, but the rules for spouses and for parents of minor children differ by program. IHSS allows a spouse to be paid for some services and, in three of its four subprograms, allows a parent of a minor to be paid. WPCS pays parents of minors and spouses only for extraordinary care. The Self-Determination Program does not pay legally responsible persons for care they would normally provide.

• IHSS, parents of minors: under CDSS All County Letter 23-106 (December 21, 2023), minor recipients in CFCO, IPO and IHSS-R may hire any enrolled provider, a parent included, with no test of whether the parent is available or employed. Parents of minors in PCSP still cannot be paid because of a federal rule, so counties are told to place a child whose family wants a parent provider in one of the other three subprograms. Providers of minor recipients are paid only for domestic services, personal care, accompaniment to health-related appointments, protective supervision and paramedical services.
• IHSS, spouses: an able and available spouse is presumed to provide services without pay, except personal care and paramedical services, which can be paid. A spouse may also be paid for medical accompaniment and protective supervision only if the spouse left full-time work, or cannot take it, because no other suitable provider is available.
• WPCS: a parent of a minor member, or a member's spouse, may be a paid WPCS provider only for extraordinary care written into the Plan of Treatment, under DHCS policy letter HCBA PL 24-003. A broader COVID-era allowance expired on November 11, 2023. A parent of a minor cannot be paid for adult companionship. A spouse can be paid for it only after leaving, or being kept from, full-time work. A designee who is not a dependent of the paid parent or spouse must sign the timesheets.
• Self-Determination Program: legally responsible persons (generally parents of minor children, a spouse, or a court-appointed guardian of a minor) cannot be paid for services they would normally be responsible to provide. A parent of an adult may be paid, including a parent who is the adult's conservator or holds power of attorney. Workers hired by the participant for direct personal care need a criminal background clearance before they start, except family members who live in the participant's home.
• Participant-Directed Services: a family member or friend may be hired, but the 2020 DDS summary says a spouse or parent generally cannot provide respite, day care, personal assistance or independent living skills.

IHSS and WPCS also cap weekly hours. Providers are paid overtime above 40 hours a week. A provider who serves two or more recipients may work up to 66 hours a week. A provider who serves one recipient may work up to that recipient's weekly maximum, which is 70.75 hours at the 283 hour monthly cap. Up to 7 hours a week of travel time between recipients is paid. Two IHSS exemptions allow up to 90 hours a week or 360 hours a month, and going over the limits brings violations that can end provider eligibility for up to one year.

Does EVV apply to self-directed workers in California?

Yes. Electronic visit verification (EVV) applies to self-directed workers in California, but each program does it differently. IHSS and individual WPCS providers must use the State's own CDSS timesheet systems, and no outside EVV system is allowed. Self-Determination Program workers use the FMS system, the state CalEVV system or a certified alternate system, and there is no state claim check that ties payment to a matched visit.

• IHSS and WPCS, systems: providers use the Electronic Services Portal, the Telephone Timesheet System or the optional IHSS EVV Mobile App, as described on the CDSS EVV help page. A provider who serves one person under both IHSS and WPCS checks in and out separately for each program.
• IHSS and WPCS, check-in and pay: since July 1, 2023, providers who do not live with the recipient check in and out with their location. Live-in providers are exempt and may self-certify with form SOC 2298. The CDSS location services FAQ says pay is based on the hours reported on the electronic timesheet, not on the span between check-in and check-out.
• Self-Determination Program, who is responsible: EVV has applied to in-home SDP personal care and home health service codes since January 1, 2023. Under a DDS notice from August 2023, the employer of record carries the duty. Under Co-Employer that is the FMS. Under Sole Employer the participant uses the system the FMS provides, or takes on the duty with CalEVV or a certified alternate system. Under Bill Payer the vendor is responsible.
• Self-Determination Program, pay: the DDS EVV FAQs from March 2024 say CalEVV does not communicate with regional center eBilling, so the State does not check claims against EVV visits. Sole Employer staff still log in and out in the FMS system in order to be paid. Live-in staff are exempt with an attestation.

We did not find a statement on whether EVV applies to Participant-Directed Services such as participant-directed respite. Ask the regional center or the FMS agency.

What is changing next for self-direction in California?

We did not find a dated upcoming change to self-direction in California as of our last check on October 13, 2026. Several changes to the Self-Determination Program have taken effect recently, and one item, FMS certification, has been started by the State with no date posted. The points below are the ones FMS organizations and families are most likely to run into.

• Waiver renewal (in effect): CMS approved the renewal of the Self-Determination Program 1915(c) waiver on September 2, 2026. It is effective July 1, 2026 and runs through June 30, 2031.
• New FMS applicants (in effect): since April 22, 2025, a new entity that applies to become an SDP FMS provider must first pass three preliminary checks at the vendoring regional center: that it is not on any state or federal ineligibility list, that it meets minimum staff qualifications, and that it shows initial fiscal solvency. The DDS directive does not cover entities that applied on or before that date, or FMS providers of Participant-Directed Services.
• Orientation (in effect): since April 1, 2026, the State Council on Developmental Disabilities is the only approved statewide provider of SDP orientation.
• Budget and funding directives (issued): DDS issued SDP directives on reporting large changes in individual budgets (November 6, 2025), on initial individual budgets and spending plans (November 25, 2025) and on fiscal year 2025-26 SDP funding (February 6, 2026). Read them on the DDS program directives page, because they may affect how budgets are set.
• FMS certification (announced, no date): DDS has contracted Applied Self-Direction to develop certification and training for FMS agencies, and Qlarant Quality Solutions to do the same for independent facilitators. We did not find a start date or a statement that certification is required yet. Ask DDS at sdp@dds.ca.gov for the current status.

California self-direction sources

• California DDS: Self-Determination Program
• California DDS: Self-Determination Program frequently asked questions
• California DDS: Financial Management Service contact list
• California DDS: FMS models comparison chart (April 2021)
• California DDS: EVV provider compliance in the Self-Determination Program (August 2023)
• California CDSS: In-Home Supportive Services
• California CDSS: All County Letter 23-106 (December 21, 2023)
• California CDSS: EVV location services FAQ
• California DHCS: HCBA PL 24-003, WPCS parent and spouse providers

Related reading

• California Self-Determination Program Spending Plans, Explained
• Self-Direction vs. Self-Determination: Why the Words We Choose Shape the Care We Deliver
• Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
• Why Do Self-Directed Participants Choose Your FMS as Their Fiscal Intermediary?
• Self-direction in every state (map)
• California EVV requirements

Page history

• October 13, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.