Self-Direction and FMS in Connecticut
All states: self-direction map
In short: One statewide fiscal intermediary, GT Independence, runs payroll for self-directed DSS and DDS programs; workers log time in the GT app.
Connecticut self-direction at a glance
| Self-directed programs | Community First Choice (CFC), DDS Self-Direction, the PCA Waiver, and participant-hired staff in four other DSS waiver programs |
|---|---|
| FMS model | Fiscal intermediary (FI) acting as the employer's agent. DDS also offers Agency with Choice. |
| FMS vendors | One statewide fiscal intermediary: GT Independence |
| Who is the employer | The participant, or in DDS a chosen employer of record. Under Agency with Choice, a DDS qualified provider agency. |
| Can family be paid | Yes, with limits. DDS bars hiring yourself or your employer of record. The PCA Waiver bars a conservator. The spouse rule is not confirmed. |
| EVV for self-directed workers | Yes. Workers log time in the GT Independence app, not the state's Sandata system. |
| Budget authority | Yes in CFC and DDS Self-Direction. DSS says its waiver programs carry employer authority only. |
Last verified against state sources: 2026-10-13.
Which Medicaid programs in Connecticut offer self-direction?
Connecticut offers self-direction through Community First Choice (CFC), through the Department of Developmental Services (DDS) waivers, and through several waiver programs run by the Department of Social Services (DSS). CFC is the largest. DSS estimates about 7,200 people use it, and about 3,500 of them are also on a waiver. In every program the participant hires staff and a fiscal intermediary handles the payroll.
- Community First Choice (CFC): a 1915(k) State Plan option, run by DSS, for Medicaid members who live in the community and need help to stay there. Services include personal care attendant (PCA) care and other supports delivered through self-direction. The consumer is the employer. A DSS FAQ dated March 3, 2026 describes CFC consumers as setting their monthly and annual hours and says people moved to DSS waivers would no longer have budget authority.
- DDS Self-Direction: offered under three DDS 1915(c) waivers, including the Comprehensive Waiver and the Individual and Family Support Waiver, for people with intellectual disability who are eligible for DDS supports. DDS runs it. The person has both employer authority and budget authority. DDS sets an Individual Budget with its Level of Need tool, and the employer decides wages within DDS and union contract guidelines. A Self-Directed Support Agreement with DDS is required.
- Personal Care Assistance (PCA) Waiver: a 1915(c) waiver run by DSS. A DSS brochure from 2009 that is still published describes it as serving adults age 18 to 64 with a physical disability who need hands-on help with at least two activities of daily living. The participant is the employer. DSS says its waiver programs carry employer authority only, not budget authority.
- Connecticut Home Care Program for Elders (CHCPE): serves older adults and is run by DSS. Participant-hired staff are paid through the fiscal intermediary. We did not find a program document that lists which CHCPE services a participant can self-direct.
- Acquired Brain Injury (ABI) Waiver and ABI II Waiver: two 1915(c) waivers run by DSS for people with acquired brain injury. Both are on the fiscal intermediary's list of Connecticut programs. We did not find which ABI services are self-directed or a statement that the participant is the employer.
- Home and Community Supports Waiver for Persons with Autism: a 1915(c) waiver run by DSS. It is on the fiscal intermediary's program list. We did not find a DSS source that explains how participants self-direct under this waiver.
Employer authority means the participant recruits, hires, schedules and supervises the workers. Budget authority means the participant also decides how a set amount of money or hours is used. For the three programs where the details were not found, the person's care manager is the right place to ask what can be self-directed.
Who handles financial management services (FMS) in Connecticut?
One company handles financial management services for self-directed programs in Connecticut: GT Independence. Connecticut calls this role a fiscal intermediary (FI). The fiscal intermediary runs payroll and taxes as an agent, while the participant, or an employer of record the participant chooses, stays the legal employer of the workers. Because the state procured a single fiscal intermediary, participants do not pick among FMS vendors.
A fiscal intermediary is the organization that handles the paperwork side of being an employer. DDS describes it as managing the budget, payroll and taxes for people who self-direct. The state's FAQ says Connecticut procured one fiscal intermediary across three departments: Aging and Disability Services, Social Services and Developmental Services.
- Vendor by program: GT Independence lists Community First Choice, the PCA Waiver, the home care waiver for elders, the ABI and ABI II waivers, the autism waiver and DDS Self-Direction among the Connecticut programs it serves.
- Since when: GT Independence took over fiscal intermediary services for DSS and DDS consumers on March 24, 2024. The earlier fiscal intermediaries, Allied and Sunset Shores, issued final paychecks on March 29, 2024.
- Legal employer in DSS programs: in Community First Choice and the PCA Waiver the consumer is the employer.
- Legal employer in DDS Self-Direction: the employer of record is the legal employer and holds an IRS tax ID. It is usually the individual. The DDS guide to the fiscal intermediary says federal agencies prefer that the person receiving supports be the employer of record.
- Agency with Choice (DDS only): a second way to self-direct. The person finds the staff, and a DDS qualified provider agency is the employer, receives the DDS agency rate and sets staff pay. We did not find a published list of the agencies that hold this designation, so ask the DDS case manager.
Workers hired this way are not state employees. Self-directed PCAs, companions, respite workers and Independent Living Skills Trainers in DSS and DDS programs are covered by a union contract between the PCA Workforce Council and SEIU District 1199. The contract summary sets minimum hourly rates that reached $23.00 for PCAs and $20.25 for hourly respite workers and companions on January 1, 2026. It also provides paid time off (earned at 0.033 hours per hour worked, up to 50 hours a year) and pay at 1.5 times the regular rate on eight named holidays.
Who can be a paid caregiver under self-direction in Connecticut?
Relatives and friends can be hired in Connecticut, with limits that differ by program. DDS says a person who self-directs cannot hire themselves or their employer of record. Under the DSS PCA Waiver, a conservator cannot be the paid PCA. We did not find a current state source that says whether a spouse can be paid.
Important: The rules on paying a spouse, a legal guardian or the parent of a minor child could not be confirmed from a current Connecticut source for any program. Check with DSS or the DDS case manager before a family member starts work.
- DDS Self-Direction: the DDS quick guide to self-directing says you cannot hire yourself, your employer of record, or anyone on the DDS or abuse and neglect registry. A hire with a felony needs an approval process through the case manager. DDS encourages hiring people who know the individual well and suggests asking family and friends for candidates. A representative, who is often a family member or friend, is unpaid. DDS also has a separate Family Hire review procedure for relatives hired as paid staff. We could not read its text, so ask the DDS case manager what it requires.
- PCA Waiver: a conservator may supervise the PCA for a participant who cannot, but the conservator cannot be the PCA and cannot be related to the PCA. This comes from a DSS brochure dated February 2009 that is still published, so confirm it with DSS.
- Community First Choice: we did not find a current DSS or federal document that lists who may or may not be a paid attendant. The DSS resources page posts only a draft operating manual from 2016. Ask DSS or the person's care manager.
- CHCPE, ABI and autism waivers: we did not find published rules on who can be a paid worker.
We did not find a weekly hour cap for self-directed workers in the sources we checked. DDS does require self-hired staff to finish required online training within 90 days, or the fiscal intermediary stops paying them. In Community First Choice, a person who has difficulty self-directing can use a support and planning coach, paid from the member's personal care budget. The consumer's own PCA cannot be the coach.
Does EVV apply to self-directed workers in Connecticut?
Yes. Electronic visit verification (EVV) applies to participant-hired workers in Connecticut, and it runs through the fiscal intermediary rather than the state's Sandata system. Workers log their time in the GT Independence app, the employer approves it, and the fiscal intermediary pays from the approved time.
- DSS programs: the PCA Workforce Council announcements page says that from 12:00 AM on March 24, 2024 all time worked is entered in the GT Independence application and none in the old Sandata EVV system.
- DDS Self-Direction: staff log hours in the EVV function of the GT Caregiver app. The workweek runs Sunday to Saturday. The employer approves the hours by 5:00 PM Monday, and the fiscal intermediary pays the following Friday.
- Agency vendors: the split depends on who employs the worker. GT Independence says vendors and their employees who provide EVV-required services keep using Sandata, and GT works with Sandata to issue their payments.
The state's FAQ says self-directed services moved from paper timesheets to EVV, which ended the need to fax timesheets. Good practice follows from the pay cycle: time that is logged and approved on schedule is paid on schedule.
Three points could not be confirmed. We did not find a published EVV exemption for live-in self-directed caregivers. We did not find a public statement on whether self-directed visit data is passed to the state's Sandata aggregator. We also did not find a written rule that the fiscal intermediary may not pay until a visit is in the EVV system. What the sources confirm is that payroll runs from time logged in the app and approved by the employer. For any of these, ask GT Independence customer service at 1-877-659-4500.
What is changing next for self-direction in Connecticut?
We found no confirmed upcoming change to how self-direction works in Connecticut as of the last check. One large proposal is unresolved, and wage rates are moving under the union contract. Anyone planning around either should confirm the current status with DSS.
- Community First Choice proposal: the Governor's 2026 budget proposed moving CFC participants from the 1915(k) State Plan option to waivers or another authority. The DSS FAQ on the proposal gave a target of April 2027 and said self-direction would remain an option, but people moved to DSS waivers would no longer have budget authority. The FAQ is still posted. We did not find a state source that confirms whether the proposal went ahead, so treat it as not final and ask DSS.
- Union contract and rates: a DSS notice dated June 29, 2026 says the PCA collective bargaining agreement was amended and extended through June 30, 2027, after General Assembly approval on April 30, 2026. In the same notice DSS proposed a State Plan amendment to raise CFC self-directed PCA rates for dates on or after July 1, 2026. We did not find confirmation of federal approval or the wage amounts in the extension. The PCA Workforce Council (860-418-6370) is the place to ask.
- Home care program for elders: DSS posted a State Plan amendment listing in July 2026 to renew the State Plan portion of CHCPE. We read only the listing title, so we cannot say whether it affects participant-hired staff.
The fiscal intermediary is also worth watching. The state's FAQ says the new fiscal intermediary has struggled to meet the program's operational requirements and caseload growth and has been handling hundreds of grievances. We did not find any notice that the contract is being rebid or changed.
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Who to ask about self-direction in Connecticut
Questions about self-direction in Connecticut are best put to the state. Start with DSS Community First Choice. Published contact: GT Independence customer service 1-877-659-4500, customerservice@gtindependence.com; PCA Workforce Council 860-418-6370, PCAcouncil@ct.gov.
Connecticut self-direction sources
- Connecticut DSS: Community First Choice
- Connecticut DSS: Community First Choice transition FAQ (March 3, 2026)
- Connecticut DDS: Quick guide to self-directing (May 2025)
- Connecticut DDS: Quick guide to the self-direction fiscal intermediary (August 2025)
- PCA Workforce Council: Important announcements
- PCA Workforce Council: Collective bargaining agreement summary
- Connecticut DSS: State Plan amendment 26-AA notice, CFC collective bargaining updates (June 29, 2026)
- Connecticut DSS: Personal Care Assistance Waiver brochure (February 2009)
- GT Independence: Connecticut
Related reading
- Self-Directed Medicaid Home Care Services in 2026
- Understanding Self-Direction and FMS
- Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
- 5 Big Challenges in Self-Directed Care And How FMS Providers Can Solve Them
- Self-direction in every state (map)
- Connecticut EVV requirements
Other states with one statewide FMS vendor
Arkansas, District of Columbia, Indiana, Iowa, New Mexico, North Dakota, Oklahoma, South Carolina, Tennessee, Vermont, Washington, West Virginia, Wyoming. See every state on the self-direction map.
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.
