IDGS Chart Addendum A.4
5/6/2022
Page 1 of 11
Individual Directed Goods and Services (IDGS) Definitions Chart
TABLE 1: Allowable IDGS Expenses
IDGS
Category
Available To
Individuals in
Certified
Residences?
Description
Qualifications
Pricing Parameters
Camp
• No
• Funding may be requested for the cost of camp in a
self-directed plan for a camp that is able to provide the
needed safeguarding supports and supports to
achieve the person’s valued outcomes.
• Camps can be either focused on supporting
individuals with disabilities or camps that are available
to the general public.
• Directly related to a valued outcome.
• For a camp, a state,
city, or county health
department permit to
operate legally and
must operate in
compliance with
Subpart 7- of the State
Sanitary Code
requirements. A permit
is issued only when
the camp is in
compliance with the
state's health
regulations.
• Not to exceed
published fees
• Annual cap
$4000/year.
Community
Classes &
Publicly
Available
Training/Coac
hing
• Yes
• Classes available to the general public in any subject
area that relates to a person’s valued outcomes (Art,
Dance, Exercise, Cooking, Computer Training, Etc.)
• Sessions with a private trainer (physical
education/exercise) may be covered as long as the
service relates to a valued outcome).
• Classes must be related to a habilitative need in the
individual’s person-centered plan and not just for
recreational purposes.
• Classes must be non-credit bearing; IDGS funding is
for non-matriculating students.
• Not to exceed the
published fees as
outlined in the entity’s
published course fees.
IDGS Chart Addendum A.4
5/6/2022
Page 2 of 11
Coaching/
education for
parent(s),
spouse and
advocates
involved in the
person’s self-
directed
services
• No
• IDGS funding is for Parent/Spouse/Advocate to
attend/participate in educational opportunities (not
covered by other public programs) that assist
participants and those close to them to achieve goals
established in the individual’s service plan.
• Self-directing individual is over age 18 (Under 18 is
through FET).
• May Include registration, and conference fees.
• Annual cap $500/year
based on Family
Education & Training
(FET) pricing
parameters in 1915(c)
HCBS waiver.
• Reimbursement is only
up to FET
reimbursement levels;
overnight lodging or
travel not allowable.
Clinician
Consultants,
Independent
Contractors –
(Non-Direct
Service
Provision --
Clinical
Consultation
Specialties)
• Yes, but
only related
to self-
directed
services
• Consultants/contractors are clinical specialists who are
hired for the following purpose:
Evaluate an individual’s habilitation plan
Training self-hired staff in delivering the self-
directed plan (NOTE: State Plan clinic services
may not be used to train and consult with paid
caregivers. To the extent that IDGS
Consultation services are being used to train self-
hired staff, who might otherwise not have such
resources available to them, it will not duplicate
State Plan services)
Evaluation of the effectiveness of the self-hired
staff in carrying out the services in the self-
directed plan
• Consultants/contractors services cannot replicate any
service available through a third-party insurer, the
Medicaid State Plan or the HCBS Waiver Service.
• Consultants must provide a written outline of services
to be delivered prior to approval; consultants must
provide an annual update of progress/provision of
service and need to continue.
• A consultant/
contractor who is a
member of a
profession that is
under the jurisdiction
of the NYSED Office
of the Professions,
must meet all
licensure or
registration
requirements as
verified at the
following site:
http://www.op.nysed.g
ov/opsearches.htm
• Discipline authorized
under Article 16 clinic
regulations
(Psychology, OT, PT,
SLP, social work,
nursing, nutrition/
dietetics, rehabilitation
counseling)
The hourly amount paid to
the therapist cannot
exceed the 90th
percentile for the hourly
wage for the
therapeutic or
consultant’s
professional discipline
(i.e., the standard
occupational code)
published by the
Bureau of Labor
Statistics (BLS), see
http://www.bls.gov/soc/
home.htm.
IDGS Chart Addendum A.4
5/6/2022
Page 3 of 11
Clinician
(Direct-
Provision of
Therapies/
Therapeutic
Activities Not
Otherwise
Funded in the
State Plan)
• Yes, but
only
related to
self-
directed
services
Hippo Therapy:
A treatment strategy by physical therapists, occupational
therapists, and speech language pathologists that is
incorporated into the professional’s plan of care to
achieve functional outcomes. Hippo therapy is a medical
treatment, not a recreational program of teaching a
progressive riding and horsemanship skill.
• Funding may be requested for hippo therapy in a self-
directed plan by individuals with cerebral palsy and
other neurological disorders that permanently affect
body movement and muscle coordination.
• Funding may be requested for hippo therapy in a self-
directed plan by Individuals with cerebral palsy and
other neurological disorders that permanently affect
body movement and muscle coordination.
Therapeutic Riding & Equine-assisted Activities
• Therapeutic Riding and equine-assisted activities
address and contribute positively to the cognitive,
physical, emotional and social well-being of
individuals with special needs. Therapeutic riding and
equine-assisted activities are taught by a PATH
International Instructor to individuals five (5) years old
and older.
• The PATH instructor will provide written policies on
the eligibility and discharge of individual, written
documentation of the initial evaluation of the individual
and written progress notes for the individual. The
initial evaluation of abilities establishes the
appropriate goals and objectives for the individual and
the progress notes document the achievements and
problem areas. The discharge should be supported
by appropriate documentation that shows a baseline
for goals and objectives and a recommended course
Hippo Therapy
• An individual providing
hippo therapy must be
a NYS licensed
Occupational, Physical
or Speech Therapist; if
he/she is an Assistant
in one of those
categories (OTA, PTA)
then he/she must be
working under an OT or
PT.
Therapeutic Riding &
Equine Assisted
Activities
• PATH International
Instructor must carry a
certification business
card with an annual
expiration date, and
must requalify each
year to be certified
The hourly amount paid
to the therapist cannot
exceed the 90th
percentile for the hourly
wage for the therapeutic
or consultant’s
professional discipline
(i.e., the standard
occupational code)
published by the Bureau
of Labor Statistics (BLS),
see
http://www.bls.gov/soc/ho
me.htm.
IDGS Chart Addendum A.4
5/6/2022
Page 4 of 11
Clinician
(Direct-
Provision of
Therapies/
Therapeutic
Activities Not
Otherwise
Funded in the
State Plan)
• Yes, but
only
related to
self-
directed
services
of action when continued participation is no longer
appropriate. Instructors communicate with the
individual/parents/guardians at the start and at the
end of the session (6-8 weeks) to discuss the goals,
objectives, accomplishments and the next steps, and
best practice includes mid-session meetings and
informal discussions each time the individual rode.
• Individuals may engage in horseback riding and
equine related activity as therapy or through a
community class that is available to the general
public. When individuals engage in community
classes the activity must be in support of a valued
outcome and paid based on published class prices.
• Riding stables may offer both public classes and
equine related therapies. Based on the purpose of the
activity the rates and fees must be supported for
billing purposes consistent with the guidance defined
in this chart and other related guidance.
Aquatic, Art, Massage, Music, Play Therapy:
• Funding for massage therapy may be included in a
self-directed plan when the service has been
prescribed by the individual’s medical doctor to
ameliorate a specific medical diagnosis/condition for
which massage therapy has recognized efficacy.
Funding is not available to support vague goals such
as "promote well-being," "reduce stress,” or “promote
relaxation." There must be a corresponding valued
outcome in the individual's plan.
• Funding for music therapy may be included in a Self
Direction Budget only if there is a specific
communication or audiological requirement for the
service as stated in the plan and justified by the
individual’s medical doctor or licensed clinician, and a
corresponding valued outcome.
Aquatic, Art, Massage,
Music, Play Therapy:
• A consultant/
contractor who is a
member of a
profession that is
under the jurisdiction
of the NYSED Office
of the Professions,
must meet all
licensure or
registration
requirements as
verified at the
following site:
http://www.op.nysed.g
ov/opsearches.htm
IDGS Chart Addendum A.4
5/6/2022
Page 5 of 11
Clinician
(Direct-
Provision of
Therapies/
Therapeutic
Activities Not
Otherwise
Funded in the
State Plan)
• Yes, but
only
related to
self-
directed
services
All Services – Ordering, Treatment Plan &
Documentation Requirements
• The request for funding must be accompanied by a
written prescription from the individual’s medical
doctor with a goal of treating a specific medical
diagnosis/ condition and shall support a specific
valued outcome.
• The therapist shall conduct an initial assessment,
report findings, and propose a treatment plan. These
documents are not required as part of the request for
funding since these documents are not likely to be
developed until after treatment begins. The treatment
plan shall outline treatment goals, proposed
therapeutic activities, and their anticipated frequency
and duration. The treatment plan shall acknowledge
the individual's personal goals and support a specific
valued outcome(s) described in the ISP/Life Plan.
The treatment plan becomes active upon the
referring/prescribing medical doctor's review and
written approval.
• On-going treatment services shall be delivered only in
accordance with the approved treatment plan. Each
session shall be documented with a brief treatment
note outlining the therapeutic services/activities
performed, duration, and response to treatment.
• The therapist shall provide periodic (at least semi-
annual) progress reports to the referring/ prescribing
medical doctor. Such report shall review the
individual's progress toward goals and the efficacy of
services to date; it shall propose any necessary
updates/ revisions to the treatment plan. The medical
doctor shall review the individual's progress and, if
warranted, approve the updated treatment plan and
continuation of services in writing.
IDGS Chart Addendum A.4
5/6/2022
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Health Club/
Organizational
Memberships
• Yes
• Health club memberships; Community membership
dues -- Funding for a gym, health club or other
community organization membership may be included
in the self-directed plan for reasons of health and
fitness or community integration in accordance with
the participant’s valued outcomes.
• Membership is for the individual only; no family
memberships allowed with IDGS funding.
• The club/organization must offer open enrollment to
the public, and cannot be a private club with a closed
membership where membership is available by
invitation only.
• An individual may have multiple memberships to
health clubs.
• Payment not to
exceed the entity’s
published membership
dues/fees specified.
• Annual cap
$1500/year.
Household-
Related Items
and Services
• No
• Item cannot be funded through any other funded
program and may include Appliances that assist a
person to live more independently (i.e., a microwave
oven for someone who cannot safely use a stove or
oven)
• Appliance must benefit the individual and be related to
a valued outcome as well as be related to health and
safety.
• Household support (cleaning, minor maintenance,
snow removal, lawn mowing) only for individuals not
living in the family home.
• Note: The Community Transition Services (CTS)
waiver service and funding cap remains separate from
IDGS funding in this category.
• N/A
• Annual cap
$1500/year.
Interpretation
Services
• Yes, but
only related
to self-
direction
services
• Cannot duplicate any Medicaid funded service
providers' requirement to communicate with the
person, e.g., Community Habilitation, Medicaid
Service Coordination, Hospitalizations
• Includes language interpretation, but not translation
services.
• Payment may not
exceed the entity’s
established fees
• Payment must be to a
formal interpretation
service
• Published fees cannot
be exceeded.
IDGS Chart Addendum A.4
5/6/2022
Page 7 of 11
Interpretation
Services
• Yes, but
only
related to
self-
direction
services
• Must be directly related to valued outcomes,
safeguards and services identified and approved in
the Self Direction Budget. In order to make the
determination whether the interpretation is service
related, and costs may be reimbursed, the questions
to be answered are:
1. What valued outcome/safeguard is this
activity in support of?
2. What service was the interpretation related
to?
3. What service was actually provided?
4. Who provided the service?
Paid Neighbor
• No
• Stipend paid to neighbor to be “on-call” to assist a
person who lives independently. If the paid neighbor
is called upon to provide direct services, he/she is
paid an hourly wage for the delivery of self-hired or
agency supported community habilitation.
• The specific duties are defined in a contract signed by
the paid neighbor and the Fiscal Intermediary.
• The paid neighbor staff
person cannot be a
family member of the
person.
• Must meet all
requirements for
background check,
and training that would
be required of a self-
hired staff person.
• Monthly cap $800
Self-Directed
Staffing Support
• Yes, but
only related
to self-
directed
services
• Assistance with scheduling self-hired staff and with
assisting the person to complete staffing related
paperwork.
• Not to duplicate FI employer responsibilities or Broker
services related to development of the person’s self-
directed plan.
• The ‘self-hired’ staff person providing this support is
not a staff person of a NFP agency and is not a
person who is active in assisting the person with
decision-making regarding his/her self-directed
services (not a family-member or a member of the
person’s freely chosen planning team).
• All staff, volunteers
and trainers are
screened for criminal
background and
excluded provider
status
• Not to exceed payment
of $20/hour
IDGS Chart Addendum A.4
5/6/2022
Page 8 of 11
Transition
Programs for
Individuals
with IDD
• No
• Tuition for non-credit bearing transition programs for
individuals with IDD who have already completed their
educational program (i.e. ‘aged out’).
• The coursework must address a person’s valued
outcomes and address skill building and employment
outcomes.
• Programs may be provided in non-site based settings,
on college campuses, but not in locations certified by
OPWDD.
• Coursework may include training on personal care
skills, and socialization skills, but this training is
provided to support vocational outcomes for the
person.
• To be funded via a person’s Self Direction Budget, the
program cannot be funded by ACCESS-VR, IDEA or
other funding sources.
• Services are time-limited and cannot exceed a two
year timeframe.
• No room and board costs are fundable.
• All staff, volunteers
and trainers are
screened for criminal
background and
excluded provider
status
•
• Published fees cannot
be exceeded.
• Per class limit for
tuition is $350/course.
• Where tuition is on a
monthly basis, not to
exceed $800/month
Transportation
• Yes, only
related to
self-directed
services
• Funding may be requested for the cost of service
related transportation that is directly related to valued
outcomes, safeguards and services identified and
approved in the Self Direction Budget. In order to
make the determination whether transportation is
service related, and costs may be reimbursed, the
questions to be answered are:
1. What valued outcome/safeguard is this
activity in support of?
2. What service was this transportation related
to?
3. What service was actually provided?
4. Who provided the service?
• Transportation costs are not reimbursed through the
Self Direction Budget for transportation to and from
OPWDD funded services for which transportation
costs are included in the rate/fee developed or paid
via billable service time.
• Vehicle must be
operated by a licensed
driver.
• Mileage reimbursement
not to exceed standard
federal mileage rate:
https://www.irs.gov/new
sroom/irs-issues-
standard-mileage-
rates-for-2019
• Reimbursement of
public transportation
and paratransport
limited to published
rates. Discounts for
individuals with
disabilities shall be
requested, where
available.
IDGS Chart Addendum A.4
5/6/2022
Page 9 of 11
Transportation
• Yes, only
related to
self-
directed
services
• Mileage may not be reimbursed for medical
appointments as this duplicates a State Plan service.
• Transportation reimbursement takes several forms:
1. Reimbursement for service related miles may
be made to:
a. Staff person who drove his/her personal
vehicle to a service related activity,
b. Participant who drove or was driven in
his/her personal vehicle to a service related
activity, or
c. Friend or family member who drove his/her
personal vehicle to a service related activity.
• Service related mileage may be paid from IDGS for
transportation costs required for the individual to
access a generic service in the community that is
Medicaid reimbursable within the Self Direction
Budget (directly related to a valued outcome or
safeguard) regardless of whether or not there is a paid
staff person present.
• Mileage reimbursement covers all operating costs
related to the vehicle and included in the IRS standard
mileage rate standards, i.e., gas, registration, vehicle
inspection, insurance, repairs & maintenance.
• Reimbursement for the cost of public
transportation or paratransit, such as bus passes,
bus, taxi and train fares that is directly related to
valued outcomes, safeguards and services identified
and approved in the Self Direction Budget.
Individuals may purchase metro cards under this
category for self-hired staff providing habilitation
supports as long as the card is kept in the possession
of the individual and is only used during the provision
of service.
• Vehicle must be
operated by a licensed
driver.
• Vendor transportation
limited to published
fees.
IDGS Chart Addendum A.4
5/6/2022
Page 10 of 11
TABLE 2: The Following items cannot be funded through IDGS
Academic Tutoring
• Academic tutoring is not funded through the IDGS. This service should be pursued through the school
district or college setting. Academic tutoring/homework assistance is not an appropriate task for self-hired
staff.
Automatic pill dispenser/
medication system
• Available through Assistive Technology, outside the person’s Self Direction Budget
Cell Phones/Telephones
• Funding for cell phones is not an allowable IDGS expense.
• The SafeLink Wireless program is available to eligible individuals in New York State who receive
Supplemental Security Income (SSI).
• The SafeLink service in New York State allows for a cell phone and limited free minutes for a person who
has a diagnosed developmental disability and receives social security benefits under SSI.
Computer Hardware
•
Not allowable in IDGS
Computer
Programs/Software
• Computer Software may be available through Assistive Technology, outside the person’s Self Direction
Budget.
Leased and Purchased
Vehicles
• Leased or Purchased Vehicles are not allowable expenses under IDGS.
Health-Related Services,
Equipment and Supplies
• Health related supplies such as food and beverage thickeners, trachea collars, disposable bed pads, wipes,
incontinence products, and supplemental medications are funded through the State Plan only; not through
IDGS funding.
Items and services from a
vendor that present a
conflict of interest
• IDGS cannot fund items or services if the purchase, as determined by OPWDD: (a) leads to significant
monetary gain for an individual’s support person(s); (b) provides the support person(s) with significant
influence over the individual; and/or (c) constitutes a conflict of interest. As used herein, the term “support
person” includes an individual’s spouse, children, parents, guardians, any person engaging in sexual activity
with the individual, partners residing with the individual, and/or any person who provides paid services
authorized by OPWDD, including but not limited to DSPs and Support Brokers.
Parents’ Activity Fees,
Expenses, and Meals
•
Activity fees, expenses, and meals incurred by parents of individuals are not reimbursed with IDGS funds
and must be paid by the parents when they accompany an individual to an activity supported by his/her Self
Direction Budget.
IDGS Chart Addendum A.4
5/6/2022
Page 11 of 11
Participants’ Activity Fees,
Expenses, and Meals
• Activity fees, expenses, and meals incurred by individuals are not reimbursed with IDGS funds and must be
paid by the individual or his/her family.
Personal Monitoring
Systems
• Available through State Plan
Staff Activity Fees,
Expenses, and Meals
• Activity fees, expenses, and meals incurred by self-hired staff supporting individuals are not reimbursed with
IDGS funds, but may be funded through Other Than Personal Services.
Direct Clinician service
delivery and Therapies:
Physical Therapy,
Occupational Therapy,
Speech Therapy,
Psychology (Medicaid state
funded)
•
On-going therapies that are provided directly to the person are funded through the individual’s State Plan
Medicaid Card or, if the individual is school-aged, through the local school district, and are not funded under
IDGS.
Experimental Therapies
•
Experimental therapies are not reimbursable in any clinical category within IDGS and are not a permitted
expense in the OTPS payment category.
