Consumer Directed Choices (CDChoices) is a nonprofit organization founded and managed by people with disabilities and their families. With the expertise of the "end users" of home health care, CDChoices created a Consumer Directed Personal Assistance (CDPA) program in the greater Capital Region based on the independent living philosophy. CDPA was developed to empower seniors and people with disabilities (Consumers) receiving home care services. Using CDPA, Consumers have greater flexibility and freedom of choice in obtaining services, while reducing the state’s administrative costs. The model reflects a view that individuals with disabilities should be able to select their own Personal Assistants and manage their own care. Under CDPA, eligible Consumers directly employ and supervise Personal Assistants to help them with medical and personal care. Consumers recruit, hire, train, supervise and discharge their own Personal Assistants based on the Consumer's assessment of the Personal Assistant's qualifications, suitability and performance. CDChoices acts as a fiscal intermediary and facilitates program administration. We provide payroll and program administration services to Consumers who employ Personal Assistants.