About Florida Self-Directed Care

Florida Self-Directed Care (SDC) is an innovative service delivery paradigm placing individuals with mental illnesses squarely at the center of decision-making that affects them. SDC was conceived in Jacksonville, Florida in early 2000, from a grass-roots effort. A group of dedicated self and systems advocates came together around the belief that there had to be a better road to recovery than found in traditional treatment modalities. From this journey, SDC was born. The original program covers a five-county area in NE Florida, and has served over 150 people since 2002.  The success of the NE Florida program has led to the creation of a second program, serving five counties in Southwest Florida. The website you are exploring is a product of the SW Florida SDC program. The website associated with the original SDC program is currently under revision, and will be linked here as soon as ‘renovations’ are completed.

The FloridaSDC Program hinges on the belief that individuals are capable of choosing services and making purchases that will help them begin or remain on the road to recovery and to develop or regain a life of meaningful, productive activity. The goal of FloridaSDC is to respect and promote self-determination, recovery and full community inclusion for people who have been diagnosed with a mental illness and who depend on government subsidized mental wellness services. Participants in FloridaSDC select the providers, services, and activities that they deem necessary for recovery and the achievement of the highest level of desired personal wellness and quality of life. Through a careful self-assessment of previous purchases, experiences, and outcomes, individuals are given the flexibility to make adjustments to fit their needs in order to engage in meaningful activities and to attain a higher quality of life. 

The FloridaSDC program gives each participant control of the public financial resources to access mental health services that are normally directly contracted to a public community mental health provider. FloridaSDC participants can use their budgets to purchase mental wellness services from any member of the FloridaSDC Network that provides services within the district in which the participant resides. The primary purpose of these funds is to purchase psychiatric and mental wellness care. However, a unique option within the program is the opportunity for participants to access alternative and non-traditional services that result in the same outcomes as traditional mental health services. For example, instead of attending psychotherapy group for depression at a local mental health professional’s office, a FloridaSDC participant may elect to participate in a community-based support group. The personal outcomes are similar, but the type of actual service is very different, both in cost and experience. FloridaSDC also offers participants match-funding opportunities to purchase tangible items, such as clothes and shoes that will enhance the person’s integration into the community so that he or she can return to work or other meaningful activity. 

Participants in the FloridaSDC program choose from a variety of community-based providers that may or may not already be a part of the current public community mental health system. Residential and crisis stabilization services are delivered by existing community mental health providers through the traditional delivery system. Participants are responsible for determining exactly which community-based services they want and by whom these services will be provided. Participant recovery is measured in a number ways including productive days in the community (productive as defined by each individual) and structured self-reports about achievement of personal recovery goals and objectives. Standard objective measures are used to evaluate individual outcomes that will include input from significant others and life coaches. The major difference in measurements between FloridaSDC and the traditional system is the focus on participant self-reports about personal recovery achievement and satisfaction with the total FloridaSDC delivery system.

Why does FloridaSDC work?

The FloridaSDC model utilizes self-determination at each point in the service delivery process. People participating in mental health services have guided the development of this program through the development of forms for reporting and planning, creation of operational policies and procedures, and expansion of the provider network. As a result, there is confidence that the model reflects the values and priorities of participants and enhances the ability of each to live and interact as independently as possible, enjoy an improved quality of life, and demonstrate successful outcomes.  

The ultimate goal of the FloridaSDC Program is to give Participants the opportunity to design and travel a personalized road to recovery from the adverse effects of mental illness so that they can return to a productive lifestyle. A productive lifestyle is legislatively defined, for purposes of this program, as achieving a state of mental wellness so that a person can return to work and begin to generate earned income through employment. 
The approach to providing services is participant-driven and seeks to maximize each participant's ability to control the most important decisions about how he or she will manage his/her own personal recovery. “Participant” is used throughout the rest of this document to emphasize that individuals who enroll in the program are contributing participants to the program. The FloridaSDC program encourages individuals to learn to live life as fully, independently, and productively as possible and to take responsibility for their choices and the consequences of these choices. FloridaSDC seeks to decrease, and, in some cases, eliminate patterns of participant dependency on formal systems of care and to promote participant self-control and self-efficacy and use of natural and community supports. The goal of FloridaSDC is to promote each participant’s ability to set and achieve personal mental wellness and productivity goals, thereby enhancing each participant’s quality of life. Participants will have the opportunity to increase their strengths within many components of life. 

The program abides by the philosophy that natural supports should be identified and utilized by the individual as a first choice. Natural supports create an opportunity for individuals to feel greater autonomy and to integrate into the community. Community supports are identified and utilized in a way that truly involves individuals in the community at large and helps them to feel like they belong to the environment in which they live. Helping individuals have meaningful lives is a large part of recovery in mental health. The FloridaSDC program staff work with individuals in a cooperative relationship and act as coaches rather than experts. The FloridaSDC program is dedicated to listening to individuals’ specified needs and preferences rather than imposing values upon participants. 

The FloridaSDC program is a model in which public funding follows the participant rather than the provider. Also, it is a program in which the individual (instead of the provider) makes decisions and selections to the greatest extent possible with respect to service provision. Accordingly, the following components are included in the program to maximize the principle of participant self-determination.  

Recovery: In its simplest form recovery can be defined as improving, mending, healing and renewal. Recovery is about developing individual’s strengths and assets and giving individual’s the room, support and confidence to do so in the process. Recovery is about overcoming the adverse effects of mental illness that may have hampered the ability to fulfill personal life goals. (Believe You Can Recover! by Cindy Highsmith)

Choice: Choice is the ability and opportunity to select between alternatives, to have a say in the choice made, and to have options. Choice does not mean that a person can have anything he or she wants, but gives a person at least two options to choose from which gives the person a sense of control so that he or she may become more invested in attaining personally defined goals. 

Responsibility: Responsibility is taking accountability for one’s choices and behaviors. In order to have responsibility people must be treated as if they can be responsible. Responsibility involves accepting that one makes good and sometimes not so good selections. Taking responsibility for mistakes does not make a person a failure but a true learner. Likewise, taking responsibility for triumphs and other accomplishments serves as positive support especially when shared with others. Learning from anything often requires non-judgmental and honest feedback from others combined with thinking of options for the next time. 

Accountability: Accountability is much like responsibility in that a person understands that he or she is accountable for the selections made and not made. Accountable adults accept they are human but do not make excuses when they know they have done something wrong. Accountable adults understand the difference between having limits due to having chronic mental illness symptoms and blaming things they can control and improve upon due to their mental illness. Recovery is about looking at the holistic picture and especially on focusing on strengths that individuals have as opposed to limits they cannot control. 

Control: Control for our purposes is about helping individuals identify the things they can control, i.e., personal goals, hopes and dreams, and things they have no control over, i.e., how other people act or think. Control in recovery is about developing and accomplishing goals, while knowing human beings cannot control everything.  

Self-Determination: Self-determination stems from the ability to believe in personal control, accountability, selections and responsibility. Self-determination and free will come from the feelings and practices that success is possible, regardless of the odds. The more chances human beings are given to succeed through a focus on personal strengths and positive feedback about personal accomplishments, no matter how small to someone else, the more likely that self-determination will develop as a foundation.  

Self-Directed: Self-directed is a concept in the recovery process which treats individuals as capable of making and determining their purposes and goals. Self-direction is encouraged and supported by people who work with individuals. Individuals are engaged in discussions regarding their capabilities and strengths therefore helping the individual see hope and possibilities. Individuals can gain a sense of independence by determining their life’s direction.