Ask Mike - Wanting to start up a small agency providing support coordination to folks with disabilities

Dear Starting

Thanks for getting in touch. You wrote that you are interested in starting a small agency to provide "support coordination" for folks with disabilities. As you will see, this is not an easy endeavor.

You will need to address issues entailed by the creation and start-up of a new business. Will your agency be for-profit or not-for profit? Will you incorporate your agency at all? If you incorporate, you will need to decide what type of corporate model to use. You should take a look at a couple of earlier "Ask Mike" questions and answers that address starting up a new agency. These are Future Home Health Proprietors and Texas Agency Owner. Finally, I strongly recommend that you consider obtaining assistance from an attorney with experience in setting up the type of agency you ultimately decide to found.

"Support coordination" for whom is the next consideration. "Folks with disabilities" are sometimes broken into discrete sub-populations such as developmental disability, traumatic brain injury, frail elderly, physical disability, and so on. Each sub-population likely has different service provider requirements and separate funding streams. Examples include Medicare, Medicaid, state funding, private insurance and private pay individuals. All of these have various sub-elements. For example, Medicaid long term services may include various HCBS Waivers, Personal Care, Home Health or Money Follows the Person. Again, there is wide variation from state to state.

Finally, "service coordination" is still not a universally understood and accepted term. Individuals, other professionals and insurance companies / funders may not recognize this term. You may, in fact, be providing "case management", "targeted case management", or "counseling" in order to contract for payment or reimbursement, especially from public programs.

The PAS Center's website can also be of assistance in addressing the issue of what service to which population. On our 'Agencies Related to PAS' page you will see various state and related agencies and their contact information. You can now contact state officials and others to ask about programs within their purview that fund, or reimburse, service coordination.

Good luck. It is a lot of work to set up a brand new agency.

Mike