All states have an office that provides services to children and adults with different types of disabilities. Whether or not someone is eligible, and what services are available, is different for each state.
Types of services available through state programs
As an example, you can look at the service page for the New York State Office for People with Developmental Disabilities.
In some states, there can be a wait list to get services for people with developmental disabilities. Sometimes this wait list is many years long. As an example, in 2021, the wait list in Oklahoma was 12 years.
This wait is due to the need of people to be on a Medicaid waiver to receive services in their home and in the community. A waiver is used to "waive", or get around, certain Medicaid rules to allow more people to get needed services. You can learn more about Medicaid waivers for children at the Kids Waivers website.
This video from ARC in Indiana might also be helpful.
You can find YOUR state office here:
Developmental disability office state links
Olmstead Rights also provides links to many available services by state.
Self-direction refers to the ability of a person to manage their own services. People with disabilities who are getting services from the state get an amount of money in their budget determined by a number of factors. The money goes to an organization. The individual can then determine what services and supports they want to use and either bill the organization or get reimbursed. They can also hire their own staff using money from the budget.
There are a lot of rules and regulations when using self-direction, and it can differ across different states. Usually there are people like care managers and support brokers who help people with disabilities with this process.
Below is a short video and roadmap created for New York state that can help you learn more about self-direction.