Consumer direction can exist in differing degrees across many types of service programs. It can range from people making all decisions and managing their own services to the individual using a representative to help them manage their services. The one unifying theme in consumer direction is that individuals with disabilities have the authority to make choices that work best for them, regardless of disability type or the source of payment of service. The implementation and development of a service delivery system should be based on the presumption that individuals with disabilities are experts on their own service needs. This would include the integration of choice and control for all consumers of services regardless of type or level of disability, or payee source for services. Consumer direction should not be limited to those who have the ability to pay for services directly.