Micro- organization is currently fragmented in services for people with learning disabilities. Care management, person- centered planning (PCP) and direct payments have developed through separate policy strands, with tasks and agency responsibilities blurred. A wide diversity of care management arrangements currently operates, with the relationship between care management, PCP and direct payments imprecisely defined. PCP and direct payments have also been variably implemented. This paper argues for a new 'person- centered case management' with these different devices better integrated and decision- making and action more person- centered. Drawing on practice experience from the original British case management experiments, the new 'case' management would be centered on the needs and wants of individuals. be conducted independently from assessment, operate outside the public sector and be able to access personal budgets. it would consequently have the capacity to further de- institutionalize services and support and transfer more control to people with learning disabilities.