Elderly and Disabled Waiver Services: Important Dimensions From the Client's Perspective

Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted an exploratory survey of clients receiving HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. The goal of the survey was to learn about clients’ experiences with HCBS and to identify the most important dimensions of service provision from their perspectives. An initial focus group with 11 caregivers was first held in Big Stone Gap. Twenty-five telephone interviews were then completed (18 clients and 7 caregivers) in five areas of the Commonwealth. Fifteen were in urban areas (Northern Virginia, Richmond, and Chesapeake) and ten in rural or non-metropolitan areas (New River Valley and Planning Districts 13 and 14).