The consumer-directed model of services in Virginia offers an individual more control over their own personal care, companion, and respite services. The ability to self-direct services through this type of model has been shown to increase positive outcomes for individuals. Virginia shares in the nationwide trend of significant growth in consumer-directed (CD) services in the last decade.

While the benefits of CD services are many, participants surveyed in preparation for this assessment reported a number of barriers or challenges presented by the current system. This assessment addresses some of the more common challenges CD services participants raised. Virginia has the opportunity to update some of its CD services to provide even more positive outcomes for participants.

The majority of data used for this assessment was provided by the Department of Medical Assistance Services (DMAS) and CD services participants who responded to a VBPD survey to identify the benefits and challenges of CD services. Most of the recommendations are focused on actions required by DMAS. This is unavoidable as DMAS is responsible for administering the CD services available in Virginia’s Medicaid programs.

This assessment evaluates the benefits and challenges surrounding consumer-directed (CD) services in Virginia. It is grounded in one overarching key finding: Medicaid consumer-directed services offer people with disabilities greater control over their services and supports. The ability to have that control results in increased satisfaction and fulfillment in all aspects of life. In survey responses, CD services users shared the benefits and challenges they experience. Those challenges are addressed throughout this assessment in the five different categories below. The key findings in each area informed the development of recommendations aimed at improving CD services in Virginia.