Elderly & Disabled Waiver Services: Utilization Review Summary Report

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Virginia Department of Medical Assisstance Services

: As part of Virginia’s Real Choice Systems Change Grant (July 20, 2001), the Center for Gerontology at Virginia Tech is responsible for Goal 4: “Address gaps in quality assurance and client satisfaction for community-based waiver service programs through the development of performance, outcomes, and satisfaction measures for continuous quality improvement and use.” To meet this goal, the Center has conducted extensive research in client satisfaction with E&D Waiver services (reported elsewhere, e.g., Glass, Roberto, Teaster & Brossoie, 2003a). In addition, the Center reviewed the existing Utilization Review (UR) process, as it is currently the primary means of quality assessment (QA) for the E&D Waiver program in Virginia. Our evaluation, based on the following activities, indicates that mechanisms are now in place to address and monitor the quality of services delivered by provider agencies. Continual development and refinement of the UR process will help ensure clients receive quality services and are satisfied with the assistance they receive.