Consumer-Directed vs. Agency-Directed

In Virginia, people approved for a Medicaid Waiver have the right to select which model of service delivery they would like to utilize: Consumer-Directed or Agency-Directed. The person has the right to receive services in the community. It is the person’s choice whether to receive services in the community through a Medicaid Waiver or other placement. The person has the right to choose their Waiver service providers and to change providers. 

It is the person’s right to choose or change a provider. The person will want to be comfortable with the model of service and provider that will be assisting them with personal needs and support. 


  • Consumer-Directed is a model of service delivery for which the person or the person’s Employer of Record, as appropriate, shall be responsible for hiring, training, supervising, and firing of the attendant who provides the direct support or specific services covered by DMAS and whose wages are paid by DMAS through its fiscal agent.


  • Model of service delivery where an agency is responsible for providing direct support staff, for maintaining a person’s records, and for scheduling the dates and times of the direct support staff’s presence in the person’s home and community for personal and respite careAt Home Your Way will soon be providing agency-directed services. These services will be unique because they will allow families a choice in the attendant that will be employed by the agency. This is a great option for families that cannot go with the consumer-directed model because they do not have someone to fill the role of the EOR.

Contact your local DSS for a comprehensive list of providers.

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