Interview Topic	Medicaid Admin		Service Agency Staff		Patient Advocate
	BIP	Non -BIP	BIP	Non -BIP	BIP	Non -BIP
I’m particularly interested in any differences that might have existed between groups in access to HCBS or use of HCBS.  • Can you describe any differences between groups in terms of their access to or use of HCBS? For example, differences between racial/ethnic groups, or between different communities such as the disability community and the behavior health community?  • How about geographic differences, such as between rural vs urban areas?  • How about differences related to family structure, e.g. whether a beneficiary has a spouse or children  • Are there any other differences among demographic groups in terms of access or utilization of HCBS during the pre-BIP period that you think are important for me to know?	X	X	X	X	X	X
Are some groups in your state more likely than others to use HCBS instead of institutionalized care? If so, why?	X	X	X	X	X	X
What are the key factors that determine whether or not someone is able to receive HCBS in your state?  • What kinds of things may make it more difficult for people to access HCBS?  • What kinds of things may make it easier for people to access HCBS?		X		X		X
In what ways has the availability of HCBS (e.g. in certain areas) affected beneficiary utilization?		X		X		X
What are some ways your agency, or the State has tried to address these disparities in access? What challenges have you faced in trying to address them?  • To the extent that access has been improved, to what extent has the system (or your agency) been able to absorb the additional demand or utilization?				X		X
Now that BIP has ended, in what ways would you say access to or use of HCBS has changed?  • Earlier, you mentioned some differences in access and use of HCBS between certain groups. In what ways would you say BIP has addressed those differences?  • To the extent that access increased, to what extent has the system been able to absorb the additional demand or utilization?	X		X		X
Is there anything else that you think is important for us to know? [if BIP: about the implementation or impact of BIP in (state)?]	X	X	X	X	X	X

^*Because the discussion guides were tailored for BIP vs. non-BIP states, as well as stakeholder type (e.g., Medicaid administrators versus patient advocates), there are 6 versions of the discussion guide. However, the questions that were germane to health disparities were similar across discussion guides (e.g., Are there differences across groups in their access to HCBS in your state?)