Waiver Services

A Waiver is a list of services for individuals who need help with long-term care needs, such as developmental disability (DD). When an individual receives a Waiver they will have a series of options for services based on their needs & wants. Services range from respite care offering families a break from providing supports, sponsored residential where individuals lives with a sponsor, group home services, employment support, day services engaged in meaningful activities, assistive technology, environmental modification, and more.

Individuals who are in need of assistance taking care of themselves in their environment (home, community, work) and meets Virginia's Definition of Developmental Disability. Individuals will need a developmental disability diagnosis before the age of 21 to apply for Waiver services. If the individual is diagnosed after the age of 21, they will need to provide documentation indicating a disability was present before the age of 21 (statement from a doctor, or IEP). Individuals will also need to show, through assessments (VIDES Adult), that the need functional help with daily activities and financial eligibility to apply.

There are three types of Disability Waivers. Community Living Waiver, Family Support Waiver, and Building Independence Waiver.

• The Community Living Waiver focusses on the minority of our population who have extremely high medical, behavioral, or support needs and provides 24/7 active services. This Waiver sometimes requires a waiting period.
• The Family and Individual Supports Waiver is for the majority of people- those who need supports for between a few hours and most hours of the day, including overnight monitoring in some cases.
• The Building Independence Waiver is for people who can live and work with a fair amount of independence, but need drop in supports.

Individuals receiving Waiver services are assessed every 3 years to measure the level of support they require. Levels range from Tier 1 Level 1 to Tier 4 Levels 7. Individuals can move between the three services based on the their needs.

To apply Developmental Disability Waiver services, get in touch with your local Community Services Board. The dedicated staff at the Community Services Board (CSB) will evaluate whether you:
1. Qualify as someone with a developmental disability, as per the defined criteria, and
2. Fulfill the functional requirements assessed through the VIDES screening tool.

Your local Community Services Board manages the process of assigning Waivers. These Waivers are allocated based on the level of support needed. Eligible individuals are placed on a needs-based waiting list since the number of funded waivers is limited. Please note that this waiting list is not based on the order of application but rather on the level of needs.

Helpful Pointers

Familiarize yourself with the necessary forms: Before the DD Waiver Screening, take the time to carefully review the VIDES and Priority Needs Checklist forms. This will help you gather and report the required information to the Community Services Board screener/case manager.

Provide an accurate assessment during the VIDES: When undergoing the VIDES assessment, describe how you or your family member would perform without any supports or services available. Imagine a scenario where there are no parents, family members, or caregivers present. Explain the challenges and difficulties that would arise in carrying out the assessed skills in such a situation. It's important to be honest and not gloss over any obstacles.

Keep track of documentation: Make sure to keep copies of the VIDES and Priority Needs Checklist forms. Regularly review these documents for accuracy and report any changes that occur while you're on the wait list. Staying up-to-date with your information will help ensure that your needs are accurately represented during the application process.

Waiver are funded by Medicaid. The individual must qualify for long-term care Medicaid to use a Waiver. Individuals have been assessed and diagnosed with a disability cannot have more than $2,000 in assets in their name, unless those assets are in a Special Needs Trust or Able Account. Individuals also cannot earn more than $2,205 per month. When an individual receives a Waiver they will also get Medicaid. The can use Medicaid as a supplemental health insurance, or they drop their other insurance coverage and only use Medicaid if they choose.

Waiting for a Waiver is based on urgency of need, categorized Tier 1, Tier 2, and Tier 3

• Tier 1 – Individuals who need services within a year.
• Tier 2 – Individuals who need services in 1 – 5 years.
• Tier 3 – Individuals who need services several years out, but are planning for the their future.

The waiting list can change depending on the individuals situation. So its best to be in touch with your local Community Service Board (CSB) about your situation as it changes. The CCC Plus Waiver has fewer services, but no waiting list. About 1/3 of the individuals use the CCC Plus Waiver while the wait to qualify to receive support.

Reserve slots for Developmental Disability Waivers can be utilized for the purpose of transitioning an individual under the following circumstances:

(i) A documented change in the individual's assessed support needs necessitates a service that is unavailable in their current DD Waiver.
(ii) The individual expresses a preference for supports offered in a waiver that provides a less comprehensive range of services, and they require and request a transfer from their current DD Waiver to another one that can provide the necessary services.

When an individual needs to transition between the DD Waivers, they will not be placed on the DD Waivers waiting list. Community Services Boards (CSBs) or Behavioral Health Authorities (BHAs) are responsible for notifying the VA Department of Behavioral Health and Developmental Services (DBHDS) in writing. DBHDS manages the assignment of reserve slots and maintains a chronological list of individuals awaiting a reserve slot in case the supply is depleted.

Within three business days of adding an individual's name to the reserve slot list, DBHDS will send a written notification to the individual, informing them of their placement on the list. If an individual requests an update on their status, DBHDS must respond within three business days, providing them with their current chronological list number.

Once a reserve slot becomes available and an individual is selected from the chronological list to fill the slot, the support coordinator will ensure that the service necessitating the transfer to the new waiver (e.g., group home residential) has been identified, and a targeted date for service initiation has been established before the reserve slot is assigned to the new waiver..

In order to qualify for an Emergency Waiver, one of the following conditions must be met:

1. Child protective services has verified instances of abuse or neglect against the primary caregiver, resulting in the individual being removed from their home. For adults, this criterion applies when (i) adult protective services determines that the individual requires and accepts protective services, or (ii) although abuse or neglect has not been substantiated, other reliable sources (such as agencies) indicate an inherent risk exists, and there are no other available caregivers to provide support services to the individual.
2. The primary caregiver has passed away, or there is a lack of alternative caregivers, and the individual is unable to care for themselves, thereby posing a risk to their own well-being or the safety of others without the necessary supports.
3. An individual who previously transitioned from one of the DD Waivers to the Medicaid Works program chooses to resume DD Waiver services.

The request for an Emergency Waiver is submitted to the VA Department of Behavioral Health and Developmental Services by either the Community Services Board or the Behavioral Health Authority.

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• DBHDS Waiver Services