TYPES OF VIRGINIA MEDICAID WAIVER PROGRAMS

 The Commonwealth Coordinated Care (CCC) Plus Waiver [1915 (c)] provides care in the home and community rather than in a nursing facility (NF) or other specialized care medical facility. It delivers services through agency and consumer directed models. This waiver is for: 

• adults 65 and older with a medical or nursing need 

• Individuals less than 65 with a disability and a medical or nursing need

 Eligible Population 

 The following individuals may be eligible: 

• Meet the NF level of care criteria (i.e., they are functionally dependent and have a medical nursing needs); or 

• Individuals who are dependent upon technological support and require substantial, ongoing skilled nursing care; and 

• The health, safety, welfare of the individual must be safely maintained in the home when the nurse personal care aide is not present; and 

•Are determined to be at imminent risk of NF placement; and 

• Are determined that community-based care services under the waiver are the critical services that enable the individual to remain at home rather than being placed in a NF

How to apply 

To apply for CCC Plus Waiver services, contact your local Department of Social Services. The local Department of Social Services will complete a screening to determine your eligibility for the waiver services. If you are eligible, you will then apply for Medicaid (if you don’t already have Medicaid coverage).  

 The DD Waiver Program provides supports and services options for successful living, learning, physical and behavioral health, employment, recreation and community inclusion. This program does have a waiting list and the slots are allocated based on urgency of need. DD Waivers are administered jointly with the Virginia Department of Behavioral Health and Developmental Services (DBHDS). Each person who receives a waiver slot will be offered one of these three waivers depending on what kind of supports are needed and what waivers the CSB has available to assign. Each waiver is a little bit different. 

•  Building Independence Waiver 
•  Family and Individual Supports Waiver 
•  Community Living Waiver 

 Eligibility 

•  The individual must meet diagnostic eligibility consistent with Virginia’s Definition of Developmental Disability. 
• The individual must meet the functional criteria for the VA Individual Developmental Disability Eligibility Survey (VIDES). (VIDES Adult, VIDES Child, VIDES Infant)
•  The individual must meet financial eligibility. 

A child does not have to apply or be enrolled in Medicaid when being screened for a waiver. Parent income is never considered for Medicaid Waiver eligibility for a child once he or she has been approved for a waiver slot. To utilize the waiver, the individual must apply and qualify for Medicaid if he or she is not already enrolled in Medicaid. 

How to Apply 

 To apply for the Developmental Disability Waiver services contact your local Community Services Board. The Community Services Board (CSB) staff will determine if the child: 

• meets the definition of a developmental disability and

 • meets the functional criteria as assessed on the VIDES screening tool.