Call us at 844.828.5591

CCC Plus Process

Effective July 1, 2017, the state will combine what is currently the EDCD waiver and the Technology Assisted waiver into one new waiver called the CCC Plus Waiver (not to be confused with the CCC Plus Program). If you are on the EDCD waiver, you will automatically be switched over to the new waiver and do not need to do anything.

The CCC Plus Waiver is a Medicaid program for elderly and individuals with disabilities, to receive services in their homes and communities. These services can be consumer directed.


The Application Process – Two Approvals Needed:

Apply for Medicaid:

  1. Online – CommonHelp – Apply for Assistance (Medical Assistance for the individual and Appendix D).
  2. For live assistance completing this form, call (855) 242-8282 (available in English and Spanish).
  3. On paper – Bring a completed financial application for Adult Medicaid and Appendix D to your local Department of Social Services (DSS) and request a screening for Long Term Care.
  4. Write “CCC Plus/Long Term Care Screening” on the top of the form.
  5. Print The Application:
    1. English Version
    2. Spanish Version
  6. Print The Appendix D
  7. Find Your Local DSS
  8. For children, find your local DOH

Waiver Screening – A social worker from DSS and a nurse from the local Department of Health (DOH) will schedule an assessment with you:

  1. This should take place in your home.
  2. The individual must be in attendance.
  3. The team will use the Uniform Assessment Instrument to assess the individual.
  4. They will be looking for (see Pre-Admission Screening Manual Appendix B for details):
    1. A Disability
    2. Functional Dependencies (see Functional Dependency Categories for details)
    3. Medical/Nursing Needs
    4. Risk of Nursing Home Placement (It is often helpful to have a letter from your physician supporting this need)

 What are the Criteria?

You must qualify in two areas AND be at risk for nursing home placement:

  1. Functionally – Meet Nursing Home Criteria – determined during your screening – must meet a level of dependency across various areas such as:
    1. ADLs – Activities of Daily Living – i.e. Need help / supervision / prompting with bathing, dressing, toileting / etc.
    2. IADLs – Instrumental Activities of Daily Living – i.e. Using the phone / cooking/ cleaning / shopping / etc.
    3. Orientation / Behavior – Disoriented always or at times to person / place / time.  Aggressive or disruptive behavior.
  2. Must have Medical / Nursing Needs:
    1. Multiple complex interrelated conditions
    2. Unable to self-assess or monitor
    3. Respiratory therapy
  3. AND – Risk For Nursing Home Placement (“individual’s current condition and available support are insufficient to enable the individual to remain in the home.” – Va Regs):
    1. Evidence that deterioration in individual’s condition or change in support prevents needs from being met:
      1. Behaviors increasing
      2. Medical condition worsening
      3. Change in family situation (new child, deployment, new demands from other family members)
    2. No change in condition or support, but evidence that functional, medical or nursing needs are not being met:
      1. Not able to potty train
      2. Unable to manage all therapies

When Department of Social Services asks you to define “Imminent Risk”:

  1. The regulation DOES NOT REQUIRE THAT A FAMILY WOULD PUT THE INDIVIDUAL IN A NURSING HOME if they don’t get help.

The individual meets the Imminent Risk criteria if:

  1. They have been accepted to a nursing home
  2. Their health is deteriorating such that they WILL require nursing home placement in 30 days
  3. Even if their health is NOT deteriorating, if a doctor certifies that they have health care needs that cannot be met at home without additional services.

 After Approval:

  1. Select Model of Service Delivery and Choose Provider
    1. Agency Directed:
      1. You chose an agency.
      2. They place their hired staff with you.
    2. Consumer Directed:
      1. You are the boss.
      2. You choose a provider such as At Home Your Way to be your “Service Facilitator.”
      3. You hire and schedule your own attendants.
      4. A Service Facilitator helps you continually.

If You Choose Consumer-Directed Care:

Service Facilitator Conducts Initial Visit:

  1. Trains Employer of Record (EOR) on hiring procedures.
  2. Initiates process by contacting Medicaid’s Fiscal Agent (PPL).
  3. Conducts initial assessment.
  4. Creates Plan of Care (POC).
  5. Estimates how many hours the Individual will qualify for.

Post Initial Meeting:

  1. Service Facilitator – Requests prior-authorization for hours through a prior authorization 3rd party.
  2. EOR is set up to be employer.
  3. EOR recruits, hires, and schedules attendants.

To Review the DMAS CCC Plus Waiver Manual:

Visit DMAS’s Website:

https://www.virginiamedicaid.dmas.virginia.gov/wps/portal/ProviderManual

Select the drop down option of: “Elderly or Disabled with Consumer Direction Services.” This will return all the chapters of the manual.  Chapter four outlines the services available via this waiver.