Development Disability Waivers

Overview

The state of Virginia currently offers three Developmental Disability waivers. Moms In Motion offers the following services (as noted in the table below) under two of the waivers:

  • Community Living (CL)
  • Family and Individual Supports (FIS)
DD Waiver Services Community Living Family & Individual Supports
CD Companion Services
CD Personal Assistance Services
CD Respite
CD Services Facilitation
Assistive Technology*
Environmental Modifications*
Click here for a comprehensive list of additional services offered through these waivers.
*For access to these particular services, please visit Ability Unlimited.

The Process

Criteria:

  • Must have documented diagnosis of developmental disability or intellectual disability.
  • Must be eligible for Medicaid when assigned to a waiver.
    • Medicaid eligibility is not necessary when applying for a screening or to be added to the wait list.

Before Requesting a DD Waiver Screening:

  • Call At Home Your Way’s Family Resource Specialist team at (800) 417-0908, option 2 for waiver coaching.
    • Waiver coaching includes:
      • Explaining the benefits of applying for a DD Waiver.
        • DD Waivers have a wait list. While waiting, you are eligible to apply for an annual IFSP grant.
        • While CCC Plus Waivers require some medical nursing needs, DD Waivers do not.
      • Discussing potential eligibility for the CCC Plus Waiver or EPSDT.
        • Reviewing eligibility criteria and how to apply for both.
      • What to expect during your screening.
      • Defining an ID/DD diagnosis based on Virginia’s definition.
      • How to respond to questions based on the VIDES and functional capacity.
        • Refer to the Screening section below for more information concerning VIDES.
      • After completing the first VIDES, contacting the assigned Case Manager frequently to keep it updated, as well as scheduling annual meetings with them to keep the VIDES updated.
      • Waiver slots are assigned during the beginning of the state’s fiscal year (July).
        • There are a limited number of emergency slots to be assigned throughout the fiscal year (July – June).

What to Expect After Receiving a CL/FIS Waiver:

  • You will be assigned a Support Coordinator.
    • The Support Coordinator will be responsible for guiding the individual through what services he/she is eligible for.
    • The Support Coordinator will schedule a meeting to establish the Individual Support Plan (ISP) with all providers of services.
      • The individual will be required to have a physical exam within 1 year of start of services.
      • The individual will be required to have a VIDES dated within 6 months of the start of services.
    • If selecting Consumer-Directed Waiver services through the DD Waiver assignment, they may begin the first of the following month if you are transitioning from CCC Plus.
      • If the individual is new to all Waivers and is selecting Consumer-Directed Waiver services, those services can begin at any time. 
Screening:
  • Contact your local Community Services Board (CSB) to schedule an intake appointment.
  • A case manager will screen the individual using the assessment form called the Virginia ID/DD Eligibility Survey (VIDES) that will measure the following:
    • Functional capacity: the level of support needed for ADLs and IADLs.
    • Meet Virginia’s definition of a developmental disability.

I/DD Definition

  • A severe, chronic disability of an individual that is:
    • Attributable to a mental or physical impairment, or a combination of mental and physical impairments, other than a sole diagnosis of mental illness.
    • Manifested before the individual reaches 22 years of age.
    • Likely to continue indefinitely.
    • Results in substantial functional limitations in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, or economic self-sufficiency.
    • Reflects the individual’s need for a combination and sequence of special interdisciplinary or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are 2 of 3 individually planned and coordinated.
  • An individual from birth to age nine, inclusive, who has a substantial developmental delay or specific congenital or acquired condition may be considered to have a developmental disability without meeting three or more of the criteria described above if the individual, without services and supports, has a high probability of meeting those criteria later in life.

Wait List:

  • The DD Waivers have a wait list based on priority.
  • During this waiting period, you are eligible to apply for IFSP.
  • The waiver assignment process is coordinated by your local CSB.
  • Waivers are assigned based on support needs.
    • It is not a chronological waiting list.
  • It is important for Virginia and the Federal Government to know how many people are in need of services and not getting them.

Waiver Assignment

When your waiver has been assigned:

    • You will receive a letter or phone call, advising you of your awarded waiver.
      • You will need to accept or deny.
    • You will have an intake meeting with a Case Manager (CM) who will:
      • Complete a Level of Function (LOF)
      • Complete another VIDES to determine functional capacity
      • Require a recent annual physical exam performed by a doctor
    • At this point, you will be required to meet Medicaid eligibility.
    • A Support Coordinator (SC) will be assigned to you to coordinate all services available.
      • Services include but are not limited to:
        • Benefits planning
        • Crisis support services: center-/community-based
        • Community coaching
        • Community engagement
        • Group day service
        • Group/individual supported employment
        • Peer support service
        • For a comprehensive list, click here
    • For services such as Personal Care, Respite, and/or Companion, you will select a model of service delivery and choose a provider.
      • Consumer-Directed:
      •  Agency-Directed:
        • You choose the Agency who will then place their hired staff with you and take responsibility for continued scheduling, staffing, and paperwork.

Consumer-Directed Model

Individuals choosing to receive services through the Consumer-Directed model may do so by choosing an SF to provide the training and guidance needed to be an EOR. As the EOR, the individual is responsible for hiring, training, supervising, and firing attendants. The individual may choose to designate a person to serve as the EOR on his/her behalf. If the individual is under 18 years of age the parent or responsible adult must serve as the EOR. A person serving as the EOR cannot be the paid caregiver, attendant, or SF. An EOR can only serve on behalf of one individual. The only exception to this is that EORs can serve on behalf of multiple individuals only if the individuals reside at the same address. All CD services must be authorized by the service authorization contractor and require the services of an SF. Specific duties of the individual or EOR, as the employer of the CD personal care attendant, include the following:

  • Checking references
  • Determining that the employee meets basic qualifications
  • Submitting required hiring documentation to the fiscal employer agent (F/EA)
  • Training, supervising performance, and submitting time sheets to the F/EA on a consistent and timely basis

CD attendants are not eligible for Worker’s Compensation, overtime, or holiday pay.

Initial visit with Service Facilitator (Intake):

  • Visit conducted in the home with the individual present.
  • Consumer-Directed services and process are explained.
  • EOR is identified and established.
    • Using the EOR Manual, the EOR is trained on hiring responsibilities.
  • Support needs of the individual are identified and developed in the Plan of Care (POC).
  • Signatures are collected on all DMAS-required documentation, including the EOR’s contract with the SF.
  • Electronic Visit Verification (EVV) requirement is discussed with the EOR.
  • SF and EOR schedule next visit date.
  • After the intake, the following will occur:
    • Level of Care (LOC) determined and prior-authorization for hours are requested through the Virginia Waiver Management System (WaMS).
    • Fiscal Agent Request Form (FARF) sent to FA to establish individual and EOR with the FA.

Routine on-site visits (Monthly):

  • Visit conducted in the home with the individual present.
  • EOR may receive Management Training (MT) on hiring responsibilities and any changes implemented by DMAS.
  • SF and EOR discuss any updates needed for the individual’s POC or any changes that have occurred since the last visit. Examples of this may include:
    • Health of the individual
    • Medication changes
    • Recent hospitalizations
  • SF and EOR discuss any changes to the individual’s support plan (ISP), FA issues, and attendant issues (hiring/onboarding/etc.).
  • Signatures are collected on all DMAS-required documentation.
  • SF and EOR schedule next visit date.

Useful Links

Virginia Sites

Additional Resources

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