Section III: Waivers for People with Developmental Disabilities

In this section, you will learn about the variety of supports and services that are available through Waivers and how people become eligible for Waiver supports and services. The assessment, planning, implementing, and documenting activities are also discussed.

Waivers for People with Developmental Disabilities

The three Virginia Medicaid Waivers that support people with developmental disabilities (DD) provide a way to pay for certain long term supports and services in communities with a mix of state and federal funding. Federal funding comes from the Centers for Medicare and Medicaid Services (CMS) and “waives” specific federal Medicaid requirements. Waivers have provided funding to allow many individuals who would have required institutional services to receive a variety of needed services and supports in the community.

Virginia’s Waivers are built on the idea of individualized supports. Services are developed and funded based on a person-centered approach as discussed in Section I. Each person (with assistance if needed) chooses different types and levels of supports based on his or her desired goals, outcomes, choices and needs. Most services are agency-directed services, in which the provider agency hires staff to work with the person. Some are consumer-directed services (also known as self-directed), in which the person (or his/her family) employs the staff person. People can also use a combination of both agency-directed and consumer-directed services.

Virginia recently redesigned the Waivers for people with DD and there is now one process to qualify for and access supports and services. The redesigned Waivers:

• Provide more targeted, flexible, needs-based services;
• Create more choices and opportunities;
• Promote consistency, equity, quality and accountability across the waivers; and
• Increase flexibility in service design. 

As presented in Section 1, three Waivers support people with DD:

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