Medicaid Waivers in Virginia
What is a Medicaid Waiver?
A waiver is a process that allows states to "waive" federal law so certain individuals can receive a combination of medical, rehabilitative, and other services in home or community-based settings as an alternative to receiving care in a hospital, nursing home or an institution.
Individuals with a brain injury who are determined to have a disability and meet the requirements to receive care in a nursing home or hospital and are eligible for Medicaid may be eligible for the Commonwealth Coordinated Care Plus Waiver.
This waiver is available to the elderly or disabled. This is a new waiver and it combines the old Elderly or Disabled with Consumer Direction (EDCD) and Technology Assisted (Tech) waivers.
To find out if you or a loved one is eligible, a screening team conducts a screening at a hospital or you can contact your local Department of Health or your local Department of Social Services. a screening team typically including a nurse will come to your home to screen for eligibility. The screening tool used is called the Uniform Assessment Instrument.
To find out if you are eligible for Medicaid you can go to: www.commonhelp.virginia.gov
Services that can be provided:
- Adult Day Health Care
- Personal Assistance Services
- Environmental Modifications
- Assistive Technology
- Respite Care
- Transition Services
- Personal Emergency Response System & Medication Management
What is Commonwealth Coordinated Care Plus (CCC Plus)?
- Statewide Medicaid managed care program began Aug 2017 for over 214,000 individuals .
- Participation is required for qualifying populations.
- Integrated delivery model that includes medical services, behavioral health services and long term services and supports (LTSS).
- Care coordination and person centered care with an interdisciplinary team approach.
What if I have CCC Plus or am receiving CCC Plus waiver services and I have a concern or complaint?
Contact your Long Term Care Ombudsman.
Virginia Department of Behavioral Health & Developmental Services manages three Medicaid Waivers for individuals with a developmental disability.
Individuals with a brain Injury do not always qualify for a Medicaid Waiver. If an injury occurs before an individuals 22nd Birthday they may be eligible for a Developmental Disability Waiver.
The currently available Developmental Disability waivers are:
- Building Independence Waiver
- Family and Individual Supports Waiver
- Community Living Waiver
Not everyone is eligible for one of the developmental disability waivers. For individuals with a brain injury your injury must have occurred prior to your 22nd birthday to be considered eligible. If this is the case for you or your loved one, contact your local Community Services Board (CSB) or Behavioral Health Authority (BHA) to find out if you are eligible. When you call ask to start the process for determining eligibility for a Developmental Disability Waiver.
Navigating the Developmental Disability Waivers: A guide for Individuals, Families, and Support Partners