Navigating the Virginia Waiver System

Q&A with Lucy Beadnell, Director of Advocacy, The Arc of Northern Virginia

Your loved one has an intellectual and/or developmental disability for which he or she needs and deserves support services. To receive those services, he or she is going to need something called a Waiver. If you’re wondering what exactly a Waiver is, how you go about getting one, and why, for Pete’s sake, it’s called a Waiver, read on. Lucy Beadnell, Director Advocacy at the Arc of Northern Virginia, explains it all.

Lifestyle: What is a Waiver?

Lucy Beadnell: A Waiver is a long-term support system for someone who will have long-term care needs.  Once you’re awarded a Waiver, you will have access to a menu of services offered by your Waiver.

L: You said that a waiver is “awarded.” There’s an application process?

LB: Yes, and a waiting list, generally.

L: So, the person with the disability applies, is approved, waits, and ultimately gets a Waiver. What kinds of services come with it?

LB: Frequently used services include attendants who work one on one with the person with a disability, respite care so parents can have a break from care provision, group home supports where a person with a disability lives in a home shared by other people with disabilities, long term employment or meaningful day services, assistive technology, environmental modifications, nursing, and more.  These services are offered at no or very low cost.

L: Then who pays for them?

LB: Waivers are funded by Medicaid and are often called Medicaid Waivers.  The person with a disability must qualify for long-term care Medicaid to use a Waiver.  As of 2019, this means that the person with a disability cannot have more than $2,000 in assets in their name (no cap if they’re under 18 years old), unless those assets are in a Special Needs Trust or ABLE Account, and they cannot earn more than $2,313 per month.  

L: I’m confused. What comes first, Medicaid or a Waiver?  

LB: First you get a Waiver and then you can get long-term Medicaid. You can’t even apply for long-term Medicaid until you get a waiver.

L: Tell me more about who benefits from a Waiver.

LB: People who need assistance with taking care of themselves, managing their environment, or maintaining a job because of a disability should consider Waivers. I recommend them for people with the full range of disabilities.  If your disability is more significant, you’ll use more services and if you have fewer needs, you’ll use less.

L: So, anyone with a developmental disability should apply?

LB: Yes. Even though some Waivers have waiting lists, if you qualify for a Waiver, you will eventually receive services.  As you grow and change, you can use more or fewer Waiver services to meet your needs. The Waiver should grow with you over time and provide the supports you need to be as independent as possible in your community. Also, as a result of a 2012 Department of Justice settlement agreement with Virginia, if you’re on the waiting list for either an ID or DD Waiver, you can apply for up to $1,000 each year to purchase supports you need to be independent and safe.  This is called the Individual and Family Supports Program.

L: How many kinds of Waivers are there?

LB: Virginia has several Waivers.  The three most commonly used by people with intellectual and developmental disabilities are all broadly called Developmental Disability Waivers.  The specific names are the Community Living Waiver, the Family and Individual Supports Waiver, and the Building Independence Waiver. Sometimes people with disabilities and medical support needs also use the Commonwealth Coordinated Care (CCC) Plus Waiver.

L: I’ve decided to apply. What do I do first?

LB: First you consider your specific situation. For example, let’s say you have a diagnosed developmental disability that started before age 22. If this is the case, you should apply for the Developmental Disabilities Waivers. This is done through your county’s Community Services Board, who will assess you using the VIDES survey to test functional eligibility. You’ll also be asked questions to assess your urgency of need. If you qualify, you will be put on a waiting list. Of course, the more urgent your situation, the sooner you will receive a Waiver. You will be given one of the three developmental disability Waivers based upon the type of services you need.

On the other hand, if you have a disability and a medical nursing need, you should apply for the Commonwealth Coordinated Care Plus (CCC+) Waiver, too. This Waiver has limited services, but no waiting time, so you could use it while waiting on a more robust Developmental Disability Waiver.  You would apply through either your county’s Department of Health or Department of Social Services, who will assess you using the Uniform Assessment Instrument (UAI). If you qualify, you’ll start what’s called the intake process, and your services will begin in a few months. At this point, you may also apply for the Developmental Disabilities Waiver.  

L: Just one last question. Why is it called a Waiver?

LB: The Federal Medicaid system has a lot of rules.  If a state wants an exception to any of those rules, they request special permission to do that.  That permission is called a “Waiver.”  In this case, the term Waiver indicates that Virginia got approval to offer additional Medicaid services (i.e., long term care supports) to people with developmental disabilities.  These are services that other people with Virginia Medicaid cannot get.

Developmental Disabilities Waiver Contacts
For residents of Fauquier, Rappahannock, Culpeper, Madison and Orange:
Rappahannock Rapidan Community Services – 540-825-3100

For residents of Prince William County, Manassas and Manassas Park:
Prince William County Community Services – 703-792-7800 or 703-792-4900

CCC Plus Waiver Contacts
Fauquier County – For those under 18 call the Department of Health at 540-347-6400. For those 18+ call the Department of Social Services at 540-422-8400
Rappahannock County – 540 675-3313
Culpeper County – 540-727-0372
Madison County – 540-948-5521
Orange County –  540-672-1155
Prince William County, Manassas and Manassas Park – 703-792-7500

For more information, visit

To watch a recorded webinar that walks you through Waivers from start to finish, visit

Virginia Waiver Assistance Hotline: 1-844-603-9248

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