Medicaid Home and Community-Based Waivers
Waivers are programs that help meet the needs of people who live in the community but are at risk of entering an institution (such as a nursing home). Listed below are the different types of Home and Community-Based Waiver programs.
Alzheimer's Assisted Living Waiver
What makes someone eligible for the Alzheimer's Assisted Living Waiver?
The Alzheimer's Assisted Living Waiver is available to individuals who are 55 years of age or older and who have a diagnosis of Alzheimer's or a related dementia but no diagnosis of a serious mental illness or intellectual disability. In addition, the individual must be living in (or willing to move to) an assisted living facility instead of a nursing home, and also be receiving (or be eligible to receive) an Auxiliary Grant.
As with all Medicaid-funded services, there are also financial eligibility criteria.
Services offered through the Alzheimer's Assisted Living Waiver
- Help with activities of daily living (ADL's) bathing, dressing, eating, getting out of bed, walking or using the bathroom
- Medication administration
- Meals
- Help with laundry
- Transportation
- Coordination of medical services
- Special therapeutic, recreational and social programs
If you answer yes to any/all of the following questions, you may be eligible for the Alzheimer's Assisted Living Waiver
- Are you 55 years of age or older and do you have a diagnosis of Alzheimer's or related dementia, such as small stroke, or Lewey body?
- Do you need help with bathing, dressing, eating, getting out of bed, walking or using the bathroom?
- Do you need help remembering to take your medications or in taking your medications?
- Are you currently living in, or are seeking admission to, an assisted living facility?
- Are you currently receiving, or have you applied for, an auxiliary grant?
Next Steps
If you think that you might qualify for the Alzheimer's Assisted Living Waiver, contact your local department of social services or local health department. To find information on-line, visit the VirginiaNavigator website, in the 'What you need?' box then type in "Social Services" or "Health Department," and put in your zip code. After you contact your local department, a nurse and social worker will schedule a time to meet with you, assess your needs and determine your financial eligibility. If you are in the hospital, a discharge planner may also do this.
DD Waiver Services
The Commonwealth’s system of services and supports for individuals with developmental disabilities is undergoing significant transformation as Virginia redesigns its waiver system under the My Life, My Community initiative. The term My Life, My Community encompasses an overarching vision whereby people with developmental disabilities live, work, play and thrive in their communities, just as others do, with the support they need.
The Day Support Waiver is now called the Building Independence Waiver:
This waiver is for adults (18+) able to live independently in the community. Individuals own, lease, or control their own living arrangements and supports are complemented by non-waiver-funded rent subsidies. Supports are episodic/periodic in nature.
The DD Waiver is now called the Family & Individual Supports Waiver:
This waiver is for Individuals living with their families, friends, or in their own homes, including supports for those with some medical or behavioral needs. Available to both children and adults.
The ID Waiver is now called the Community Living Waiver:
24/7 services and supports for Individuals with complex medical and/or behavioral support needs through licensed services. Includes residential supports and a full array of medical, behavioral, and non-medical supports. Available to adults and some children.
The Community Services Boards will serve as the single point of entry for waiver services for ALL individuals with a developmental disability. Visit MyLifeMyCommunity for more information about the DD Waiver redesign.
Next Steps
If you think that you might qualify for the DD Waiver, contact your local community services board (CSB). To find information on-line, visit the VirginiaNavigator website,in the 'What you need?' box, type in "Community Services Boards," or 'Waiver Expert' and put in your zip code. After you contact the Community Services Board, a support coordinator / case manager will schedule a meeting with you to assess your needs.
Elderly or Disabled with Consumer Direction (EDCD) Waiver
The EDCD Waiver provides services that help individuals live in their own home or community instead of a nursing home. It is available to individuals 65 years of age and older, and to individuals of any age who have a disability. Individuals who depend on another person for their supports and have medical or nursing needs may be eligible for the EDCD Waiver.
As with all Medicaid-funded services, there are also financial eligibility criteria.
Services offered through the EDCD Waiver:
- Adult Day Health Care
- Agency and Consumer-Directed Personal Care
- Personal Emergency Response System (PERS)
- Agency and Consumer-Directed Respite Care
- Medication Monitoring
- Transition Services
- Transition Coordination
- For individuals participating in the Money Follows the Person project, environmental modifications and assistive technology for 12 months following a move to the community from a hospital or nursing home.
If you answer yes to any/all of the following questions, you may be eligible for the EDCD Waiver.
- Are you 65 years or older or do you have a disability?
- Do you need assistance with bathing, dressing, eating, getting out of bed, walking or using the bathroom?
- Do you have a medical or nursing need?
- Do you need help remembering things or forget how to do things?
- Do you sometimes wander away from home?
- Do you forget who you are or where you are?
- Do you need help remembering to take your medications or need assistance in taking your medications?
Next Steps
If you think that you might qualify for the EDCD Waiver, contact your local department of social services or local health department. To find information on-line, visit the VirginiaNavigator website, in the 'What you need?' box, type in " Social Services" or "Health Department," and put in your zip code. After you contact the department, a nurse and a social worker will schedule a meeting with you to assess your needs. If you are in the hospital, a discharge planner may also do this. To view the assessment instrument that will be used (the Uniform Assessment Instrument or "UAI"), look on-line at at http://www.dss.virginia.gov/files/division/dfs/as/as_intro_page/forms/032-02-0168-01-eng.pdf
Technology Assisted (Tech) Waiver
What makes someone eligible for the Tech Waiver?
The Tech Waiver provides home and community-based services for individuals who depend on technological medical support to survive, need substantial, ongoing skilled nursing care, and would otherwise have to live in a hospital, nursing home, or other institution.
As with all Medicaid-funded services, there are also financial eligibility criteria.
Services offered through the Tech Waiver
- Private Duty Nursing
- Personal Assistance
- Respite Care
- Transition Services
- Personal Emergency Response Systems (PERS)
- Case Management
- Transition Services
- Environmental Modifications
- Assistive Technology
If you answer yes to any/all of the following questions you may be eligible for the Tech Waiver.
- Do you depend on technological medical support in order to survive?
- Do you need substantial and ongoing skilled nursing care in order to maintain your quality of life?
- Are home and community based services critical to help you live in your home and community?
Next Steps
If you think that you might qualify for the Tech Waiver, contact your local department of social services or local health department. To find information on-line, visit the VirginiaNavigator website, in the "What you need?' box, type in "Social Services" or "Health Department," and put in your zip code. After you contact the department, a nurse and a social worker will schedule a time to meet with you to assess your needs. If you are in the hospital, a discharge planner may also do this. To view the assessment instrument that will be used (the Uniform Assessment Instrument or "UAI"), look on-line at http://www.dss.virginia.gov/files/division/dfs/as/as_intro_page/forms/032-02-0168-01-eng.pdf.
For more information about this and other Medicaid Waiver programs, look on-line at the Department of Medical Assistance Services or contact the Medicaid Mentor Program (toll free) at 1-866-323-1088 or 757-461-8007.