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Medicaid Home and Community-Based Waivers

Medicaid Commonwealth Coordinated Care Plus

Commonwealth Coordinated Care Plus (CCC Plus) is a new Medicaid program that provides medical, behavioral, substance use disorder, and long term services and supports all under one program. 

CCC Plus is for full Medicaid members who are either: 65 and older, children or adults with disabilities, nursing facility residents, or someone receiving services through the CCC Plus Waiver (formerly the EDCD and Technology Assisted waivers), or one of the three Developmental Disability (DD) waivers. If you receive long term services and supports through one of the Developmental Disability (DD) waivers, how you receive your DD waiver services will not change. However, you will be required to receive your non-waiver services through CCC Plus. Non-waiver services include medical, behavioral, substance use disorder, pharmacy, and transportation to non-waiver services. The former Assisted Technology Waiver and the Elderly or Disabled with Consumer Direction Waiver (EDCD) were combined into one singular waiver, the Commonwealth Coordinated Care (CCC) Plus waiver.

DD Waiver Services

The Commonwealth’s system of services and supports for individuals with developmental disabilities has undergone a significant transformation as Virginia redesigned 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 do you need?' box,  type in "Community Services Boards," 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.  

Commonwealth Coordinated Care Plus (CCC+) Waiver

The CCC+ 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 CCC+ Waiver.

As with all Medicaid-funded services, there are also financial eligibility criteria.

Long Term Services and Supports (LTSS)

All CCC+ plans cover LTSS if you are on a home and community-based waiver or in a nursing facility. LTSS can help you live in your own home or other settings of your choice.

  • Adult day health care
  • Assistive technology
  • Environmental modifications
  • Personal care
  • Personal emergency response system (with or without medication monitoring)
  • Private duty nursing services
  • Respite care
  • Skilled and intermediate (custodial) nursing facility or long stay hospital
  • Help for members transitioning to the community from a nursing facility
  • Other services

These services are covered by the Department of Medical Assistance Services (DMAS) or a DMAS contractor:

  • Community mental health services
  • Dental services for children
  • Developmental Disabilities (DD) waiver services
  • School health services including some medical, mental health, hearing or rehabilitation therapy services as arranged by your child’s school
  • See your member handbook for a full list of services.

If you are enrolled in one of the Developmental Disabilities(DD) waivers, you will be enrolled in CCC Plus for your non-waiver services. DMAS will keep paying for your DD waiver services.

Added benefits -- CCC Plus Plans also offer added benefits such as phone services and wellness programs. To compare the added benefits of each plan, go to Compare plans.

► For more information about this program, look on-line at  Commonwealth Coordinated Plus.

 


Article Source
Virginia Department for Aging and Rehabilitative Services
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