Apply for a Medicaid Waiver Now

If your child has a disability and meets certain requirements, he/she may be eligible for funding for support services through the Medicaid Waivers. The waivers provide states with the flexibility to offer services to an individual in the community rather than living and receiving services in an institution and can include, but are not limited to, personal care, respite care, day support, supported employment, and assistive technology. Virginia has seven waivers but the following waiver programs are most appropriate for school aged children who meet functional level of care criteria as well as financial and diagnostic criteria.

Waiver	Information	Contact
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.	Local Community Services Boards Fairfax/Falls Church CSB 703-324-4400
Family and Individual Supports Waiver (DD Waiver)	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.	Local Community Services Boards Fairfax/Falls Church CSB 703-324-4400
Building Independence Waiver	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.	Local Community Services Boards Fairfax/Falls Church CSB-ID 703-324-4400
Elderly or Disabled with Consumer-Direction Waiver (EDCD Waiver)	Must meet nursing facility eligibility criteria including medical needs and functional capacity	Call your local Department of Social Services for intake:  Fairfax 703-324-7500
Technology Assisted Waiver	Must require ongoing skilled nursing care and be dependent on technology to substitute for a vital body function	DMAS conducts the screenings for individuals under the age of 21 who request tech Waiver services.  Call 804-786-1465 or local Health Department or Department of Social Services

Do you have questions about the Waiver Redesign of the intellectual, developmental or day support waivers?  

For your local contact, call the Virginia Waiver Line at 844-603-9248 Toll Free

Remember:

• There are waiting lists for waiver services – some can take years. It is important to put your child on the waiting list as early as possible so that funds are available to you when you need them. These lists also tell our legislators how many people are waiting for services when they are making decisions on funding priorities.
• Services are NOT mandated after your child turns 21.  Your child must meet eligibility requirements and funding must be available to receive services.
• Consider another Medicaid Waiver while your child is on a waiting list. 

Other Services to Consider

SSI – Supplemental Security Income is a program that pays benefits to adults and children with disabilities that have limited income and resources. Prior to age 18, family income is considered. After 18, individual income is considered. Contact the Social Security Administration (SSA) 30 days prior to a student turning 18. Call 800-772-1213 for application information or go to http://www.ssa.gov/pgm/links_ssi.htm for more information.

Medicaid provides medical benefits to low-income people and people with disabilities who have no medical insurance or have inadequate medical insurance. Call the Department of Family Services at 703-324-7500 or go to http://www.fairfaxcounty.gov/dfs/ss/medicaid.htm  for more information.

EPSDT - Early and Periodic Screening, Diagnosis and Treatment is available to children under the age of 21 who are eligible for Medicaid.  Personal care, dental care, nursing, therapies and other Medicaid services not typically provided to adults in Virginia are available to children who are eligible for Medicaid.  More information is available by calling 804-786-6134.

FAMIS - Family Access to Medical Insurance Security Plan is a low cost medical insurance program for the children of working families in Virginia.  Based on income, families with uninsured children may enroll in FAMIS.  This program covers families that do not qualify for Medicaid.  For more information call toll free 866-873-2647.

HIPP – Health Insurance Premium Payment Program is a program for people receiving Medicaid where Department of Medical Assistance Services may reimburse for all or part of monthly private health insurance premiums. For more information call 800-432-5924.

Comprehensive Services Act pools funds from various agencies to meet the needs of children, up to age 18, who are “high risk.”   Decisions about funds and services are determined at the local level by Community Policy and Management Teams (CPMT) and Family Assessment and Planning Teams (FAPT).  More information is available by calling 804-662-9815 and at http://www.doe.virginia.gov/support/comprehensive_services_act/index.shtml.

MetroAccess is a shared-ride, door-to-door, paratransit service for people who cannot use public transportation due to a disability. The service is available to individuals who are age 5 and older.  Children must be accompanied by a parent/guardian. More information is available by calling 301-562-4640 and at https://www.wmata.com/service/accessibility/index.cfm.

Adapted from the Virginia Department of Behavioral Health and Developmental Services

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