Virginia Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Dec 12, 2024
- 2 min read
Virginia, known as The Old Dominion State, has a well-structured Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.
Administered by the Virginia Department of Medical Assistance Services (DMAS) in collaboration with the Department of Behavioral Health and Developmental Services (DBHDS) and the Department for Aging and Rehabilitative Services (DARS), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings instead of institutional care.
Key waiver programs include the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, which provides personal care, respite, and assistive technology for seniors and adults with physical disabilities, and the Developmental Disabilities (DD) Waivers, which include the Community Living (CL) Waiver, the Family and Individual Supports (FIS) Waiver, and the Building Independence (BI) Waiver, all of which offer residential, employment, and habilitative services for individuals with intellectual and developmental disabilities (IDD). Virginia also offers Self-Directed Services, allowing waiver participants to manage their own caregivers and support services.
Regulatory oversight in Virginia is managed through DMAS, DBHDS, and DARS, with additional provider licensing and compliance enforcement handled by the Virginia Department of Health (VDH) and the Office of Licensure and Certification (OLC). The state operates under a Managed Care model, with HCBS services coordinated through CCC Plus Managed Care Organizations (MCOs) to enhance service delivery and cost-effectiveness.
Virginia has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and accountability in home-based care programs. Providers must navigate Medicaid enrollment, prior authorization requirements, and rigorous quality assurance measures to successfully participate in the state’s HCBS system.
With a strong emphasis on community-based care, person-centered planning, and self-directed service options, Virginia’s Medicaid waiver programs ensure that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and inclusion in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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