VA Community Living Waiver

Published on
August 30, 2023
Last updated
April 19, 2024
Written by
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Katie Wilkinson
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A guide to the Community Living Waiver in Virginia, a Medicaid program that provides home and community-based services for individuals with intellectual and developmental disabilities.
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The Community Living Waiver is a Medicaid program that provides home and community-based services for individuals with intellectual and developmental disabilities (I/DD) in Virginia. The waiver supports individuals to live in the community and avoid institutionalization by offering services and supports that meet their needs and preferences. The waiver also gives individuals more choice and control over their services through self-direction.

Overview of Community Living Waiver

The Community Living Waiver is one of the three developmental disabilities waivers in Virginia, along with the Family and Individual Supports Waiver and the Building Independence Waiver. The waivers are administered by the Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS).

The Community Living Waiver is the most comprehensive and flexible, as it offers the highest number of services and supports and has no limit on the amount of funding allocated to each individual. The waiver serves individuals with I/DD who meet the level of care criteria for an intermediate care facility for individuals with intellectual disabilities (ICF/IID), requiring constant supervision and assistance with daily living activities.

The waiver has limited slots available, which are allocated based on a priority list that considers factors such as urgency of need, length of time on the waiting list, and availability of resources. 


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Eligibility Requirements

To be eligible for the Community Living Waiver, an individual must meet the following requirements:

  • Be a Virginia resident
  • Be eligible for Medicaid
  • Have a diagnosis of I/DD or a related condition
  • Have an assessed need for ICF/IID level of care
  • Have an individualized support plan (ISP) that identifies the services and supports needed to live in the community
  • Agree to receive at least one waiver service per month
  • Not be enrolled in another Medicaid waiver or ICF/IID

Services and Supports

The Community Living Waiver offers various services and supports tailored to each individual’s needs and preferences. Some of the services and supports include:

  • Personal assistance: Help with activities of daily living (ADLs) like bathing, dressing, eating, toileting, etc., and instrumental activities of daily living like shopping, cooking, cleaning, etc.
  • Respite: Temporary relief for caregivers who provide unpaid care to individuals with I/DD
  • Environmental modifications: Adaptations or alterations to an individual’s home or vehicle that are necessary to ensure health, welfare, and safety or enable greater independence
  • Assistive technology: Devices or equipment that enhance an individual’s ability to perform ADLs or IADLs or communicate effectively
  • Supported employment: Services that help an individual find and maintain paid work in an integrated setting
  • Day support: Services that provide opportunities for socialization, recreation, education, skill development, and community integration during daytime hours
  • Crisis support: Services that provide immediate intervention and stabilization for individuals who experience a behavioral or psychiatric crisis that poses a risk to themselves or others
  • Therapeutic consultation: Services that provide specialized expertise and guidance to individuals and their caregivers on how to address specific behavioral, medical, or communication issues
  • Transition services: Services that help an individual move from an institutional setting to a community-based setting

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Compensation for Caregivers

The Community Living Waiver allows individuals to self-direct some of their services, which means they can choose their service providers, manage their budgets, and hire their workers. Self-direction gives individuals more choice and control over their services, as well as more flexibility and convenience.

One of the benefits of self-direction is that individuals can hire their family members as paid caregivers for some of their services. For example, an individual can hire their parent, spouse, sibling, child, or other relative as a personal assistant or a respite provider. This option can be beneficial for both individuals and their families, as it can provide financial support for caregivers who may otherwise have to quit their jobs or cut back their hours to care for their loved ones, as well as emotional support for individuals who may prefer to receive care from a person they know and trust.

However, not all services can be self-directed or provided by family members. Some services, such as environmental modifications, assistive technology, supported employment, day support, crisis support, therapeutic consultation, and transition services, require professional providers who meet specific qualifications and standards. Additionally, some family members, such as legally responsible individuals (LRIs), cannot provide paid care under the waiver. LRIs are parents of minor children or spouses of waiver participants lawfully obligated to provide care and support for them. However, the waiver is undergoing an amendment that would allow LRIs to offer personal assistance services under certain conditions.

A Note from Givers

If you are interested in applying for the waiver or receiving its services or want to learn more about the other developmental disabilities waivers in Virginia, please fill out this form to determine if you may be eligible for compensation. We will contact you as soon as possible and guide you through the process. 

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