Waivers

Overview

The Medicaid waivers are home and community based offering supports and services to a Medicaid individual, both children and adults. The waiver services will differ based on individual need and program criteria met.

For more information on the Commonwealth Coordinated Care Plus Waiver (CCC+) and the Developmental Disability (DD) Waivers, please use the links near the bottom of the page...

Announcements

  • DMAS is in the process of developing a targeted case management service for individuals with severe traumatic brain injury and has convened a workgroup with relevant stakeholders to develop program structures and cost estimates for implementing a continuum of treatment and supports for individuals with brain injury and neuro-cognitive disorders; including waiver and facility based neurorehabilitation and neurobehavioral services.
  • E-MAIL IN BOX - For Consumer Directed Services Questions related to time sheets and service authorizations for fee for service CCC Plus waiver members, submit your question to: cdsf@dmas.virginia.gov
  • E-MAIL IN BOX - For Brian Injury Services Questions related to time sheets and service authorizations for fee for service CCC Plus waiver members, submit your question to: braininjuryservices@dmas.virginia.gov
  • E-MAIL IN BOX - For CCC Plus Waiver Questions related to program criteria and clarification of policy for fee for service members, submit your question to: cccpluswaiver@dmas.virginia.gov
  • New guidance available: In Home Support Service Guidance Document
  • Questions about Legally Responsible Individuals (LRI)? Please visit the LRI webpage for information.

1915(c) Home and Community-Based Waiver Amendments Effective January 1, 2027: A Summary of Proposed Changes

As part of legislative actions in the 2026 General Assembly, the Department of Medical Assistance Services is requesting authority via the 1915(c) waiver amendment process to amend the Community Living (CL), Family and Individual Support (FIS), and Commonwealth Coordinated Care Plus (CCC+) Waivers.  Below is a simplified summary of requested changes.  Detailed information can be found in each application.

Summary of Changes

  1. Item 291.MMMMM of the 2026 Budget: Add a 56-hour “soft cap” for personal assistance with the same exception criteria that is currently in the CCC+ Waiver for more hours. (CL, FIS)
  2. Item 295.PP of the 2026 Budget: Adding support brokers through the Fiscal-Employer Agent for the consumer-directed model and end Services Facilitation.  More information below. (CL, FIS, CCC+)
  3. Item 295.ZZ of the 2026 Budget: Modify consumer-direction rules to allow one person to perform the day-to-day Employer of Record (EOR) responsibilities and have the Employer Identification Number assigned to the individual receiving care. (CL, FIS, CCC+)
  4. Removing the Eligibility Group “Working Individuals with disabilities who buy into Medicaid (TWWIIA Basic Coverage Group as provided in §1902(a)(10)(A)(ii)(XV) of the Act)" as an eligible to be enrolled in both Medicaid Works and a waiver.  This group was included in error and never put into operation.  (CL, FIS)
  5. Removing “Legally Responsible Individual” as an allowable provider of the Employment and Community Transportation service.  This selection was made in error and never put into operation.  (CL, FIS)
  6. Correcting requirements for when a Legally Responsible Individual is the paid aide/attendant for personal care/assistance to match current practices.  (CL, FIS)
  7. Removing the requirement that a higher level review by a DMAS nurse is performed following a Level of Care Review (LOCERI) that finds the individual no longer meets criteria. (CCC+)
  8. Updating quality measures to remove the managed care organizations as reviewers of service plans and references to higher level reviews for LOCERI. (CCC+)

Looking for Electronic Visit Verification (EVV)?

Changes to Electronic Visit Verification requirements do not require a waiver amendment according to the Centers for Medicare and Medicaid Services.  Therefore, EVV is not being discussed in these amendments.

Support Brokers

As part of the implementation of support brokers, DMAS has proposed a phased-in transition while ending Services Facilitation as a service.

  • Support Brokers will replace Services Facilitation.
  • Support Brokers will be hired through the Fiscal-Employer Agent, either CDCN or PPL.
  • Support Brokers will begin on March 1, 2027 in a regional transition.
    • March 1, 2027: Western and Southwestern Virginia
    • April 1, 2027: Central Virginia
    • May 1, 2027: Tidewater and Eastern Virginia
    • June 1, 2027: Northern Virginia and Tangier Island
  • An individual cannot receive both Services Facilitation and Support Brokers.
  • Once the region starts Support Broker services, the individual will no longer have a Services Facilitator.
  • Services Facilitators will continue to visit individuals until their region has transitioned to Support Brokers.
  • Services Facilitation as a service will end on May 31, 2027.
  • Support Brokers will conduct visits quarterly to all consumer-directed individuals and perform assessments to develop the Plan of Care for personal care/assistance, respite, and/or companion.
  • Individuals, EORs, and attendants will not have to complete any new paperwork to enroll in Support Brokers. 
  • DMAS will provide informational sessions after receiving approval from CMS and closer to March 1, 2027.  Keep an eye out for future communications! 

View the Applications

The proposed applications in full are available here:

Public Comment

Want to make a public comment?  Visit the Virginia Town Hall at https://townhall.virginia.gov/index.cfm.  The public comment period lasts from September 17, 2026 to October 17, 2026.