Other Waiver Roles

Backup Plan

A Backup caregiver is a secondary person who assumes the role of providing direct care to and support of the waiver individual in instances of emergencies and in the absence of the primary caregiver who is unable to care for the individual. The backup caregiver shall perform the duties needed by the waiver individual without compensation and shall be trained in the skilled needs and technologies required by the waiver individual. The backup caregiver shall be identified in the waiver individual’s records.
 

The inability to identify and document a Backup caregiver for the Primary Caregiver, may result in termination of home and community based services (HCBS).

DD Support Coordinator (SC)

Support Coordinators are employed by the Department of Behavioral Health and Developmental Services (DBHDS) in Community Services Board (CSB) offices throughout Virginia. They are responsible for determining eligibility for CL, FIS, and BI waivers when allocated funds for slots are available.

Support coordination consists of assessing and planning of services; linking the individual to services and supports identified in the individual support plan; assisting the individual directly for the purpose of locating, developing, or obtaining needed services and resources; coordinating services and service planning with other agencies and providers involved with the individual; enhancing community integration; making collateral contacts to promote the implementation of the individual support plan and community integration; monitoring the individual to assess ongoing progress and ensuring that authorized services are delivered; and educating and counseling the individual to guide him to develop supportive relationships that promote the individual support plan.

MCO Care Coordinator

Care Coordinators are employed by respective Managed Care Organizations (MCOs). In Virginia, those MCOs are:

  • Aetna
  • Anthem
  • Magellan
  • Optima
  • United Healthcare
  • VA Premier

Care Coordinators are responsible for completing Health Risk Assessments (HRA) for newly enrolled members and reassessments every 6 months. HRAs are comprehensive assessments of a member’s medical, psycho-social, cognitive, and functional status in order to determine their medical, behavioral health, Long-term Services and Supports (LTSS), and social needs.

Primary Caregiver (PCG)

A Primary Caregiver is the primary person who consistently assumes the role of providing direct care and support of the individual to live successfully in the community without compensation for providing such care.
 
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