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FIS/CL Comprehensive Waiver Processes

What are the FIS/CL Comprehensive waivers?

new-waiver

These waivers are Medicaid program for individuals who have a developmental disability (CL included).  These waivers offer many services which the individual can receive in his/her home and community.  Some services can be consumer- or agency-directed.


How to Apply:

  1. Contact your local CSB. Find your local CSB here.

What Are The Criteria?

You must qualify in three areas:

  1. Must have a diagnosis of developmental disability (autism, cerebral palsy, etc.)
  2. Financial –  See Step 1 under “How Do I Apply?” on our EDCD (CCC+) Page.
  3. Functional– Determined during your VIDES screening with your local CSB.

What are the Benefits of Being on the BI, CL, FIS Waiver?

  1. Consumer- or Agency-Directed Services:  Companion Services, Personal Care & Respite Care.
  2. Additional Services:  Individual/Group supported employment, community engagement, community coaching, group day services, workplace assistance(FIS/CL), companion services, independent living supports (BI), shared living, supported living (FIS/CL), assistive technology, crisis stabilization & supervision, day support, environmental modifications, residential support services(CL), skilled nursing (FIS/CL), therapeutic consultation(FIS/CL), and transition services.

After Approval:

The FIS/CL Comprehensive Waivers have a very long wait list based on priority, so you will start on the combined waiting list for BI, CL & FIS waivers.

  1. Select a Case Manager to develop your Plan Of Care (POC):
    1. If you are on Medicaid via Straight Medicaid or FAMIS or the EDCD (CCC+) Waiver, you may receive targeted case management on an as-needed basis.
    2. If you do not have Medicaid, the initial POC will be developed and no further services will be available until your slot is funded on the FIS Waiver, however, you could be served through the IFSP program or private pay for CM.
  2. Why would I want to do this if the wait list is so long?
    1. It is important for Virginia and the Federal Government to know how many people are in need of services and NOT getting them!
    2. If you have Medicaid via the EDCD (CCC+) Waiver, FAMIS, etc, you can receive targeted case management.
    3. You are eligible for the Individual and Family Support Program, which provides up to $3,000/fiscal year to the individual or family member of the individual on the wait lists in varying amounts, as requested and approved by DBHDS.
  3. When your “slot” is funded:
    1. Case Manager assists you to coordinate all services available.
    2. Select model of service delivery for Personal Care / Respite / Companion Services and choose a provider.
  4. Choosing a Provider:
    1. Agency-Directed:
      1. You chose an agency.
      2. They place their hired staff with you.
    2. Consumer-Directed
      1. You are the boss.
      2. You choose a provider such as Moms In Motion to be your “Service Facilitator.”
      3. You hire and schedule your own attendants.
      4. A Service Facilitator helps you continually.

If You Choose Consumer-Direction for Your Personal Care Services:

Service Facilitator Conducts Initial Visit:

  1. Trains Employer of Record (EOR) on hiring procedures.
  2. Initiates process by contacting Medicaid’s Fiscal Agent (PPL).
  3. Conducts initial assessment.
  4. Creates Plan Of Care (POC).
  5. Estimates how many hours the individual will qualify for.

Post Initial Meeting:

  1. Service Facilitator – Requests prior authorization for hours.
  2. EOR is set up to be employer.
  3. EOR recruits, hires, and schedules attendants.

Begin Services.


To Review the DMAS FIS Waiver Manual:

Visit DMAS’s Website:

https://www.virginiamedicaid.dmas.virginia.gov/wps/portal/ProviderManual

Select the drop down option of: “Individual and Family Developmental Disabilities Waiver Services.”

This will return all the chapters of the manual.

Chapter four outlines the services available via this waiver.

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