What Are Waivers?
Medicaid waivers were created in 1981 to address the “institutional bias” of Medicaid funding. Medicaid HCBS waivers allow states to exempt some Medicaid program rules, allowing them to provide services and assistance in the community rather than in an institutional setting.
Medicaid Waivers provide a variety of supports and services for children and adults with developmental The Americans with Disabilities Act (ADA) defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activity. This includes people who have a record of such an impairment, even if they do not currently have a disability. It also includes people who do not have a disability but are regarded as having a disability. The ADA also makes it unlawful to discriminate against a person based on that person’s association with a person with a disability. More and their families who need long-term support systems to live successfully in the community rather than in institutional settings. Unlike general Medicaid, household income is not considered. As a Waiver, only the income/assets of the person seeking eligibility are reviewed.
Virginia Medicaid offers several different Waivers that supply various supports: Commonwealth Coordinated Care (CCC Plus), One of the three types of developmental disability (DD) Medicaid waivers in Virginia, the Community Living (CL) Waiver is aimed for the minority of our population who have extremely high medical, behavioral, or support needs and provides 24/7 active services. More, and One of the three types of developmental disability (DD) Medicaid waivers in Virginia, the Family and Individual Supports (FIS) Waiver is the waiver for the majority of people – those who need supports for between a few hours and most hours of the day, including overnight monitoring in some cases. More. Within these waivers, services such as Personal Care, Short-term care for a child or adult that allows the primary caregiver relief. More, and A waiver-paid service focused on presence of a caregiver for safety, but less on hands on caregiving. More are available.
Consumer-Directed vs. Agency-Directed
Services where the person using them is allowed to select, hire, fire, and train their particular caregiver(s). More is a model of service delivery for which the person or the person’s Employer of Record, as appropriate, shall be responsible for hiring, training, supervising, and firing of the person who provides the direct support or specific services covered by DMAS and whose wages are paid by DMAS through its fiscal agent.
Agency-Directed is a model of service delivery where an agency is responsible for providing direct support staff, maintaining records, and scheduling the dates and times of the direct support staff’s presence in a person’s home and community.
The following Waivers utilize both Consumer- and Agency-Direction as a service delivery model: