Virginia Medicaid Waiver Guide

Virginia runs three developmental disability waivers — Community Living, Family and Individual Supports, and Building Independence — and access to all three runs through your local Community Services Board. The waiting list is sorted into three priority levels based on when you will need services, and one rule shapes everything: for the Community Living and Family and Individual Supports waivers, someone with Priority Two status receives a slot only after every Priority One person in the entire state has one. Knowing that changes how you approach the process.

You must have a developmental disability and be screened and assessed through your local Community Services Board or Behavioral Health Authority, and you must meet Virginia Medicaid eligibility. Beyond that, waiver slots are allocated by urgency: Priority One covers people who will need waiver services within one year, Priority Two covers one to five years, and Priority Three covers five years or longer.

Slots are assigned by urgency of need across three priority levels. For the Community Living and Family and Individual Supports waivers, someone with Priority Two status receives a slot only when every person in the state assigned Priority One has received one. Building Independence works differently: someone assigned Priority Two or Three may receive a slot if no one in a lower priority category has requested independent living.

Type

Three priority levels, with a stark rule for Priority Two

Typical timeline

Because Priority Two on the CL and FIS waivers waits behind the entire statewide Priority One population, the practical question is whether your circumstances actually place you in Priority One. If your situation changes — a caregiver's health, a housing loss, escalating needs — request a re-screening rather than waiting quietly at Priority Two.

How to check status

Contact your local Community Services Board or Behavioral Health Authority. Ask which priority level you are assigned and what would justify a change.

1. Contact your local CSB or BHA

   The first step to learning about waivers or being screened and assessed is your local Community Services Board or Behavioral Health Authority. Virginia routes all waiver access through them.

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2. Get screened and assessed

   The CSB conducts the screening and assessment that establishes your developmental disability and assigns your waiting list priority level.

3. Understand your priority assignment — and challenge it if wrong

   Priority One means services needed within a year. Because Priority Two on the Community Living and Family and Individual Supports waivers waits behind every Priority One person statewide, an inaccurate assignment has enormous consequences. Ask what your level is and what evidence would support a different one.

4. Apply for IFSP funding while you wait

   Virginia's Individual and Family Support Program provides financial assistance to people on the DD waiver waiting list, covering eligible costs that support continued living in an independent setting. Apply through the My Life, My Community IFSP-Funding page — this is real money available during the wait.

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5. Report changes promptly

   Priority level reflects when you will need services, so a change in your circumstances is precisely what can move you. Tell your CSB rather than assuming they know.

• The person's age, diagnosis, and county of residence.
• Medicaid status or whether you still need to apply.
• Current supports, urgent needs, and living situation.
• School, medical, evaluation, or eligibility documents.
• Questions about waitlists, timelines, and next steps.

Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.

Virginia offers consumer-directed services across its DD waivers, letting participants hire and manage their own personal assistants, companions, and respite workers with support from a services facilitator. Ask your support coordinator which services can be consumer-directed under your waiver.

1. Early childhood

   Virginia's Infant & Toddler Connection provides early intervention, separately from the DD waivers. You can be screened by a CSB and placed on the waiting list well before adult services are needed.

2. School age

   School districts provide special education under an IEP. Waiver services are separate and additional. Get on the waiting list early, and use IFSP funding in the meantime.

3. Approaching the transition out of school

   This is often when a family's priority level should change — services will be needed within a year once school supports end. Request a re-screening ahead of that rather than after.

4. Adulthood

   Building Independence serves adults living independently, and its slot rules differ from the other two waivers — Priority Two or Three can receive a slot if no one in a lower priority category has requested independent living. Worth asking about if independent living is the goal.

If eligibility, a priority assignment, or a service is denied, reduced, or ended, you have appeal rights within the deadline stated on your notice. Virginia also operates under a settlement agreement with the U.S. Department of Justice concerning services for people with developmental disabilities, which publishes information publicly. The disAbility Law Center of Virginia is the state's designated protection and advocacy organization.

DBHDS

Virginia Department of Behavioral Health and Developmental Services — oversees the DD waivers.

CSB / BHA

Community Services Board or Behavioral Health Authority — your local entry point for screening, assessment, and support coordination.

Community Living (CL) Waiver

The comprehensive waiver, including 24-hour residential services.

Family and Individual Supports (FIS) Waiver

For people living with family or in their own home who need support short of residential care.

Building Independence (BI) Waiver

For adults living independently with supports, with different slot assignment rules from the other two waivers.

Priority One / Two / Three

The waiting list levels reflecting whether waiver services will be needed within one year, one to five years, or five years or more.

IFSP

Individual and Family Support Program — financial assistance for people on the DD waiver waiting list, plus family-led regional councils.