In other words: don't wait on a waiver decision to pursue ABA therapy if your child already has Medicaid. But if your family's needs extend into long-term supports, respite, or community living services, the waiver system is where that conversation starts.
Virginia's Developmental Disability Waivers Explained
Virginia's primary waiver pathway for individuals with autism and other developmental disabilities is the
Developmental Disability (DD) Waiver system, jointly administered by DMAS and DBHDS. It isn't a single program. It's three separate waivers, each built for a different level and type of need.
Community Living (CL) Waiver
This is the most comprehensive of the three, intended for individuals who need extensive, ongoing supports, potentially including residential services. It's generally reserved for those with the highest level of need.
Family and Individual Supports (FIS) Waiver
FIS is the waiver most families of children with autism encounter, since it's designed for people living with family or independently who need support but not full residential services. It can help fund things like respite care, in-home supports, therapeutic consultation, and skill development.
Building Independence (BI) Waiver
BI is intended for adults 18 and older who can live largely independently with some support, rather than around-the-clock assistance. It's less commonly relevant during a child's early years but becomes part of the planning conversation as families think about the transition to adulthood.
The CCC Plus Waiver
You may also see references to the Commonwealth Coordinated Care Plus (CCC Plus) Waiver. This program serves individuals of all ages who need long-term services and supports, and while it's not autism-specific, some individuals with autism and co-occurring medical or long-term care needs may qualify. For most families whose primary concern is autism-related developmental support, the DD Waivers (CL, FIS, BI) are the more relevant starting point, but it's worth asking your Community Services Board whether CCC Plus applies to your situation.
Who Typically Qualifies for a DD Waiver
Eligibility for Virginia's DD Waivers is based on both a diagnostic and a functional determination, not diagnosis alone. In general terms, applicants need to:
- Have a documented developmental disability (which includes autism) that originated before age 22 and is expected to be lifelong
- Meet the functional criteria assessed through Virginia's screening and eligibility process, administered by the local Community Services Board
- Meet Medicaid financial eligibility requirements, which vary depending on the waiver and the applicant's living situation
Because these determinations involve both clinical documentation and a functional assessment, families often benefit from having organized records: diagnostic reports, current treatment plans, and documentation of daily support needs. In our own work with families preparing for these evaluations, we've seen how much smoother the process goes when a child's ABA provider and support coordinator are already communicating and can supply consistent, well-documented information about functional needs.
The Waitlist Reality and What to Do While You Wait
Here's the part families are rarely prepared for: Virginia's DD Waivers operate on an active waitlist, and slots are assigned based on urgency of need rather than the date of application. Depending on the waiver and a family's priority level, the wait can range from a relatively short window to several years. Because slot allocations and waitlist volumes change from year to year, we won't cite a specific number here. Ask your Community Services Board for the current outlook, since it's the only reliably up-to-date source.
This is exactly why understanding the distinction from the first section matters so much. Families sometimes delay starting ABA therapy while waiting on a waiver decision, when in fact standard Medicaid or
private insurance may already cover therapy in the meantime. In our sessions, we regularly work with families who are simultaneously receiving
ABA services under standard Medicaid coverage and sitting on a DD Waiver waitlist for additional community supports. The two tracks aren't mutually exclusive, and pursuing both early tends to serve children best.
How the Application Process Generally Works
While your
Community Services Board (CSB) will walk you through the specifics, the general path looks like this:
- Contact your local CSB. This is the entry point for all DD Waiver applications in Virginia, regardless of which of the three waivers may eventually apply.
- Complete the eligibility screening. A CSB representative will assess whether your child meets the definition of a developmental disability and administer the functional eligibility survey.
- Get placed on the waitlist with a priority designation. Priority levels reflect urgency of need, which is reassessed periodically rather than fixed at the time of application.
- Receive a waiver offer when a slot becomes available. At that point, families work with a support coordinator to select services and providers.
- Build a service plan. Once assigned, families choose from approved waiver services and providers, which can include behavioral supports, respite, and other community-based services depending on the specific waiver.
Throughout this process, it's worth staying in touch with your child's existing care team. A consistent record of documented needs, from ABA providers, school teams, and medical providers, tends to support both the initial eligibility determination and later priority reassessments.
Why This Matters for the Whole Care Team
Parents aren't the only audience for this information. Educators and school personnel are often the first to notice when a family could benefit from waiver-funded support, particularly around behavioral needs that extend beyond the classroom. ABA therapists and other professionals working with a family also play a role, since documentation from ongoing therapy can directly support a waiver application or priority reassessment. And for individuals with autism who are approaching adulthood, understanding the BI Waiver and the broader waiver system early can make the transition into adult services considerably less disruptive.
Getting Support While You Navigate the Waiver System
Virginia's Medicaid waiver system exists to help families access supports that go beyond a single therapy or service, but it isn't the only door into care, and it doesn't need to be the first one you knock on. Whether your child already has Medicaid, private insurance, or is still waiting on a diagnosis, there are usually options available now, while a waiver application moves through the process in the background.
At
Career Based Solutions, we work with families throughout Virginia, including
Thornburg,
Richmond, and
Fredericksburg to coordinate in-home ABA therapy, school-based ABA therapy, early intervention, and parent training, and we're happy to help your family understand where standard Medicaid coverage ends and where a waiver conversation might begin.
Contact us today
if you have questions about ABA therapy, Medicaid coverage, or how waiver support might fit into your child's care plan. We'll help you sort through the options and connect you with the right next step for your family.
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