CCC Plus Waiver 

The Commonwealth Coordinated Care Plus (CCC+) Waiver is a Virginia Medicaid program that provides long-term services and supports to individuals with complex medical needs or disabilities, allowing them to receive care in their homes or communities instead of in nursing facilities. It serves older adults, individuals with disabilities, and those with significant health needs by covering services like personal care, respite care, assistive technology, environmental modifications, and private duty nursing. The goal of the CCC+ Waiver is to promote independence and improve quality of life while reducing the need for institutional care.
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The CCC+ Waiver serves Virginians of all ages who have complex medical needs or disabilities and require a level of care typically provided in a nursing facility. This includes:

• Older adults with chronic health conditions
• Individuals with physical or developmental disabilities
• Children and adults with complex medical needs
• People transitioning from institutions back into the community
• Individuals who meet Medicaid financial eligibility and require help with daily activities like bathing, dressing, or mobility.

​Eligibility is based on both medical and financial criteria, and applicants must be assessed to determine if they meet the required level of care.

Cardinal Care is a Medicaid managed care program in Virginia designed to provide long-term services and supports to individuals who qualify for nursing facility care but prefer to receive care in their homes or communities. The program helps people with disabilities or chronic conditions by coordinating medical, personal, and support services to promote independence and improve quality of life outside of institutional settings.

CCC Plus Waiver Fact Sheet ​

Agency Directed vs. Consumer Directed

Once you are screened and approved for the CCC Plus waiver, you have two options for how to use the personal care services. 

1. Agency Directed (AD) is where a licensed home care agency is responsible for managing and providing personal care services to someone who needs help with daily activities. The agency hires, trains, supervises, and pays the caregivers, taking care of all the administrative tasks. The person receiving care, or their family, helps develop a care plan, but the agency handles the rest. 
2. Consumer Directed (CD) services allows individuals receiving Medicaid waiver services to hire, train, and manage their own caregivers—often friends or family members—so they can receive personalized care at home. This model gives participants more choice, control, and flexibility in how their care is provided, while a fiscal agent (CDCN or PPL) handles payroll and taxes on their behalf. For this option you will need a Service Facilitator company to facilitate the waiver services.  

CCC + Waiver Step by Step 

1. The individual may request a LTSS Screening through their local Dept. of Social Services.
   
2. A Community-Based Screening Team (i.e.: Social Worker and Health Dept. Nurse), will meet with the individual and a family member/caregiver, if available, to assess the individual’s need for the CCC Plus waiver. If an individual is hospitalized and needs a screening, this can be done in the hospital by a discharge planner; and
   
3. The individual must be eligible for Medicaid in order to receive and have waiver services paid by Medicaid.
   
4. The individual may:
   Complete a Medicaid electronic application online at CommonHelp.virginia.gov.
   Call the Cover Virginia Call Center at 1-833-5CALLVA (1-833-522-5582, TDD: 1-888-221-1590) to complete the application over the phone, or contact their local Dept of Social Services agency to request a Medicaid paper application and request Appendix D, which is specific to long-term services and supports.
   
5. Once approved for Medicaid eligibility, screened and approved for the CCC Plus waiver, the individual may choose the desired waiver services. The screening team will assist the individual with locating providers in their area.
   
6. Choose between Agency-Directed or Consumer-Directed care services under the waiver. 
7. If you choose Consumer-Directed services, contact a service facilitator to develop a plan of care and start services.  

To learn more. . . 

Visit our resource page to watch our collection of hand picked videos from leading agencies and organizations.  

Developmental Disability Waivers (DD)

Developmental Disabilities (DD) Waivers in Virginia provide specialized support and services to individuals with intellectual or developmental disabilities to help them live as independently as possible in their communities. Unlike the CCC+ Waiver, which primarily serves older adults and people with complex medical needs who require nursing facility-level care, DD Waivers focus on a broader range of supports tailored to developmental disabilities, such as day programs, skill-building, and residential services. While both waivers aim to promote community living and independence, DD Waivers offer more targeted services that address the unique needs related to intellectual and developmental disabilities, whereas CCC+ focuses on medical and personal care for individuals with significant health challenges.

​ A developmental disability is a severe, chronic disability that:

1. Is attributable to a mental or physical impairment or a combination of both.
2. Is manifested before the individual turns 22 years old.
3. Is likely to continue indefinitely.
4. Results in substantial limitations in three or more major life activities, such as self-care, learning, mobility, communication, or self-direction.
5. Reflects the individual’s need for ongoing support and services throughout their lifetime.

 
To apply for DD Waiver services, contact your local Community Services Board (CSB) or visit the Virginia Community Services Board website to locate the CSB in your community and request a waiver screening. There is a wait list. 

Wait List - the Developmental Disabilities (DD) Waiver waitlist is managed by the Department of Behavioral Health and Developmental Services (DBHDS). Individuals seeking DD Waiver services are assessed and placed into one of three priority levels based on their immediate need for services.

Priority Levels:

1. Priority One: Individuals who require waiver services within one year due to significant health and safety concerns. This includes cases where the primary caregiver has a chronic condition that severely limits their ability to care for the individual, or when there are no other unpaid caregivers available.
2. Priority Two: Individuals who need waiver services within one to five years. These individuals may have less immediate needs but still require support to prevent potential health or safety issues.
3. Priority Three: Individuals who do not require waiver services within the next five years. These individuals are placed on the waitlist with the lowest priority.

The allocation of waiver slots is based on these priority levels, with Priority One individuals receiving the highest consideration. As of December 2023, Governor Glenn Youngkin announced additional funding to eliminate the Priority One waitlist by providing enough waiver slots for all individuals in this category.

The Individual and Family Support Program (IFSP) An annual financial grant that assists individuals with developmental disabilities and their families with accessing person-centered and family-centered resources, supports, services and other assistance. The program’s primary target population is individuals on the waiting list for Virginia’s Developmental Disabilities (DD) Medicaid waivers.

​DD Waiver Services
The system of services and supports for individuals with developmental disabilities has undergone a significant transformation as Virginia redesigned its waiver system. The My Life, My Community initiative encompasses an overarching vision whereby people with developmental disabilities live, work, play, and thrive in their communities, just as others do, with the support they need. 

Read more here: Navigating the Developmental Disability Waivers: Covered Services by Waiver Type & Glossary of Key Terms

Navigating the Developmental Disability Waivers: Covered Services by Waiver Type & Glossary of Key Terms

Navigating the DD Waivers Guidebook 

EPSDT  ( A program not a waiver) 

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid’s Managed Care or FAMIS Plus program. EPSDT is key to ensuring that children and adolescents receive appropriate screenings, preventive, dental, mental health, developmental, and any medically necessary services, and that services are provided early before health problems become complex or impact growth and development.

EPSDT PERSONAL CARE FACT SHEET 

​ASSISTIVE TECHNOLOGY FACT SHEET