DD Waiver in Virginia: What It Covers and How to Apply

For families raising a child or supporting an adult with autism or another developmental disability, the biggest barrier to consistent in-home support is often not finding the right caregiver. It is figuring out how to pay for one. Virginia’s Developmental Disabilities (DD) Waiver was built to close that gap, funding home and community-based services for people who would otherwise need institutional care. Here is what the DD Waiver covers, who qualifies, and how to start the application process.

What Is the Virginia DD Waiver?

The DD Waiver is not a single program. It is a set of three Medicaid Home and Community Based Services (HCBS) waivers administered jointly by the Virginia Department of Medical Assistance Services (DMAS) and the Department of Behavioral Health and Developmental Services (DBHDS). Each waiver funds services and supports for people with developmental disabilities, including autism and intellectual disabilities, so they can live in their own home or community instead of an institution.

Virginia introduced this model in 1991, when the state began waiving the requirement that someone with a developmental disability had to live in an institution to receive Medicaid funded care. More than three decades later, the DD Waiver system remains one of the primary funding sources for autism and disability home care across the state, including for families in Sterling, Loudoun County, Manassas, and the wider Northern Virginia region.

The Three DD Waivers, Explained

Virginia’s DD Waiver system is split into three tracks, each built for a different level of need.

Community Living (CL) Waiver

For individuals with the most intensive support needs, including around the clock care, skilled nursing, or significant behavioral support.

Family and Individual Supports (FIS) Waiver

For individuals who live with family or independently but need a moderate level of support, such as personal care, respite, or therapeutic consultation.

Building Independence (BI) Waiver

For adults 18 and older who can live mostly on their own and do not need support around the clock, but still benefit from services like community coaching or supported employment. This track pairs closely with independent living support services for adults building greater independence day to day.

A support coordinator, assigned once someone is offered a waiver slot, helps determine which track fits and builds the individualized plan of care around it.

Who Qualifies for the DD Waiver?

Eligibility for the DD Waiver rests on three separate tests, and a family has to meet all three.

Diagnostic

The individual must have a developmental disability as defined under Virginia law: a permanent disability that began before age 22, is not solely a mental illness, and causes functional limitations in at least three areas of daily life for adults (or two for children), such as self-care, communication, learning, mobility, self-direction, or the capacity for independent living. Autism, intellectual disability, and certain other developmental conditions can qualify with a diagnosis from a licensed provider. For intellectual disability specifically, Virginia law requires the diagnosis to have been made before age 18, rather than the broader age-22 threshold that applies to other developmental disabilities.

Functional

A support coordinator conducts the Virginia Individual Developmental Disabilities Eligibility Survey (VIDES) to measure how much daily support a person needs in practice. Advocacy groups such as the Arc of Virginia recommend describing what the person could do with no supports or family help present, since that is the standard the survey is built around.

Financial

The individual must be eligible for Virginia Medicaid. Here is a detail many families do not expect: for applicants under 18, only the child’s own income and resources count toward Medicaid eligibility, not the parents’. That single rule allows many middle-income households to qualify for a minor child who otherwise would not meet Medicaid’s income limits.

What Services Does the DD Waiver Cover?

The specific services available depend on which of the three waivers a person is assigned and what their plan of care identifies as necessary, but common services include:

• In-home personal care services, helping with bathing, dressing, meals, and other daily living tasks
• Respite care for autism, giving family caregivers scheduled time off
• Community coaching and independent living skills, building toward greater self-sufficiency
• Supported employment, helping adults find and keep community-based jobs
• Assistive technology and environmental modifications, funding equipment or home changes that improve safety
• Behavioral support and therapeutic consultation, addressing specific behavioral or clinical needs
• Group home and residential support, for individuals on the Community Living Waiver who need a higher level of daily supervision

How to Apply for the DD Waiver in Virginia

The steps below reflect the standard process families go through with their local Community Services Board (CSB). Butterfly Home Care is not involved in determining eligibility or approving waiver applications — we’re a Medicaid-credentialed provider families can choose once a waiver plan of care is in place.

Step 1: Contact your local Community Services Board (CSB)

The CSB is the single point of entry for DD Waiver screenings in every region of Virginia. You can find your local CSB through the Virginia Community Services Board directory or by contacting DBHDS directly. Advocacy organizations such as The Arc of Virginia can also help families navigate this process.

Step 2: Complete the VIDES assessment

A CSB support coordinator will schedule the Virginia Individual Developmental Disabilities Eligibility Survey to determine functional eligibility.

Step 3: Apply for Medicaid, if you have not already

Medicaid eligibility runs alongside, not after, the functional assessment. Families can apply through Cover Virginia or their local Department of Social Services office.

Step 4: Wait for a waiver slot

This is the part families are least prepared for. Virginia’s DD Waivers have a statewide waitlist, and slots are assigned based on urgency of need rather than simply how long someone has been waiting. As of late 2025, close to 20,000 Virginians held an assigned waiver slot, with more than 14,000 on the waitlist. Applying early, even years before support is urgently needed, is the most common advice from advocacy organizations across the state.

Step 5: Accept your offer and meet your support coordinator

When a slot opens, you will receive a call or letter offering the waiver. Once accepted, a support coordinator helps build the individualized plan of care and select providers.

Step 6: Choose your provider

As with other Virginia Medicaid waivers, families have the right to select their own Medicaid credentialed provider for personal care and in-home support services.

Apply Before You Need It Because DD Waiver slots are assigned by urgency rather than application date, waiting until a crisis hits can mean waiting longer for help. Families who apply early are often better positioned when a slot becomes available.

DD Waiver vs. CCC+ Waiver: What Is the Difference?

Families researching Medicaid waivers in Virginia often come across both the DD Waiver and the CCC+ (Commonwealth Coordinated Care Plus) Waiver, and the overlap can be confusing. A few distinctions matter most:

• Age: The DD Waiver has no minimum age, so children can qualify. CCC+ is primarily an adult program for people 18 and older.
• Eligibility standard: CCC+ requires a nursing facility level of care determination through the Uniform Assessment Instrument. The DD Waiver uses the VIDES survey and Virginia’s specific legal definition of developmental disability.
• Waitlist: The DD Waiver has a well-known statewide waitlist. CCC+ generally does not, though the assessment and enrollment process still takes time.
• Household income counting: Under the DD Waiver, a minor child’s Medicaid eligibility is based on the child’s income alone. CCC+ eligibility, since it primarily serves adults, is based on the individual’s own income and resources under adult Medicaid rules.

Some families end up interacting with both systems over time, especially as a child on the DD Waiver waitlist becomes an adult, and CCC+ becomes relevant. If you are unsure which waiver fits your situation, our guide on how the Virginia CCC+ waiver works walks through that program in detail.

How Butterfly Home Care Works with the DD Waiver

At Butterfly Home Care, we provide autism home care services for individuals with autism and other developmental disabilities across Northern Virginia. We are a Medicaid-credentialed provider, which means families whose DD Waiver plan of care includes personal care or in-home support can request us directly through their support coordinator.

Our team is based in in-home care in Sterling, VA and also serves families throughout in-home care in Fairfax County, VA, in-home care in Arlington, VA, and Medicaid home care in Manassas, VA, the same Northern Virginia communities most affected by DD Waiver wait times.

We also work alongside families still waiting for a waiver slot. Not every family can wait years for funded services to begin, and our team can talk through private pay and other funding options in the meantime, including our community guide services for individuals building independent living skills while their waiver application moves forward.

Common Questions Families Ask About the DD Waiver

How long is the DD Waiver waitlist?

Wait times vary widely by region and by which of the three waivers a person needs, ranging from under a year to several years for the Community Living Waiver in particular. Because slots are assigned by urgency rather than a strict first-come, first-served order, someone with more intensive needs may be assigned a slot sooner than someone who applied earlier.

Can a family member be paid as a caregiver under the DD Waiver?

In many cases, yes. Virginia’s Consumer Directed Services option allows families to hire and manage their own caregivers, including certain relatives, through a fiscal agent. Your support coordinator can confirm whether this applies to your specific plan of care.

What happens if we are denied?

Families have the right to appeal a DD Waiver denial. Start by asking your CSB for written documentation of the reason for denial, then request the CSB’s appeal forms. Advocacy organizations such as the Arc of Virginia can help families through this process.

Does having an autism diagnosis automatically qualify someone for the DD Waiver?

No. An autism diagnosis alone does not guarantee eligibility. The individual still has to meet the functional criteria measured by VIDES and the financial criteria for Medicaid. Many autistic children and adults do qualify, but the assessment process determines eligibility case by case.

Can someone be on the DD Waiver waitlist and still receive other services?

Yes. Being on the waitlist for a DD Waiver slot does not prevent a family from using other resources in the meantime, including private pay home care, standard Medicaid benefits where eligible, school based services, or community organization support.

Start the Process Early

The most consistent piece of advice from Virginia’s disability advocacy community is to apply for the DD Waiver long before a crisis makes funded support urgent. Waitlists move slowly, but they do move, and applying earlier only helps. If your family is navigating this process in Northern Virginia, contact Butterfly Home Care to talk through how in-home care fits into your plan while you wait for a waiver slot, or once one is assigned.

Sources

1. Developmental Disability (DD) Waivers, Virginia Medicaid (DMAS)

2. Developmental Disabilities Waiver, The Arc of Virginia

3. Waiver Information for Individuals and Families, Virginia Department of Behavioral Health and Developmental Services (DBHDS)