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4.5.16

Waiver Redesign News

At the end of March 2016, the Department of Behavioral Health and Developmental Services submitted the application to the Centers for Medicaid and Medicare Services (CMS), the federal agency who will approve the plan for our redesign.  CMS has up to 90 days to make that decision.  It could go faster, or slower if they have a number of issues they need Virginia to address.

Starting on July 1, 2016 we will have funding for the newly Redesigned Waivers.  Once the application is approved by CMS, the state will start implementing the changes we all have worked so hard to make happen.

What will happen on July 1, 2016 if all goes well?
·         Existing Waiver services will start to be reimbursed at the higher rates approved by the General Assembly.

·         Anyone entering the Waiver system will go through the Community Services Boards for screening

·         Current ID and DD Waiting Lists will be combined based on new, three tier criteria focused on urgency

·         Brand new Waiver services will start to be offered as regulations are written and providers come online to provide the services

What should I expect?

If you currently have an ID or DD Waiver, expect that not much will change immediately.  Your Waiver will change names and you’ll keep your current case manager.  We expect that by sometime later this year, you’ll have the option to move from county to private case managers or vice versa, but details are unclear on that.  We also hope that anyone with a current DD Waiver will be able to access 24/7 supports and nursing services previously not available if needed.  Anyone with a current Waiver will be able to utilize the new services as soon as they’re available.

If you’re on the waiting list, for either an ID or DD Waiver, someone should be reaching out to you to help determine your spot on the newly structured waiting list.  Advocate for yourself by sharing your needs, any relevant crises, and why you need services immediately.

If you’re not yet on the waiting list, you’ll still need to get a recent psychological evaluation showing your disability to apply for Waivers.  No matter what the IQ score, if you have a developmental disability, you’ll reach out to your local Community Services Board to start the application process.

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