Step-by-step Guide to the Enrollment Process
We encourage you to print this out and use it as guide to ensure you or your loved one completes the process to be place on the waiting list. A person is assigned to the waiting list upon completion of this process. Therefore, it is critical that you follow-up with the expected time frames.
1. Complete the “Request for Screening” Form (below)
“Individuals or their legal guardians must initiate the DD Waiver screening process to determine diagnostic and functional eligibility. To request a screening, complete a Request for Screening form and send it to your regional DD Waiver Screening Facility
2. Setup an appointment for an initial screening
Once the screening form is submitted, it is routed to the Child Development Clinic (CDC) designated to provide screenings for the DD Waiver in the applicant’s area. A screener will contact the individual or legal guardian to set-up an in person meeting to determine diagnostic and functional eligibility. During that meeting, the screener will conduct a Level of Functioning (LOF) Survey. This should be done within 45 days.
3. Receive letter from the County Health Dept or CDC
Once the screening is complete, a letter will be sent notifying the applicant of his/her diagnostic and functional eligibility.
If the individual is determined to be ineligible, it is possible to appeal the decision and the letter should include information regarding the right to appeal. If it does not, you should contact the VA DMAS at 804-786-1465 to find out more about your options.
4. Select a case manager
When an individual is determined to be functionally and diagnostically eligible for DD Waiver services, the screening team informs the individual (or family caregiver) of the individual’s eligibility in writing, and documents the individual’s choice of waiver or institutional care by obtaining signatures on the “Documentation of Consumer Choice between Institutional Care or Home and Community-Based Service”. At this time, the individual is also provided with a list of case management providers. The individual must choose a case manager within 10 calendar days from the date of the screening and notify the screening team. The screening team must then forward the screening materials to the selected case manager within 10 calendar days of being notified of selection.
5. Set up an appointment with the case manager to complete the plan of care
Once the case manager has received notice of being selected, he/she will contact the individual within ten (10) calendar days of receipt of screening materials and arrange a face-to-face meeting within thirty (30) days to assess the individual’s situation, complete a social assessment, and develop an initial Plan of Care (POC). The case manager will then prepare the necessary paperwork and submit it the VA DMAS. The VA DMAS will notify the individual of its decision in writing, with a copy to the case manager. This letter will alert the individual that he/she:
1) Will be enrolled as requested;or
2) Has been placed on the statewide waiting list; or
3) That additional information is needed.
If the decision is to enroll the individual as requested, then the case manager will take the necessary steps to get the pre-authorization required for the requested services to be rendered, work with the individual and his/her family to get the requested services in place, and then monitor those services on a quarterly (3 month) basis. Due to the number of those on the waiting list, you will be placed on the waiting list.
If the POC is denied, the case manager will notify the individual in writing of the denial and provide information about the individual’s appeal rights.