DD Waiver Eligibility
Who is eligible to receive DD Waiver Services?
The IFDDS Waiver provides services to individuals at the earliest 5 years, 9 months of age and older with a developmental disability such as Autism Spectrum Disorder, but who do not have a diagnosis of an intellectual Disability (ID), and who have been determined to require the level of care provided in an ICF/MR.
The DD Waiver is designed to serve individuals six years of age and older who meet criteria in three areas of eligibility diagnostic, functional, and financial.
An individual must have a developmental disability and not have a diagnosis of Intellectual Disability (ID) as defined by the American Association on Intellectual and Developmental Disabilities (AAIDD).
A developmental disability is defined as “a severe chronic disability that is evident before a person is 22 and is likely to continue indefinitely.” Attributes relating to this definition, other than mental illness, results in substantial functional limitation in three or more of the following areas of major life activity: self-care, understanding and use of language, learning, mobility, self-direction, and capacity for independent living. While ID is considered a developmental disability in Virginia, there is a separate waiver for persons with a diagnosis of ID.
The individual must meet the Intermediate Care Facility (ICF) for the Intellectual Disability (ID) level of care criteria. This is determined during the initial screening process.
It is the responsibility of the Department of Social Services (DSS) to determine an individual’s financial eligibility and patient pay responsibilities for Medicaid. Medicaid policies for individuals who receive home and community-based services allow a different method of determining income and resource eligibility. Some individuals, not otherwise eligible for Medicaid, may become eligible for enrollment into the DD Waiver and receive waiver services as well as all other Medicaid covered services when deemed medically necessary.