How to Get on Virginia’s Medicaid Waiver Waiting List

To get on Virginia’s Medicaid waiver waiting list for developmental disability services, contact the Community Services Board (CSB) that covers your county or city and ask for a DD waiver screening. A support coordinator will meet with the individual, complete an eligibility assessment, and submit the results to the state. If the person qualifies, they are placed on the statewide waiting list at one of three priority levels based on how urgently services are needed, not on the date you applied.¹

That priority system is the single most important thing to understand before you start. Someone screened last month can receive a slot ahead of someone who has waited five years, if their situation is more critical. Everything below is built around that reality.

Which Waiver You’re Waiting For

Virginia operates three DD waivers, and the same waiting list feeds all three. The waiver you’re eventually offered depends on your level of need:

Community Living (CL) is for children and adults who need around-the-clock support, often in staffed group homes or supported living.
Family and Individual Support (FIS) is for children and adults who live with family, friends, or in their own homes and need functional, behavioral, or medical supports.
Building Independence (BI) is for adults 18 and older who can live mostly on their own with periodic support.

All three are run jointly by the Department of Medical Assistance Services (DMAS) and the Department of Behavioral Health and Developmental Services (DBHDS).¹ You don’t pick a waiver when you apply. The state matches you to one when a slot becomes available.

Who Qualifies

Two separate standards have to be met. First, the person must have a developmental disability as Virginia defines it: a mental or physical impairment (or both) that appeared before age 22, is expected to continue indefinitely, and causes substantial functional limitations in three or more major life areas. Those areas include self-care, language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency. Children from birth through age nine can qualify under a broader rule if they have a substantial developmental delay or a specific congenital condition and a high probability of meeting the full criteria later.²

Second, the person must need the level of care provided in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). This is measured by a required screening tool, not by general medical opinion.³

Medicaid financial eligibility also applies. Waiver programs often use different income rules than standard Medicaid, and for children, parental income may be treated differently than it would be for a regular Medicaid application. Raise the financial question with the CSB during the initial screening; meeting the disability criteria alone is not enough.

How to Apply Through Your CSB

The CSB is the single entry point for every DD waiver service in Virginia.¹ Call the board that serves your locality and ask specifically for a DD waiver screening. A support coordinator will schedule an in-person meeting with the individual and family.

Before that meeting, pull together a psychological evaluation or detailed medical records that document the developmental disability diagnosis and show it meets the state definition. Make notes on daily support needs, behavioral challenges, and medical conditions. Incomplete documentation is one of the most common reasons screenings get delayed.

At the meeting, the support coordinator administers the Virginia Individual Developmental Disabilities Eligibility Survey (VIDES) in the presence of the individual. Family members or others who know the person well can provide information.⁴ The adult VIDES evaluates eight categories, including health status, communication, personal care, motor skills, behavior, community living skills, and self direction. The individual must show needs in two or more of those categories to meet the ICF/IID level-of-care standard.⁵

The CSB enters the results into the state’s electronic system. The state reviews the file, confirms whether the person meets the level of care, and notifies you of placement on the waiting list and the assigned priority level. One timing rule matters later: the VIDES has to be current within six months of actual waiver enrollment, so if you spend years on the list, the assessment will be redone before you can start services.³

How Priority Levels Decide Your Wait

Slots are released to the people with the highest urgency first.¹ Three levels sort the list.

Priority One

Priority One is for individuals who need waiver services within one year. You qualify if any of the following is true:⁶

The unpaid primary caregiver has a chronic or long-term physical or psychiatric condition that currently limits their ability to provide care, or no unpaid caregivers are available at all.
The individual’s behavior poses a risk to themselves or others that cannot be managed with current supports, or their physical or medical needs exceed what current supports can handle.
The individual lives in an institutional setting and has a viable plan to move into the community.
The individual is aging out of IDEA school services and wants to live independently. This criterion applies until age 27, and placement on Priority One can happen up to nine months before IDEA eligibility ends.

Priority Two

Priority Two is for individuals likely to need services within one to five years. It applies when a caregiver’s health is declining but not yet in crisis, when the individual’s skills are deteriorating from lack of support, when employment or housing is at risk, or when adequate supports would significantly improve quality of life.⁶

Priority Three

Priority Three is for individuals who will need a slot in five or more years as long as their current situation stays stable. Many are children whose parents are healthy and actively providing care.⁶

Be candid with the CSB about the caregiver’s health, competing responsibilities, and anything that threatens the household’s ability to keep providing care. Downplaying problems during the assessment is a common mistake that puts people in Priority Three when they genuinely belong in Priority Two or One.

How Long the Wait Really Is

The Priority One portion of the waiting list stood at roughly 3,440 people at the end of calendar year 2023. The General Assembly funded new slots in response, and by June 2026 Virginia is expected to have added approximately 3,440 new waiver slots along with a 3% rate increase for providers.⁷

DBHDS has noted that even as thousands of people on the list get services, new applicants keep being added. The list is not shrinking as fast as the raw slot numbers suggest. For families in Priority Two or Three, realistic waits still run many years, and no official timeline is guaranteed.

Staying on the List

Getting on the list is only half the job. Virginia requires active participation every year to stay on it. Each year, people on the waiting list must complete two forms: the Annual Attestation Documentation of Individual Choice for Home and Community-Based Services (the “Choice form”) and the Needed Services form.⁸ The state also requires documented annual contact with each person on the list to offer the choice between institutional placement and waiver services.³

Missing those requirements can get someone removed from the list. After years of waiting, losing a spot because of missed paperwork happens, and it’s devastating. Set a calendar reminder, keep your contact information with the CSB current, and respond quickly when they reach out.

Beyond the annual forms, call your support coordinator the moment circumstances change. A caregiver health crisis, loss of housing, or escalating behavior can justify a reassessment that moves someone from Priority Three or Two up to Priority One. Waiting for the annual review wastes months of possible priority adjustment.

What Happens When a Slot Is Offered

When the state releases slots, the CSB contacts individuals by priority level. Slots open through new legislative funding and through turnover, including people who move out of state, enter a nursing facility, pass away, or leave the program.⁹

One rule traps families who don’t know it. If you are offered the Community Living waiver and decline it, you are removed from the DD waiver waiting list entirely.⁹ Some families want the Family and Individual Support waiver instead and don’t realize that refusing CL means starting over. Talk through your preferences with your support coordinator well before a slot is offered.

Once you accept, the VIDES is updated if it’s more than six months old, Medicaid financial eligibility is confirmed, and the CSB works with you on a person-centered plan listing the specific services the individual will receive.

If You’re Denied or Removed

If the state denies eligibility, reduces services, or takes someone off the waiting list, you can appeal through the DMAS Appeals Information Management System (AIMS) portal.¹⁰ Under federal Medicaid rules, you’re entitled to a fair hearing before an impartial officer, and you can represent yourself or bring a lawyer, family member, or other representative. You can examine your case file, present witnesses, and cross-examine state witnesses, and you can request an expedited hearing if an urgent health need is involved.¹¹

For people already receiving waiver services, requesting a hearing before the effective date of a reduction or termination generally keeps benefits in place until a final decision issues.¹¹ State agencies must resolve fair hearings within 90 days, and a favorable decision requires the state to implement corrective action retroactively.

1
Department of Medical Assistance Services. Developmental Disability (DD) Waivers
2
Virginia Code Commission. Virginia Administrative Code 12VAC35-105-20 – Definitions
3
Virginia Code Commission. Virginia Administrative Code 12VAC30-122-70 – Assessment and Enrollment, Virginia Individual Developmental Disabilities Eligibility Survey
4
Virginia Department of Behavioral Health and Developmental Services. Virginia Individual Developmental Disabilities Eligibility Survey – Adult Version
5
Virginia Department of Medical Assistance Services. Virginia Individual Developmental Disabilities Eligibility Survey – Infants’ Version
6
Virginia Department of Behavioral Health and Developmental Services. Developmental Disability Waiver Slots in Virginia – What You Need to Know
7
Virginia Department of Behavioral Health and Developmental Services. DBHDS Developmental Disabilities Waivers Annual Expenditures and Services Report 2025
8
My Life My Community Virginia. Accessing the Waiver Waitlist Forms
9
Virginia Department of Justice Settlement Agreement. Navigating the Developmental Disability Waivers – A Guide for Individuals, Families and Support Partners
10
Department of Medical Assistance Services. DMAS Appeals
11
Medicaid.gov. Understanding Medicaid Fair Hearings