Community Living Waiver Virginia

What the Community Living Waiver Is

The Community Living waiver is the most comprehensive of Virginia's three DD waivers. It is the only waiver that funds 24/7 residential placements — group homes, sponsored residential services, and intensive in-home support for individuals with severe intellectual or developmental disabilities who require continuous active supervision.

CL waiver services include everything available under the FIS waiver (personal assistance, respite, day support, therapeutic consultation, assistive technology) plus the residential component that makes it distinct. For families whose adult child cannot safely live at home — because of complex medical needs, severe behavioral challenges, or the aging or declining health of the primary caregiver — the CL waiver is the program that makes community-based residential care possible as an alternative to institutional placement.

Who Qualifies

Eligibility for the CL waiver requires two things: functional eligibility for DD waiver services (determined by the VIDES assessment at the local CSB) and the level of support need that warrants 24/7 residential care.

The individual must meet the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care on the VIDES assessment. For adults aged 18 and older, this means showing substantial limitations in at least three of eight functional categories — self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, economic self-sufficiency, and the ability to function safely without supports.

Beyond meeting the VIDES threshold, the individual's Priority Needs Checklist must demonstrate the intensity of need that places them in the CL waiver category rather than FIS or BI. This typically includes situations where:

• The primary caregiver has a chronic physical or mental condition creating immediate jeopardy
• The individual's behavioral challenges require constant staff intervention
• Medical complexity demands round-the-clock monitoring
• The individual is aging out of a residential school placement or institutional setting

The Waitlist and Slot Allocation

CL waiver slots are allocated through the same Waiver Slot Allocation Committee process that governs all three DD waivers. The individual must be classified as Priority 1 to be eligible for active consideration. The WSAC reviews anonymized profiles and Critical Needs Summary scores, assigning slots to those with the most urgent documented need.

The Virginia General Assembly has allocated 172 new CL waiver slots annually — 43 per quarter — for FY 2027 and FY 2028. Given the statewide DD waiver waitlist of over 15,000 individuals, CL slots remain among the most competitive to obtain.

Wait times for a CL slot vary by locality and the individual's CNS score. Priority 1 individuals with high CNS scores may receive a slot within 1-3 years. Priority 2 or 3 classifications can mean a wait of many years, during which annual VIDES updates provide the opportunity to reclassify if circumstances change.

What Happens When a Slot Is Offered

Once the WSAC allocates a CL waiver slot, the family faces three firm deadlines:

1. Accept the slot in writing within 15 days of notification
2. Meet with the assigned CSB Support Coordinator within 30 days of acceptance to develop the Person-Centered Plan and begin waiver services
3. Have Community-Based Care services formally started within 180 days of the Notice of Action

The Person-Centered Plan is developed collaboratively with the individual, their family, and the Support Coordinator. It identifies the specific services, providers, and residential setting that will be funded through the CL waiver. For residential placements, this includes selecting a group home provider with an available bed that matches the individual's support profile.

Provider Capacity Is Its Own Bottleneck

Even after receiving a CL waiver slot, families often encounter a second waiting period: finding a provider with capacity. Virginia faces a severe shortage of group home providers and direct support professionals. A family may have an authorized CL waiver slot but struggle to find a group home with an available placement that serves the individual's specific diagnostic and behavioral profile.

The 180-day service initiation deadline provides some buffer, but families should begin researching residential providers and visiting group homes before a slot is formally offered. The CSB Support Coordinator can provide a list of licensed providers in the locality, and DBHDS maintains a provider directory.

Financial Eligibility for CL Waiver Services

CL waiver services are funded through Medicaid, so the individual must have active Medicaid coverage. The income limit for waiver-linked Long-Term Care Medicaid is 300% of the SSI federal benefit rate — $2,982 per month in 2026. The resource limit remains $2,000 ($3,000 for couples).

For individuals living in a group home, the financial eligibility review conducted by the local DSS raises the income standard to this 300% threshold. If income exceeds the limit, Virginia's medically needy spend-down allows medical expenses to offset the excess.

The individual's personal income (SSI, SSDI, DAC benefits) goes toward the facility's room and board costs. The Auxiliary Grant is a separate room-and-board supplement for licensed assisted living facilities, adult foster care homes, and supportive housing — not for typical Community Living group homes — at $2,450/month in Northern Virginia and $2,130/month elsewhere in the state.

The Virginia SSI at 18 & Adult Disability Benefits Guide covers the complete CL waiver process, from CSB screening through residential placement, including provider selection and the financial coordination between Medicaid, SSI, and the Auxiliary Grant.

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