Virginia DD Waiver Priority Categories and Slot Allocation

How Virginia's Priority System Works

Virginia's DD waiver waitlist doesn't operate on a first-come, first-served basis. With over 15,000 individuals waiting statewide, the system uses a priority-based allocation model that distributes slots to those with the most urgent needs, regardless of how long they've been waiting.

When your adult child is screened by the local Community Services Board and placed on the statewide waitlist, they're assigned one of three priority categories based on the urgency of their support needs. That category — not their waitlist date — determines when they'll be considered for an active waiver slot.

The Three Priority Categories

Priority 1 — Urgent Need (services needed within one year)

Priority 1 is the only category that receives active slot consideration. Individuals are classified as Priority 1 when:

• The primary caregiver has a chronic physical or mental condition that creates an immediate threat to the individual's health and safety
• The individual faces imminent risk of institutionalization without waiver services
• The individual is a transitioning young adult (aged 21 to 27) seeking independent living services
• The individual's behavioral or medical needs have escalated to crisis level

Only Priority 1 individuals are presented to the local Waiver Slot Allocation Committee for active slot assignment. If your child is classified as Priority 2 or 3, they will not be considered for a slot until their priority status changes.

Priority 2 — Anticipated Need (services needed within one to five years)

Priority 2 indicates the individual will likely require waiver services within the next one to five years. This typically applies when the primary caregiver is over age 55 and may face limitations in providing care in the coming years, or when the individual's support needs are significant but not yet at crisis level.

Priority 3 — Future Need (services needed in five or more years)

Priority 3 is assigned when the individual's current care situation is stable, support needs are being met through informal or family caregiving, and waiver services are not anticipated for at least five years.

The Critical Needs Summary

For every individual classified as Priority 1, the CSB support coordinator completes a Critical Needs Summary — a structured assessment that generates a quantifiable score based on:

• Caregiver limitations — severity and progression of the primary caregiver's health conditions, age, and ability to continue providing care
• Behavioral challenges — frequency and intensity of behaviors that threaten the individual's safety or community integration
• Medical vulnerabilities — chronic health conditions, medication management complexity, need for skilled nursing

The CNS score is the tiebreaker within Priority 1. When a waiver slot becomes available in a locality, the local Waiver Slot Allocation Committee reviews anonymized profiles of Priority 1 individuals ranked by their CNS scores. The individual with the highest score — the most urgent need — receives the slot.

Waiver Slot Allocation Committees

Each locality in Virginia has a Waiver Slot Allocation Committee (WSAC), composed of trained community volunteers who are independent of the local CSB. This independence is deliberate — it prevents conflicts of interest between the CSB (which provides case management and advocacy for waitlisted individuals) and the entity deciding who receives slots.

When DBHDS releases a waiver slot to a locality, the WSAC convenes to review the Priority 1 profiles. The committee evaluates the anonymized CNS data, discusses the relative urgency of each case, and awards the slot to the individual whose documented needs are most critical.

The WSAC process is not arbitrary, but it is human. Two individuals with similar CNS scores might be distinguished by the specifics of their situations — one whose caregiver was just diagnosed with a terminal illness versus one whose caregiver has a manageable chronic condition. The committee weighs these nuances.

New Slot Allocations: FY 2027–2028

The Virginia General Assembly has authorized the addition of 3,440 new Priority One waiver slots phased in over fiscal years 2027 and 2028:

• Community Living (CL) waiver: 172 new slots annually (43 per quarter)
• Family and Individual Supports (FIS) waiver: 1,548 new slots annually, phased in quarterly

These new slots are significant — they represent the largest expansion of DD waiver capacity in recent Virginia history. But against a waitlist of 15,000+, even 3,440 new slots won't eliminate the queue. For families currently on the waitlist, the expansion improves the odds of receiving a slot within the next one to three years if classified as Priority 1.

What You Can Do to Improve Priority Status

Your child's priority classification isn't permanent. If circumstances change, request a reassessment:

Annual VIDES updates. The CSB reassesses your child's functional needs every year through the VIDES assessment. If the assessment no longer reflects reality — behavioral challenges have intensified, medical needs have increased, your own ability to provide care has declined — make sure the update captures the current situation, not last year's.

Off-cycle priority reviews. You don't have to wait for the annual assessment. If there's a significant change — a caregiver hospitalization, a psychiatric emergency, loss of housing — contact your CSB support coordinator immediately and request an emergency reassessment. A documented crisis can move your child from Priority 2 or 3 to Priority 1.

Document worst-case days. The VIDES evaluates functional limitations, and families sometimes underreport because they describe their child on a good day. The assessment should reflect the range of functioning — including the worst days, the most challenging behaviors, and the full scope of the support your child needs when informal family help isn't available.

Accepting a Slot: The Tight Deadlines

When a waiver slot is finally offered, the timeline moves fast:

• 15 days to accept the slot in writing after notification
• 30 days to meet with the assigned CSB support coordinator and develop the Person-Centered Plan
• 180 days to formally initiate community-based care services under the waiver

Missing any of these deadlines can result in the slot being forfeited and reassigned. Families should be prepared to act immediately — have provider preferences identified, housing arrangements considered, and documentation organized before a slot offer arrives.

The Virginia SSI at 18 & Adult Disability Benefits Guide includes a complete waiver waitlist strategy with the slot acceptance timeline, provider selection preparation, and Person-Centered Plan checklist so your family can move quickly when the call comes.

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