♦ Case Management vs
Service Facilitation
♦ Consumer Directed vs
Agency Directed Services
The Arc of Northern Virginia ALLY—“A Life Like Yours.”
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ELIGIBILITY — Who is eligible to receive DD Waiver Services?
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.
*Individuals can engage in the enrollment process as early as five years and nine months old.
Diagnostic
An individual must have a developmental disability and not have a diagnosis of mental retardation (MR) as defined by the American Association on Mental Retardation (AAMR).
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 MR is considered a developmental disability in Virginia, there is a separate waiver for persons with a diagnosis of MR.
Functional
The individual must meet the Intermediate Care Facility (ICF) for the Mentally Retarded (MR) level of care criteria. This is determined during the initial screening process. Financial 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.