Creating Waiver Slots – Official Site of the Commonwealth of Virginia

Settlement Agreement Provision

III.C.1.a-c

Enhancement of Community Services

By June 30, 2021, the Commonwealth shall create 4,170 waiver slots for the target population, to be broken down as follows:
1. The Commonwealth shall create a minimum of 805 waiver slots to enable individuals in the target population in the Training Centers to transition to the community according to the following schedule:
  1. In State Fiscal Year 2012, 60 waiver slots
  2. In State Fiscal Year 2013,160 waiver slots
  3. In State Fiscal Year 2014,160 waiver slots
  4. In State Fiscal Year 2015, 90 waiver slots
  5. In State Fiscal Year 2016, 85 waiver slots
  6. In State Fiscal Year 2017, 90 waiver slots
  7. In State Fiscal Year 2018, 90 waiver slots
  8. In State Fiscal Year 2019, 35 waiver slots
  9. In State Fiscal Year 2020, 35 waiver slots
2. The Commonwealth shall create a minimum of 2,915 waiver slots to prevent the institutionalization of individuals with intellectual disabilities in the target population who are on the urgent waitlist for a waiver, or to transition to the community individuals with intellectual disabilities under 22 years of age from institutions other than the Training Centers (i.e., ICFs and nursing facilities), according to the following schedule:
  1. In State Fiscal Year 2012, 275 waiver slots
  2. In State Fiscal Year 2013, 225 waiver slots, including 25 slots prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  3. In State Fiscal Year 2014, 225 waiver slots, including 25 slots prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  4. In State Fiscal Year 2015, 250 waiver slots, including 25 slots prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  5. In State Fiscal Year 2016,275 waiver slots, including 25 slots prioritized for individuals under22 years of age residing in nursing homes and the largest ICFs
  6. In State Fiscal Year 2017, 300 waiver slots
  7. In State Fiscal Year 2018,325 waiver slots
  8. In State Fiscal Year 2019,325 waiver slots
  9. In State Fiscal Year 2020,355 waiver slots
  10. In State Fiscal Year 2021, 360 waiver slots
3. The Commonwealth shall create a minimum of450 waiver slots to prevent the institutionalization of individuals with developmental disabilities other than intellectual disabilities in the target population who are on the waitlist for a waiver, or to transition to the community individuals with developmental disabilities other than intellectual disabilities under 22 years of age from institutions other than the Training Centers (i.e., ICFs and nursing facilities), according to the following schedule:
  1. In State Fiscal Year 2012,150 waiver slots
  2. In State Fiscal Year 2013, 25 waiver slots, including 15 prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  3. In State Fiscal Year 2014, 25 waiver slots, including 15 prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  4. In State Fiscal Year 2015, 25 waiver slots, including 15 prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  5. In State Fiscal Year 2016,25 waiver slots, including 15 prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  6. In State Fiscal Year 2017, 25 waiver slots, including 10 prioritized for individuals under 22 years of age residing in nursing homes and the largest ICFs
  7. In State Fiscal Year 2018, 25 waiver slots, including 10 prioritized for individuals under22 years of age residing in nursing homes and the largest ICFs
  8. In State Fiscal Year 2019,25 waiver slots
  9. In State Fiscal Year 2020, 50 waiver slots
  10. In State Fiscal Year 2021,75 waiver slots
4. If the Commonwealth creates more waiver slots than are required in Sections III.C.l. a, b, or c above for a particular fiscal year, the number of slots created above the requirement shall be counted towards the slots required to be created in the subsequent fiscal year in the relevant Section.

About Creating Waiver Slots

The DD Waivers are slot based programs that require an appropriation of the General Assembly to increase the number of slots and, therefore the number of individuals who can be served through the waivers. Once the Virginia General Assembly appropriates the funding for a specified number of slots, the Department of Medical Assistance Services (DMAS) must submit a Medicaid Waiver Amendment to the Centers for Medicare and Medicaid Services (CMS) for approval for the federal financial participation to fund those slots. It is not until this approval is received that additional individuals can be added to the waivers for services. The General Assembly has increased the number of slots per the Settlement Agreement requirements since the onset of the Agreement.