Virginia waiver guide
CCC Plus, FIS and Community Living Waivers: What Is the Difference?
These programs support care in the community, but they have different eligibility standards and entry points. The right starting point depends on the individual’s assessed needs.
Virginia guidance · Reviewed
CCC Plus: a medical level-of-care pathway.
The CCC Plus Waiver supports people who would otherwise require a nursing facility or other specialized medical facility. It serves all ages and has no waiver waiting list. A person must still meet Medicaid, level-of-care and other program criteria, and services must be authorized.
If this may fit, ask about a Medicaid Long-Term Services and Supports screening. An absence of a waiting list does not guarantee immediate staffing or a paid family caregiver role.
FIS: supports for living with family or in the community.
Family and Individual Supports (FIS) is a Developmental Disability waiver for children and adults. It supports people living with family, friends or in their own homes, including people who need functional, medical or behavioral assistance.
The local Community Services Board assesses DD waiver eligibility. DD waiver slots are limited and assigned according to urgency of need; a qualifying assessment can lead to a waiting list rather than immediate enrollment.
Community Living: more extensive support needs.
The Community Living (CL) Waiver is also for children and adults with developmental disabilities. It generally serves people who need ongoing support, including more intensive residential or complex medical or behavioral supports.
The CSB helps evaluate needs and the DD waiver path. A family cannot secure a particular waiver merely by selecting its name on an inquiry form.
A health plan is a different part of coverage.
A Cardinal Care plan name does not replace the waiver name. Service authorization routes also differ: CCC Plus managed-care services go through the health plan, while DD waiver services generally follow the DD waiver system through the support coordinator.
If a person is moving from CCC Plus to a DD waiver, ask the support coordinator and care manager to coordinate the change. DMAS published updated continuity guidance in March 2026 to help avoid service interruption.
Where paid family caregiving fits.
Paid personal care depends on the program, service, family relationship, caregiver qualifications and authorization. The LRI extraordinary-care rules still apply when the caregiver is a qualifying parent, guardian or spouse. Start with what you know; “I do not know” is an appropriate screening answer.
Official sources
These Virginia and local government resources explain the rules and the public programs described here.
- DMAS: CCC Plus Waiver
- DMAS: Developmental Disability Waivers
- DMAS: Family and Individual Supports Waiver fact sheet (PDF)
- DMAS: Community Living Waiver fact sheet (PDF)
- DMAS: waiver enrollment and service authorization routes (PDF)
- DMAS: continuity of care when moving from CCC Plus to a DD Waiver (March 2026)
This guidance and our preliminary screening do not guarantee Medicaid eligibility, paid caregiver employment or service authorization. First Choice Home Care does not make the final Medicaid or authorization decision. Your program and care plan determine which services may be approved.
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