Virginia has a Medicaid waiver system specifically designed to fund long-term support for individuals with autism — covering ABA therapy, respite care, behavioral services, assistive technology, and more. The system is comprehensive. It is also complex, inconsistently understood, and comes with waiting lists that require families to plan years in advance.

This guide breaks down exactly what Virginia's autism waiver programs are, which one fits your child's level of need, what they actually cover, and what to do right now — whether you're just learning about waivers or already on a waiting list in Northern Virginia.

Here's the direct answer: Virginia offers four Medicaid waiver programs relevant to individuals with autism. Three are Developmental Disability (DD) Waivers administered jointly by the Virginia Department of Medical Assistance Services (DMAS) and the Virginia Department of Behavioral Health and Developmental Services (DBHDS): the Family and Individual Supports (FIS) Waiver, the Community Living (CL) Waiver, and the Building Independence (BI) Waiver. The fourth is the Commonwealth Coordinated Care Plus (CCC+) Waiver, which can serve children with medical complexity and — critically — has no waiting list. All three DD Waivers have waiting lists.

The statewide DD waiver waiting list stood at 15,486 individuals as of December 2024. Slots are assigned by urgency of need, not by application date — which means applying early is essential, even if your child's needs are not yet severe. For children under 18, waiver eligibility is based solely on the child's income and resources — not the parents' — meaning many middle- and upper-income families qualify.

What Is an Autism Waiver in Virginia?

A Medicaid waiver — formally called a Home and Community-Based Services (HCBS) waiver — is a federal program that allows states to waive standard Medicaid rules to provide services that go beyond what standard Medicaid covers. In Virginia, the autism waiver programs in this category fund community-based services that support individuals with autism (and other developmental disabilities) in living at home and in their communities rather than in institutional settings.

Virginia's DD Waivers are jointly administered by DMAS and DBHDS. They fund services like ABA therapy, behavioral supports, respite care, assistive technology, personal care assistance, community coaching, and more — all delivered in home and community settings.

These waivers fill a critical gap. Standard Virginia Medicaid covers many healthcare services, but it does not fund the intensive, individualized support that many autistic children need daily — behavioral therapy hours, caregiver respite, community coaching, and daily living skill training. The autism waiver in Virginia was specifically designed to bridge that gap.

The Four Virginia Autism Waiver Programs: What Each One Is

1. Family and Individual Supports (FIS) Waiver

Who it's for: Children and adults with autism or intellectual disability who live with their family, friends, or in their own home. The FIS Waiver is designed for individuals who need some medical, behavioral, or functional supports but do not need around-the-clock care.

Who qualifies: Individuals of all ages with a diagnosis of autism, intellectual disability, or other developmental disability who meet ICF/IID (Intermediate Care Facility/Intellectual and Developmental Disabilities) level of care criteria — meaning significant limitations in adaptive functioning in three or more areas.

Key services include:

• ABA therapy and behavioral supports
• Respite care (in-home or facility-based)
• Community coaching
• Supported employment
• Assistive technology
• Environmental modifications
• Individual and family/caregiver training
• Community engagement supports
• Personal emergency response systems
• Peer mentor supports
• Transition services

Waiting list: Yes. Slots assigned by urgency of need.

Fairfax County contact: Fairfax-Falls Church Community Services Board (CSB) — 703-324-4400 (TTY 711). Ask for an intake worker..

2. Community Living (CL) Waiver

Who it's for: Children and adults with autism or intellectual disability who require higher-level support — including those with complex medical or behavioral needs who need regular staffing or in-home support. Individuals using the CL Waiver may live with family or in a licensed residential home with staff support.

Who qualifies: Same ICF/IID criteria as the FIS Waiver, but for individuals who need more intensive, ongoing support that may include overnight staffing or structured residential placement.

Key services include:

• All FIS Waiver services, plus:
• Group home residential placement
• Private duty nursing
• Skilled nursing
• Shared living arrangements
• Sponsored residential support
• 24/7 in-home support for those with complex needs

Waiting list: Yes. Slots assigned by urgency of need.

Note: The CL Waiver is typically for individuals with the highest support needs. For most children with autism, the FIS Waiver is the starting point.

3. Building Independence (BI) Waiver

Who it's for: Adults aged 18 and older who can live independently or semi-independently but need periodic or episodic support. Individuals on the BI Waiver own, lease, or control their own living arrangements.

Who qualifies: Adults (18+) meeting ICF/IID level of care criteria who can largely live independently with episodic supports.

Key services include:

• Independent living skills training
• Personal assistance services
• Supported employment
• Community coaching
• Respite
• Assistive technology

Waiting list: Yes. Slots assigned by urgency of need.

Note for families of young children: While the BI Waiver is for adults, families of autistic children should understand it now for future planning. Transition from school-based services at age 22 is a significant stress point. Getting on the BI waiting list before adulthood is common practice [5].

4. Commonwealth Coordinated Care Plus (CCC+) Waiver

Who it's for: Individuals of all ages — including children — with significant medical or functional needs who meet nursing facility level of care criteria. This waiver serves a broader population than the DD Waivers, including seniors and people with complex medical conditions, but is available to autistic children with significant medical support needs.

Who qualifies: Must meet nursing facility level of care criteria — meaning significant medical or functional needs beyond what the DD Waivers require.

The critical difference: CCC+ has no waiting list. Slots open as individuals qualify. This makes it an important option for families of children with autism who also have significant medical complexity and need services while waiting for a DD Waiver slot.

Fairfax County contact for children under 18: Coordinated Services Planning — 703-222-0880 [4].

Key services include:

• ABA therapy and behavioral services
• Personal care assistance
• Respite
• Private duty nursing
• Assistive technology
• Community-based supports

Who Qualifies for a Virginia Autism Waiver

Eligibility for Virginia's DD Waivers (FIS, CL, BI) requires meeting two sets of criteria:

1. Diagnostic eligibility A formal diagnosis of autism spectrum disorder, intellectual disability, or other qualifying developmental disability — made by a qualified professional such as a developmental pediatrician, neurologist, psychiatrist, or licensed psychologist.

2. Functional eligibility Significant limitations in adaptive functioning in three or more categories (such as communication, self-care, social skills, community use, self-direction, health and safety, or functional academics) — equivalent to ICF/IID level of care.

Income eligibility — a critical and often misunderstood rule: For individuals under age 18, Virginia autism waiver eligibility is based solely on the child's income and resources, not the parents' income. This is one of the most important facts for families to understand. Most children under 18 have no independent income or resources — which means the vast majority of children with autism who meet the diagnostic and functional criteria will qualify financially, regardless of family income level.

This income-counting rule means that many middle-income and upper-middle-income families who might assume they don't qualify should apply anyway. A child who has no independent income qualifies on income grounds even if their parents earn $150,000 per year.

The Waiting List Reality: 15,486 People and What It Means for Your Family

The most important number in Virginia's autism waiver system is 15,486 — the number of individuals on the statewide DD waiver waiting list as of December 2024. This is not a first-come, first-served list. Slots are assigned based on urgency of need. Individuals with the most immediate and severe needs are served first.

What this means practically:

Apply early — even if your child's needs seem moderate. Most families should get their child on the waiting list as soon as they receive an autism diagnosis and the child meets functional criteria. Waiting until needs are severe to apply means waiting even longer after needs become severe.

Your position on the list is dynamic, not fixed. As your child's needs increase, their urgency score can increase — potentially moving them up the list. Document everything, including support needs on your child's "best" days, not just their hardest.

You may be able to access services while waiting. Two options are available to families on the DD waiver waiting list:

• CCC+ Waiver — If your child meets nursing facility criteria, CCC+ is available without a waiting list and can provide services while you wait for a DD waiver slot.
• Individual and Family Supports Program (IFSP) — People on the DD waiting list are eligible for an annual $1,000 grant through IFSP to cover specific disability-related expenses. While modest, this can offset some costs while waiting for full waiver services.

How to Apply for a Virginia Autism Waiver in Northern Virginia

The application process in Virginia runs through the local Community Services Board (CSB). For families in Northern Virginia:

Step 1 — Contact your local CSB

• Fairfax County and Falls Church: Fairfax-Falls Church CSB — 703-324-4400 (TTY 711). Ask for an intake worker.
• Arlington County: Arlington County Disability Services — 703-228-1700
• DBHDS statewide DD waiver hotline: 1-844-603-9248

Step 2 — Request a DD Waiver screening

Specifically request screening for the Developmental Disability Waivers — not just general Medicaid. The initial eligibility screening is the same for all three DD Waivers (FIS, CL, BI) and determines which waivers your child may qualify for based on their support needs.

Step 3 — Complete a Medicaid application through your local Department of Social Services (DSS)

Even while on the waiting list, completing a Medicaid application is required. For children, remember that only the child's income and resources are counted.

Step 4 — Prepare documentation

• Formal autism diagnosis from a qualified professional
• Records documenting adaptive functioning limitations
• School records (IEP, evaluations)
• Medical records
• Documentation of daily support needs — be thorough and include needs on "average" days, not just crisis days

Step 5 — Work with a support coordinator when a slot becomes available

When a waiver slot opens, you'll work with a support coordinator (also called a case manager) to develop a person-centered service plan that determines which services you'll receive under the waiver.

What Virginia Autism Waivers Cover: Services That Matter for Autistic Children

For families of autistic children, the most relevant services funded by Virginia's autism waiver programs include:

ABA Therapy Applied Behavior Analysis is the most evidence-based intervention for autism and is funded under behavioral supports in Virginia's DD Waivers and CCC+. Research across decades of peer-reviewed studies supports ABA therapy's effectiveness for improving communication, adaptive behavior, and school readiness in autistic children.

Respite Care Temporary caregiver relief — both in-home and in facility-based settings. Respite supports the sustainability of family caregiving and reduces caregiver burnout. Available under FIS, CL, and CCC+.

Therapeutic Consultation Behavioral and therapeutic consultation services to support IEP teams, families, and care providers in implementing evidence-based strategies.

Individual and Family/Caregiver Training Structured training for parents and caregivers in implementing behavioral strategies, communication supports, and daily living skill development at home.

Assistive Technology Devices and equipment supporting communication, mobility, and daily living — including AAC devices, communication apps, and environmental control systems.

Environmental Modifications Physical modifications to the home that support safety and independence — ramps, door widening, sensory modifications.

Community Coaching and Community Engagement Support for participation in community activities, development of social skills in natural settings, and building independence in public environments.

Supported Employment For older youth and adults, supported employment services fund job coaching and employment assistance in competitive integrated work settings.

ABA Therapy and Virginia Waivers: How They Work Together

For many families in Northern Virginia, the most immediate question is how an autism waiver in Virginia interacts with ABA therapy access and insurance.

Virginia's Medicaid program (standard Medicaid) covers ABA therapy for children with autism as a mandated benefit. The DD Waivers and CCC+ provide an additional funding layer that can cover ABA therapy hours above and beyond what standard Medicaid covers — or that fund ABA when standard Medicaid coverage gaps exist.

Families in Northern Virginia who receive ABA therapy services through Divine Steps ABA can access services funded through standard Medicaid, private insurance, or waiver funding — depending on the child's specific coverage. Our team works directly with families to identify which funding source applies and to navigate the billing process.

Supporting a child with autism in Northern Virginia? Divine Steps provides personalized in-home ABA therapy with no waitlist and full insurance support including Medicaid. We help families navigate funding — including Virginia autism waiver programs — so your child's therapy isn't delayed by paperwork.

Get in touch | Call: 888-301-4065

A Real-World Example: Northern Virginia Family Navigating the Waiver System

A family in Fairfax County received their 4-year-old daughter's autism diagnosis and immediately began in-home ABA therapy through their private insurance. Within the same month, a BCBA at their therapy provider recommended they apply for the FIS Waiver through the Fairfax-Falls Church CSB — even though their daughter's needs were currently manageable and they had insurance coverage.

They called the CSB, completed an eligibility screening, were placed on the FIS Waiver waiting list, and simultaneously applied for standard Medicaid to cover the application requirement.

Three years later, at age 7, their daughter's behavioral needs increased significantly. Because they had been on the waiting list for three years and had documented increasing need, their urgency score increased — and they received a waiver slot within several months of the escalation.

Without that early application, they would have been starting the waiting period at the point of crisis rather than having already served three years on the list. Their waiver slot funded ABA therapy hours beyond what insurance covered, respite care that allowed both parents to maintain employment, and caregiver training that extended therapy gains into their home environment.

This trajectory — early application, continued documentation, waiver funding supplementing insurance — is the most effective approach available to Northern Virginia families.

What to Do Right Now: A Practical Checklist

For families who have received or suspect an autism diagnosis in Virginia:

✅ Contact your local CSB immediately and request a DD Waiver eligibility screening. Don't wait until needs are severe.

✅ Apply for Medicaid through your local Department of Social Services — even if you think you won't qualify based on income. For children, only the child's income counts.

✅ Document your child's support needs thoroughly. Include needs on average days, not just worst days. Document all assistance provided even when it appears routine.

✅ Ask about IFSP — the $1,000 annual grant available to those on the DD waiver waiting list.

✅ Explore CCC+ if your child has significant medical complexity — it has no waiting list.

✅ Begin ABA therapy through insurance or standard Medicaid while waiting for a waiver slot. Waiver funding supplements existing coverage; it doesn't require waiting for services to begin.

✅ Work with your ABA provider to ensure therapy is documented in ways that support waiver applications and IEP development.

Conclusion: The Autism Waiver in Virginia Is a Long Game — Start Early

Virginia's autism waiver programs are among the most comprehensive state funding mechanisms available for autistic children and adults. They fund services that private insurance often doesn't cover — respite, community coaching, caregiver training, and extended ABA hours that produce better long-term outcomes. The system is not easy to navigate. The waiting list is real and long. But families who apply early, document thoroughly, and access bridge supports while waiting give their children access to resources that can make a genuine difference over years, not just months.

Divine Steps ABA works alongside families navigating Virginia's waiver system — providing in-home ABA therapy that can be funded through Medicaid, private insurance, or waiver programs, with no waitlist and no gap in services while funding arrangements are sorted. We serve families across Northern Virginia.

The waiver system rewards early action. Let's start yours.

Connect with our team today | Call: 410-220-0768

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