Virginia FIS Waiver: Eligibility, Waitlist, and How to Apply

The Family and Individual Supports (FIS) Waiver is one of Virginia's three Developmental Disability (DD) Medicaid waivers, alongside Community Living (CL) and Building Independence (BI). FIS is the middle tier: it is built for children and adults with a developmental disability, including autism, who live at home with family but need functional, behavioral, or medical supports, without 24-hour residential care. It is jointly administered by the Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS), Virginia's Medicaid agency.

A person must meet diagnostic, functional, and financial criteria. Diagnostically, Virginia defines a developmental disability as a severe, chronic disability, physical and/or mental, that manifests before age 22, is likely to continue indefinitely, and results in substantial functional limitations in three or more of seven major life activities: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency (this mirrors the federal definition at 42 U.S.C. § 15002). Functionally, your local CSB screens using the Virginia ID/DD Eligibility Survey (VIDES), and the individual must meet ICF/IID institutional level of care. Financially, Medicaid waiver eligibility looks at the individual's own income and assets only, not parent or household income. The DD Waiver fact sheets also note the individual must be determined to need waiver services within 30 days, and that community-based waiver services must be the critical piece enabling the person to delay, avoid, or exit an ICF or other institutional placement.

There is no single statewide hotline. You start by contacting your local Community Services Board (CSB) or Behavioral Health Authority (BHA), the entity that serves every county and city in Virginia. A CSB case manager screens the person using the VIDES assessment, measuring functional capacity and confirming the developmental disability definition. You do not have to already qualify for Medicaid to be screened or placed on the waitlist; Medicaid eligibility (including the Appendix D financial form, which counts only the individual's own income and assets) is confirmed later, once a slot is actually offered. Find your CSB through the VACSB directory or My Life My Community.

As of November 25, 2025, Virginia had 19,924 individuals assigned a waiver slot across all three DD waivers (11,704 Community Living, 7,412 FIS, and 268 Building Independence), per the DBHDS Developmental Disability Waivers 2026 fact sheet. That same fact sheet put the total shared waiting list at 14,258, of which 2,727 were Priority 1 (the most urgent category). Virginia funded 1,720 new slots in FY2025 and another 1,720 in FY2026, the two-year total of 3,440 approved by the 2024 General Assembly, the largest infusion of new slots since the DD waivers began; these bring the projected total to 21,479 waiver slots by the end of FY2026. Because thousands of new slots keep going out while more families keep applying, the waitlist total moves both up and down; confirm the current count with your CSB. Unlike some states, Virginia's waitlist is not first-come, first-served: it is a needs-based priority system (Priority 1, 2, or 3), and your position can change if your support coordinator documents that your child's needs have increased.

No. Virginia assigns slots by priority level, not by application date. Your CSB case manager generates a Critical Needs Summary that sets your Priority Level (1, 2, or 3), reviewed and updated at least annually. When slots open, the local Waiver Slot Assignment Committee (WSAC) scores anonymized Slot Assignment Review Forms for everyone at the top priority level and offers slots to the highest scorers, county by county. Families who assume their spot is fixed once they apply often miss the more important step: contacting their case manager whenever circumstances change (a caregiver health crisis, a lost placement, worsening behavior) so the Critical Needs Summary gets updated and the priority score reflects reality.

Per the official DMAS/DBHDS fact sheet, FIS covers: Assistive Technology; Benefits Planning; Companion Services (agency- or consumer-directed); "Meaningful Day" services (Community Coaching, Community Engagement, Community Guide); Crisis Services (community-based, center-based, and Crisis Services Facilitation); Individual and Family/Caregiver Training; Electronic Home-Based Supports; Employment and Community Transportation; Skilled and Private Duty Nursing; Group and Individual Supported Employment; Group Day Support Services; Environmental Modifications; Therapeutic Consultation; Workplace Assistance; Residential Services (Shared Living, In-Home Supports, Supported Living); Transition Services; Peer Mentor Supports; and a Personal Emergency Response System. Personal Assistance and Respite (both agency- and consumer-directed) are also billed under FIS and were the two highest-utilization services in FY2025. It does not fund 24-hour residential care; that level of support sits with the Community Living waiver instead.

The FIS Waiver is not a cash award. It funds a defined set of services directly, at rates set by DMAS, based on what is written into your child's individual support plan. For scale: DBHDS reports the average FY2025 per-person cost of all services funded under the FIS Waiver was $62,813 (compared with $138,860 for Community Living and $25,144 for Building Independence), and total FY2025 FIS expenditures across 23,659 unique service recipients were about $380.3 million. Your own plan's dollar value depends entirely on the services it authorizes, not a flat statewide amount, so ask your support coordinator what your plan authorizes once you are enrolled.

The child's own income only. Parent income is not counted once a child is being evaluated for or has been approved for a waiver slot. The basic maintenance needs standard is 165% of the SSI payment for one person. If the individual works, earned income is disregarded up to higher thresholds: up to 200% of SSI for 4 to 19 hours of work per week, and up to 300% of SSI for 20 or more hours per week. This is why many households that would not qualify for ordinary Medicaid on family income can still qualify their child for a DD waiver.

No. Virginia does not have a state-funded Education Savings Account or K-12 voucher program comparable to Florida's FES-UA or Arizona's ESA. The closest thing is the Education Improvement Scholarships Tax Credits Program, a donation-funded tax credit: private donors get a 65% state tax credit for gifts to Approved Scholarship Foundations, which then award scholarships to income-eligible students. Families of children with an IEP get a higher income ceiling (400% of the Federal Poverty Guidelines, versus 300% for other applicants), but it is not a state entitlement and award amounts depend on available donations that year.

Yes, for state-regulated plans. Virginia's autism insurance mandate (HB 2467, effective 2012, codified at Va. Code § 38.2-3418.17) requires coverage of behavioral health treatment, including Applied Behavior Analysis supervised by a Board Certified Behavior Analyst licensed through the Virginia Board of Medicine, when medically necessary. A 2019 amendment (HB 2577) removed the original age cap, and a 2020 amendment (SB 1031) extended the mandate to small-group and individual plans. The mandate applies only to state-regulated, fully insured plans; large self-funded employer plans are federally regulated and may not follow it. Separately, Virginia Medicaid covers ABA for children under 21 through EPSDT regardless of DD waiver status.

Yes. The waiver works alongside an existing IEP rather than replacing it. In fact, one of the FIS Waiver's core services, therapeutic and behavioral consultation, is designed to support IEP teams directly. Families do not need to choose between school-based special education services and the waiver; the waiver adds home and community-based supports on top of what the school already provides.

All three serve people with developmental disabilities, including autism, and share the same statewide waiting list. FIS is for people who live at home with family and need functional, behavioral, or medical support without round-the-clock care. Community Living (CL) is the highest tier, for people who need more intensive supports, potentially including residential services. Building Independence (BI) is an adult-only waiver focused on competitive employment and independent living for people who need the least support. Most families of a young child with autism start with FIS.

Yes. DBHDS keeps a small pool of emergency waiver slots outside the normal waitlist process. Your CSB can request one if your situation meets specific criteria: Child Protective Services substantiated abuse or neglect and removed the individual from the home; Adult Protective Services found the individual needs and accepts protective services; abuse or neglect was not substantiated but corroborating information shows real risk with no available caregiver; the primary caregiver died or there is no alternative caregiver and the individual cannot safely care for themselves; or someone who transitioned off a DD waiver into the Medicaid Works program chooses to resume waiver services. In FY2025, DBHDS approved 76 emergency slot requests (74 ultimately assigned). Ask your CSB directly whether your situation qualifies; this is a distinct process from the standard priority waitlist.

For services like Personal Assistance, Respite, and Companion Services, Virginia lets you choose the delivery model. Agency-Directed means you choose a licensed agency, which hires, schedules, and manages its own staff. Consumer-Directed means you act as the employer: you recruit and hire your own attendants, with help from a Service Facilitation provider, who assists you in setting up the Employer of Record role and a Fiscal Agent to handle payroll. Many families use Consumer-Directed for Respite and Companion Services because it lets them choose caregivers the child already knows and trusts.

Start with our therapy directory by city (Richmond, Virginia Beach, Fairfax, Herndon) and our Virginia schools directory. You can also tell our concierge about your child and we will connect you with ABA providers and special needs schools that fit your area, insurance, and your child's needs. The concierge is free and does not affect your position on the DD waiver waiting list. It helps you build care now while you work through the CSB process.