VIRGINIA · PROGRAM GUIDE

Virginia:
Commonwealth Coordinated Care Plus (CCC Plus) Waiver — Consumer-Directed Services

Virginia's CCC Plus waiver supports people whose needs would otherwise require nursing-facility or other qualifying institutional care. Consumer direction allows the member or an Employer of Record to hire and supervise an attendant. A services facilitator helps the family understand those responsibilities. The waiver, the health plan and the payroll agent are different parts of the arrangement. Start with LTSS screening and Medicaid eligibility rather than a promise of a fixed caregiver salary.

Official sources checked: 2026-11-15. View references

Program at a glance

Program: Commonwealth Coordinated Care Plus (CCC Plus) Waiver — Consumer-Directed Services
State agency: Virginia Department of Medical Assistance Services (DMAS)
Payroll or employer arrangement: Consumer Direct Care Network or Public Partnerships, depending on the current health-plan or fee-for-service arrangement
Payment arrangement: Authorized consumer-directed personal care or respite; legally responsible individuals have specific personal-care rules
Spouses: A spouse may be approved as a legally responsible paid caregiver for extraordinary personal care under current DMAS conditions.
Parents of minors: Parents or legal guardians of minors may be approved for extraordinary disability-related personal care, with separate role and documentation requirements.

CCC Plus waiver is distinct from DD waiver access

Virginia distinguishes the CCC Plus waiver from Developmental Disability waivers such as Community Living and Family and Individual Supports. They serve different needs and have different entry arrangements. DMAS says CCC Plus does not have a waiting list; that is not the case for every Virginia waiver. Consumer direction is a delivery model used for certain services, not a separate waiver. Ask which waiver and service are named in the authorization before assuming another family's experience will apply to yours.

Request an LTSS screening and a financial review

The local Department of Social Services can arrange a community LTSS screening, involving social-work and nursing assessment. A hospitalized person can ask the discharge planner about screening. Medicaid financial eligibility must also be established; CommonHelp, Cover Virginia and local Social Services provide application routes. Describe how the person manages daily tasks and what would happen without support at home. Ask for the written outcome and the services recommended. Being screened does not by itself complete a caregiver's employment or payroll enrollment.

No waiver waitlist does not mean immediate payroll

Although CCC Plus has no waiver waiting list, screening, financial review, service authorization and finding a qualified attendant can still take time. Keep those stages separate when following up. Ask which office is waiting for information and who can confirm the next action. If care needs change during the process, tell the screening team or case manager. Do not assume that all help given before the written start date will be reimbursed; obtain instructions about any requested earlier service dates directly from the responsible payer.

Family workers and the Employer of Record have separate roles

The Employer of Record directs the attendant; the services facilitator explains responsibilities and helps develop the care arrangement. DMAS permits certain spouses and parents or guardians of minors to provide extraordinary personal care under its legally responsible individual rules. Ordinary parenting, general supervision and household chores do not automatically become payable extraordinary care. When that arrangement is proposed, review the current form, approval criteria and employer-role restrictions. The fiscal agent depends on the payment arrangement; confirm the correct agent with the health plan or facilitator before opening payroll paperwork.

Document personal care and verify the current LRI rules

Approved attendants need records of actual services and the required timekeeping process. Virginia's current managed-care contract specifically requires paid legally responsible individuals to document daily tasks and use EVV. Do not assume a live-in exception from another state applies. The LRI guidance also restricts respite availability when an LRI is being paid for personal care. Because this policy has changed over time, use the current DMAS page and ask the facilitator to identify the rule applied to your case in writing.

Your next steps

Ask local Social Services or the hospital discharge team for an LTSS screening.
Complete Medicaid eligibility through CommonHelp, Cover Virginia or local Social Services.
After waiver approval, discuss consumer direction with the services facilitator and choose an eligible Employer of Record.
Confirm any LRI exception, the current fiscal agent, worker checks, service authorization and timekeeping before paid care begins.

Explore a pay scenario

The table uses a hypothetical amount of $18.00 per hour. This is not a rate verified for this state. Approved units depend on the assessment and written plan; the table does not establish a maximum or entitlement.

Illustrative gross amounts before applicable deductions
Hours/week	Weekly	Monthly average
20	$360.00	$1,560.00
30	$540.00	$2,340.00
40	$720.00	$3,120.00

Monthly average = weekly × 52 ÷ 12. Overtime and taxes are not calculated.

Edit this example in the calculator →

Does caregiver pay qualify for IRS Notice 2014-7?

IRS Notice 2014-7 can exclude certain qualifying Medicaid waiver payments from federal gross income when the care recipient lives in the provider’s home. Sharing a home alone is not enough: the payment and program must qualify. This is not an exemption for all caregiver wages, all taxes or all state programs. Ask payroll which payments are covered and check the IRS guidance or a qualified tax adviser. Our calculator does not apply a tax exemption.

Read the IRS questions and answers

Prepare for the conversation

Save the official program contact and application route.Prepare questions about family relationships and representative roles.Ask for the approved rate, units and start date in writing.Check enrollment, timekeeping and payroll instructions.Remember these task ticks on this device

Optional. Only task numbers are saved in your browser; nothing is sent to us. Untick to erase saved progress. Avoid saving on shared devices.

Questions families ask

Does CCC Plus have a waiting list?

DMAS says the waiver does not have a waiting list. Eligibility, screening, authorization and worker enrollment still need to be completed; other Virginia waivers differ.

Can a spouse or parent of a minor be paid?

Current DMAS LRI rules allow approved extraordinary personal care under specific conditions. Ask about the current approval form and employer-role restrictions.

Is the services facilitator my payroll company?

No. The facilitator supports the care arrangement and employer duties. A fiscal employer agent handles payroll functions; confirm the agent assigned to the plan or payment route.

Will previous unpaid family care automatically be paid later?

Do not assume that. Ask the authorizing payer about service dates and enrollment requirements; general Medicaid eligibility does not itself authorize every past caregiver hour.

Official sources and review notes

Sources describe the named programs; they do not endorse this website. Rules and provider arrangements can change. Check the linked agency before making a financial decision.

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Virginia:Commonwealth Coordinated Care Plus (CCC Plus) Waiver — Consumer-Directed Services