INDIVIDUAL & FAMILY SUPPORT SERVICES PROVIDER IN VIRGINIA

Fatumata Kaba
4 days ago
3 min read

EMPOWERING INDIVIDUALS WITH DISABILITIES AND THEIR FAMILIES TO LIVE FULLY AND SAFELY WITHIN THEIR COMMUNITIES

Individual & Family Support Services in Virginia provide flexible, person-centered supports that strengthen the capacity of individuals with disabilities and their families to live independently, access services, and actively engage in community life. These services are designed to help individuals avoid institutional care, support family caregivers, and promote self-determination.

These supports are available through the Family and Individual Supports (FIS) Waiver, Community Living (CL) Waiver, and occasionally through the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, depending on the participant's needs. Oversight is provided by the Department of Medical Assistance Services (DMAS) and administered in partnership with local Community Services Boards (CSBs).

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1. GOVERNING AGENCIES

Agency: Virginia Department of Medical Assistance Services (DMAS)

Role: Administers Medicaid Waiver programs, issues provider standards, and monitors compliance.

Agency: Department of Behavioral Health and Developmental Services (DBHDS)

Role: Manages developmental disability services and coordinates with CSBs.

Agency: Community Services Boards (CSBs)

Role: Authorize services, oversee Individual Support Plans (ISPs), and coordinate family and individual supports.

2. INDIVIDUAL & FAMILY SUPPORT SERVICES OVERVIEW

These services are highly individualized and tailored to meet the needs of both the individual receiving services and their caregivers. They include support with daily living, coordination of care, and skill development.

Examples of covered services:

Assistance with managing medical appointments, transportation, or service navigation
Help coordinate educational and community resources
In-home training and coaching for life skills
Family and caregiver training or support
Crisis support planning and access to backup staff
Advocacy and self-direction skill-building
Community engagement and inclusion activities
Flexible respite for unpaid caregivers

All services must be part of the individual’s Person-Centered Plan and authorized by the local CSB.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Virginia State Corporation Commission (SCC)
Obtain EIN and Type 2 NPI
Contract with a Community Services Board (CSB) as a Waiver service provider
Enroll as a Medicaid provider through DMAS
Create a Policy & Procedure Manual tailored to Individual & Family Services
Maintain staff training documentation and background check records
Carry general liability and workers’ compensation insurance

4. VIRGINIA PROVIDER ENROLLMENT PROCESS

Step 1: Register your legal entity, obtain EIN and NPI

Step 2: Apply to provide services through your local CSB

Step 3: Complete enrollment in DMAS via the MES (Medicaid Enterprise System) provider portal

Step 4: Submit documentation (manuals, staff credentials, insurance, etc.)

Step 5: Pass provider readiness review by CSB or DBHDS (if applicable)

Step 6: Begin delivering services upon ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation
CSB agreement and DMAS approval
Policy & Procedure Manual including:
- Scope of support services and staff roles
- Service delivery documentation and progress tracking
- Family communication protocols
- Client rights, HIPAA compliance, and grievance processes
- Emergency procedures and crisis planning
- Person-centered planning and ISP coordination
- Training and supervision procedures for staff and family trainers

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)Requirements:

High school diploma or GED
Experience with I/DD or behavioral health populations preferred
Background check and abuse registry clearance
CPR and First Aid certification

Optional Role: Family Support Specialist or Coach

Responsibilities: Supports caregivers through training, resource referrals, and coaching

Optional Role: Program Coordinator

Responsibilities: Manages referrals, ISP compliance, and quality assurance

All staff must complete:

Orientation to person-centered practices and DD Waiver requirements
HIPAA, documentation, and abuse prevention training
Annual competency assessments and continuing education

7. MEDICAID WAIVER PROGRAMS

Individual & Family Support Services may be authorized under:

Family and Individual Supports (FIS) Waiver – For individuals with developmental disabilities living with family
Community Living (CL) Waiver – For individuals in their own homes or provider-operated settings
CCC Plus Waiver – May allow related supports (e.g., service coordination or respite) for adults with physical disabilities or complex needs

All services must be documented in the Person-Centered ISP and approved by the CSB.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Policy Development

Timeline: 3–4 weeks

Phase: CSB Contracting & DMAS Enrollment

Timeline: 1–2 months

Phase: Staff Hiring & Credentialing

Timeline: 2–3 weeks

Phase: Service Launch

Timeline: Begins upon ISP referral and authorization

9. CONTACT INFORMATION

Virginia Department of Medical Assistance Services (DMAS)