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Agency-Directed Services
Agency-Directed Services

Agency-Directed Services

Did you know you could be a paid caregiver through a Medicaid waiver program?

What are Agency-Directed Services?

Agency-Directed Services are services available to families that have a Medicaid waiver in Virginia who need to receive a little extra help at home. Maybe the individual receiving services needs some additional supervision each day to make sure they stay safe, or maybe they can use some help with things like preparing their meals, getting dressed, doing their laundry, or taking a shower. Maybe they need someone to help them remember to take their medication or to transport them to appointments.

At DePaul, we know that an individual’s needs are as unique as they are, so we work with each family to meet their needs where they are and foster hope and belonging so they can continue to receive care in their home for as long as they want. We also believe that individuals should get to choose who provides their care, and we are happy to work with families to find the right fit, whether that means hiring a family member, if qualified, or seeking the right provider in the area.

DePaul is currently licensed for ADS in: Roanoke City, Roanoke County, Salem, Covington, Alleghany County, Botetourt County, Craig County, Bedford County, Franklin County, Floyd County, and Montgomery County.

What is a Medicaid Waiver?

A Medicaid Waiver is a program that the state developed to help individuals with disabilities and those who are aging receive extra assistance that they require but still stay in their homes and communities. Most waivers in the Commonwealth currently have waiting lists. To learn more about the CCC+ waiver that qualifies an individual for agency-directed services, continue reading below. To learn more about other waivers, click here to review a summary from the Department of Medical Assistance Services or email us at info@depaulcr.org.


CCC+ Waiver Screening FAQs:

Is the CCC+ waiver for any age?  Yes, but it is significantly difficult to get approved if you are under the age of 5 (because most kids under that age require a lot of assistance!).

Who do I contact for a screening?  Contact your local department of social services and request a screening for the Medicaid waiver for “long term care.” Note that this is NOT the CSB. If you are in the hospital, you can ask the hospital social worker to screen you while you are still inpatient.

Where does the screening take place?  It will be a caregiver interview in the home. They will need to see the individual being screened, but the individual does not need to be present the entire time, in fact, if they are fully aware of what is being said, it might not be best that they are present the whole time so that the caregiver can speak freely.

Is this like APS/CPS?  Is my house going to be inspected?  No, actually it might even be better if it is in its natural state. If you have it super cleaned up, it will look like you don’t need any help!

Who does the screening? Typically, it is a team of a social worker and a nurse.

What will the questions be like?  They will ask a variety of questions! They will want some basic demographic information about who lives in the house, etc. They will ask about activities of daily living and how much assistance the individual needs with those. It is important to think about the activity from start to finish when you answer those questions. For example, when you think about something like bathing, think about remembering the need to bathe, turning on the water to the correct temperature, stepping safely into the shower or tub, bathing the whole body without any kind of supervision, physical assistance, or prompting, turning off the water, stepping back out safely, and drying off. There is a lot to the activity!

They will also ask about behavior. Make sure you are honest and think about the worst day the individual has had in the past month. They will ask about orientation (how well the person knows where they are, who they are with, and when it is). They will also ask about medications, therapies, appointments, specialists, hospitalizations, and diagnoses. An after-visit summary from your last doctor appointment can be very helpful for this part. They will want to know about caregiver and financial stress. This can be really difficult to answer, but be very honest about how caring for an individual with extra needs has impacted your family…this will help you all get help!

What is important for me to know as a caregiver?  Be honest when you answer the questions, but think carefully about your word choices! For example, we could use either of these statements to answer the same question, but they sound very different. “He requires supervision the entire time he is in the shower.” Or “He doesn’t really need any physical assistance to shower, just some supervision.” Don’t downplay any needs that your loved one has during the screening. When the individual being screened is a child, they are asking about how the child’s needs differ from the typically developing child that age. For example, incontinence would not be noteworthy to mention for a two year old, but would be for a ten year old. Be sure to think about how the child compares developmentally to peers.

How long before I know the decision of the team?  You usually hear something within 60 days.

If I receive a denial, can I be rescreened?  You can request a new screening 30 days after the date on your decision letter. You can also request a different screener if you want to.


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