You may hear unfamiliar words and abbreviations when arranging your supports. This information explains common terms used in Virginia’s DD waivers and consumer-directed services. You can return to it whenever you need a quick explanation.
People and roles
Individual: The person receiving supports. Throughout this website, we use “you” or “individual” to refer to the person whose needs, preferences, and goals guide services.
Provider: A person or organization that delivers services or supports. A provider can be an agency, a professional, or a paid attendant.
Services facilitator (SF): A professional who helps you plan and manage consumer-directed supports, trains your Employer of Record, and checks whether your supports continue to meet your needs.
Support coordinator (SC): A professional who helps you develop your overall support plan, connect with waiver services and other resources, and monitor how those supports are working. Your support coordinator and services facilitator work together as part of your support team.
Employer of Record (EOR): The person responsible for hiring, training, supervising, and managing paid attendants in consumer-directed services. The individual receiving supports may serve as their own EOR, or another person may take on this role.
DMAS EOR Manual and Consumer-Directed Services Information
Paid attendant: A person hired to provide approved consumer-directed assistance. You may also hear the terms “paid caregiver” or “consumer-directed employee.”
Caregiver: Someone who helps an individual with daily needs. A caregiver may be paid or unpaid.
Primary caregiver: The person who provides most of an individual’s unpaid care or assistance. Being the primary caregiver does not automatically make someone the EOR.
Live-in caregiver: A caregiver who lives in the same home as the individual receiving supports. Living together does not automatically make someone eligible to be paid for providing care. Family and Live-In Caregiver Information
Legally responsible individual (LRI): A person who has a legal responsibility to care for another person, such as a spouse or the parent of a minor child. Special Medicaid rules apply when an LRI becomes a paid caregiver. Family and Live-In Caregiver Information
DMAS Policy and Guidance for Legally Responsible Individuals
Decisions and representation
Person-centered planning: Planning that starts with what matters to you—your needs, preferences, goals, and choices.
Supported decision-making: Getting help to understand options and communicate your decisions while remaining the person who makes those decisions.
Substitute decision-maker: Someone authorized to make certain decisions for another person. Which decisions they can make depends on their role and authority.
Authorized representative: Someone authorized to act on your behalf for a particular purpose, such as helping with an application or communicating about your services. Their authority depends on the authorization given.
Guardian: A person appointed by a court to make decisions for someone else within the authority granted by the court.
Power of attorney (POA): A legal document that gives someone authority to act on another person’s behalf. The document describes what that person is authorized to do.
Services and daily supports
Supports: Assistance, resources, or tools that help you meet your needs and participate in daily life. Supports may include paid services, unpaid help, or technology.
Consumer-directed (CD) services: Services that let you choose and direct your paid attendants. You or your Employer of Record hire, train, and supervise attendants who provide your approved supports.
Agency-directed services: Services provided by an agency that hires, trains, and supervises its staff. You share your needs and preferences with the agency to help shape your care.
Personal assistance: Help or supervision with personal care and other approved daily support needs, at home or in the community. The assistance provided is based on your assessed needs and support plan.
Consumer-Directed Personal Assistance Services (CDPAS): Personal assistance delivered through the consumer-directed model.
Respite: Temporary care that meets your support needs while giving your usual unpaid caregiver a break from caregiving.
Companion services: Nonmedical support available through the Family and Individual Supports (FIS) and Community Living (CL) waivers for eligible adults age 18 and older. Services help with community participation, daily activities, and safety, as identified in your support plan. Companion services do not cover routine assistance with Activities of Daily Living (ADLs)—including bathing, dressing, eating, toileting, or transferring. This includes physical help or supervision needed to perform those activities.
Activities of Daily Living (ADLs): Everyday personal care activities, such as bathing, dressing, eating, using the toilet, and transferring—for example, moving from a bed to a chair.
Instrumental Activities of Daily Living (IADLs): Tasks that help you manage everyday life, such as preparing meals, doing laundry, shopping, and completing household tasks.
Backup plan: A required part of consumer-directed services that explains how your support needs will be met when your usual paid attendant is unavailable. It identifies who can help and how essential assistance will be provided. ConnectChoice helps you, your family, and your Employer of Record work through these arrangements.
Waivers assessments and planning
Developmental disability (DD): A disability that begins before age 22, is expected to continue long-term, and significantly affects several areas of everyday life. Virginia uses specific criteria to determine eligibility for DD services.
DD waiver: A Virginia Medicaid program that provides eligible individuals with developmental disabilities access to services and supports for living in their communities.
Family and Individual Supports (FIS) waiver: A Virginia DD waiver designed to support individuals who live with their families or in their own homes. It includes consumer-directed services for individuals who qualify.
Community Living (CL) waiver: A Virginia DD waiver offering a broad range of supports, including residential services for individuals who need support around the clock. It also includes consumer-directed services for individuals who qualify.
Individual Support Plan (ISP): Your overall plan describing what matters to you, your goals, and the services and supports you need. You develop it with your support coordinator and the people involved in your planning.
Plan for Supports (Part V of the ISP): The part of your Individual Support Plan that explains how a particular provider will help meet your needs and work toward your goals.
Supports Intensity Scale (SIS): An assessment that explores the types and amount of support you need in different areas of your life. Information gathered through an interview helps inform your person-centered support planning.
Virginia Individual Developmental Disabilities Eligibility Survey (VIDES): An assessment your support coordinator uses to determine whether your support needs meet the level-of-care requirements for a Virginia DD waiver. It is one part of determining waiver eligibility.
Level of care (LOC): The level of support needs used to determine eligibility for a Medicaid program. For Virginia’s DD waivers, the VIDES assesses whether you meet the required level of care.
Service authorization (SA): Medicaid approval for a specific service, the amount of support approved, and the dates it covers.
Authorization request: Information submitted for Medicaid review that explains your support needs and justifies the services being requested. ConnectChoice prepares the request; the responsible Medicaid reviewers decide whether to approve it.
Service authorization renewal: A review and request to continue your services for another authorization period. Your current needs are considered when preparing the request.
Waiver Management System (WaMS): Virginia’s online system used by support coordinators, providers, and state staff to manage DD waiver information and processes.
Objective Written Documentation (OWD)
Factual information explaining why other providers are unavailable and a family member living in the home is needed as a paid attendant. Examples include recruitment records, interview notes, difficulty retaining attendants, or information about medical, behavioral, or language needs. ConnectChoice helps gather and prepare this documentation for the authorization process.
Virginia’s Objective Written Documentation Requirements
Agencies and organizations
Department of Medical Assistance Services (DMAS): The state agency that administers Virginia Medicaid and establishes policies for Medicaid-covered services, including waiver services.
Department of Behavioral Health and Developmental Services (DBHDS): The state agency that oversees Virginia’s developmental disability service system and works with DMAS to operate the DD waivers.
Community Services Board (CSB): A local organization that helps people access developmental disability and behavioral health services. Your local CSB is the starting point for requesting DD waiver services and can help connect you with support coordination.
Behavioral Health Authority (BHA): A local public organization that helps people access developmental disability and behavioral health services, serving a role similar to a Community Services Board (CSB).
Managed Care Organization (MCO): A health plan that arranges and manages covered Medicaid healthcare for its members. Some services, including DD waiver services, are managed separately from your health plan.
Centers for Medicare & Medicaid Services (CMS): The federal agency that oversees Medicare and works with states to oversee Medicaid.
Department of Social Services (DSS): Your local office that helps with applications, renewals, and questions about public benefits, including Medicaid. You may also see it called the Local Department of Social Services (LDSS).
Virginia Department of Social Services (VDSS): The state agency that provides oversight and guidance to local departments of social services across Virginia.
Enrollment payroll and time recording
Fiscal Employer Agent (F/EA): An organization that processes attendant payroll, handles payroll taxes, and helps with employment enrollment paperwork for consumer-directed services. The Employer of Record remains responsible for hiring, training, and supervising attendants.
Consumer Direct Care Network (CDCN): A fiscal employer agent serving Virginia’s consumer-directed services. CDCN helps with employer and attendant enrollment, payroll, and tools and training for recording and approving time worked.
Electronic Visit Verification (EVV): An electronic system attendants use to record when their services begin and end. It also records who provided and received the services, the service type, date, and location.
CareAttend: The mobile app used by CDCN attendants to clock in and out and record service information for Electronic Visit Verification (EVV).
DirectMyCare (DMC): CDCN’s online portal where attendants can review time entries and access pay information, and Employers of Record can review and approve or reject submitted time. Entering time manually in the portal does not replace clocking in and out through an approved EVV method.
Privacy and protection
Health Insurance Portability and Accountability Act (HIPAA): A federal law whose rules protect the privacy and security of certain health information and give you rights over that information, including the right to request access to your records.
Protected Health Information (PHI): Information protected by HIPAA that identifies you and relates to your health, care, or payment for care. It can include assessments, service records, and billing information, whether shared electronically, on paper, or verbally.
Adult Protective Services (APS): Services through your local Department of Social Services that respond to reports of suspected abuse, neglect, or exploitation of eligible adults and help arrange protection and assistance.
Child Protective Services (CPS): Services through your local Department of Social Services that respond to reports of suspected child abuse or neglect and work with families to help keep children safe.