Virginia Elderly or Disabled with Consumer Direction (EDCD) Waiver

Page Reviewed / Updated - Mar. 2014

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers" which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.

Waiver Description

Virginia Elderly and Disabled Medicaid Waiver provides community-based care services to those nursing home eligible seniors that choose to live in their own homes.  The program provides a variety of assistance options to help them do so including personal care, fall monitoring / personal emergency response services and adult day care. 

Under EDCD, participants can choose from whom to receive personal care assistance.   Even some family members can be hired and receive compensation for their assistance.

Consumer Direction means that the participant is able to choose some of their care providers. In some cases, they are able to pay their related caregiver for the personal care they provided. This type of program is occasionally referred to as Cash and Counseling or Self-Direction and it is becoming increasingly popular with families due to the increased choice. It is also popular with state officials because it has the potential to reduce costs by leveraging family caregivers.

 

Eligibility Guidelines

While open to disabled adults of any age, this program is primarily targeted towards those 65 and older. It is not necessary for these individuals to be completely disabled however they must require the level of care provided in nursing homes. As with all Medicaid programs, there are also financial requirements.

2014 Virginia Medicaid Income Limits for the Elderly
Elderly, disabled and blind state residents can fully qualify for Medicaid if their monthly incomes are less than $778 (80% of FPL). However, depending on their medical expenses, some individuals can qualify with monthly income up to $2,163 or in rare instances even in excess of that amount.

2014 Virginia Medicaid Asset Limits for the Elderly
Individuals applying for Medicaid are permitted up to $2,000 in countable assets, married couples up to $3,000 and married couples with only one spouse applying up to $117,240. Countable assets do not include their home provided at least one spouse lives in it and provided their home equity is valued at less than $543,000. The primary vehicle and final expense plans are also excluded for their countable assets.

IMPORTANT* if one's income or assets exceed Medicaid's limits, there are public and private benefits counselors who may be able to help.  Given the high cost of care, doing this can prevent many families from becoming destitute. Excess income can be allocated to pooled income trusts, and excess assets can be converted to exempt annuities.  Read more.

 

Benefits and Services

This waiver is intended to prevent persons from moving into nursing homes. The available services are selected to maximize their ability to age in place in their homes. While services are determined specifically for each applicant, they may include:

  • Adult Day Care - supervised care in a group environment during normal working hours
  • Medication Monitoring - oversight and administration of required prescription drugs
  • Personal Care Aide Services - assistance with the activities of daily living
  • Respite Care - temporary caregiving services provided to relief the primary family member or caregiver
  • Personal Emergency Response System - automated electronic monitoring and notification of emergency situations
  • Transition Coordination -should the individual be moving out of skilled nursing into a private home

Individuals who currently reside in a nursing home and are using services from this waiver to return to living at home may also receive assistance for home modifications which increase their independence and safety.  As an example, this might include a walk-in tub replacement for a shower and wheelchair ramps or stairglides. 

 

How to Apply / Learn More

This waiver is available statewide across Virginia. However, most waivers are created with a limited number of slots available. Eligible individuals may find themselves on a waiting list for services. To learn more or apply for this waiver, contact your local Department of Social Services.   Additional information about this program is available here.  

Did You Know? The number of elderly individuals living in Virginia is projected to double between the year 2000 and 2030.