Virginia Regulatory Town Hall
Department of Behavioral Health and Developmental Services
State Board of Behavioral Health and Developmental Services
Guidance Document Change: Support Coordination/Case Management is the core service that Virginians with developmental disabilities and behavioral health disorders use to help navigate and make the best use of Virginia’s publicly funded system of services. Strengthening the Support Coordinator’s/Case Manager’s role is essential to assuring effective and accountable services within the Medicaid Developmental Disability Waivers. The purpose of this manual is to guide Support Coordinators in all aspects of their work. These adjustments include altering wording for clarity, reorganizing content for easier navigation, providing language updates that are in line with current support coordination practices, and condensing portions of chapters for clarity and conciseness. The draft can be viewed here:
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1/4/24  11:59 am
Commenter: Dennis Brown, Independent Consultant

Suggested clarity of definition

I suggest rewording the proposed definition of supported living on page 58.  The proposed service description states that Supported living takes place in an apartment setting operated by a DBHDS-licensed provider.


This specificity of taking place ONLY in an apartment is restrictive and in fact conflicts with both the Licensing definition and the Waiver Manual definition.  It may mislead Support Coordinators to not consider supported living options offered by providers in a licensed residential setting such as a condominium, an attached townhouse or detached house, since the Support Coordinators may not realize that services in these settings CAN in fact be authorized as supported living services.


Licensing regulations state that Supervised living residential service means the provision of significant direct supervision and community support services to individuals living in apartments or other residential settings. These services differ from supportive in-home service because the provider assumes responsibility for management of the physical environment of the residence, and staff supervision and monitoring are daily and available on a 24-hour basis. 

The Waiver regulation 12VAC30-122-540 states that Supported living residential service shall take place in a residential setting operated by a DBHDS-licensed provider of supervised living residential service or supportive in- home service

I suggest guiding Support Coordinators on the distinction between group home (24 hour) and supported living is the scope and amount of services and to note that both services require the provider to include the physical residential setting while supportive services are distinguished because the individual provides their own housing and therefore the housing is not connected to the support services.

CommentID: 220891