Heather Norton, deputy commissioner at the Department of Behavioral Health and Developmental Services, updated the Virginia Disability Commission on June 5 about the Commonwealth’s developmental disability (DD) Medicaid waiver waiting list and slot assignment process.

Norton said Virginia’s DD waitlist stands at 14,168 people across three waivers (Building Independence, Family and Individual Support, and Community Living). She described the priority categories used to triage assignments: Priority 1 (projected need within a year) at 3,002 individuals; Priority 2 (need in 1–5 years) at 6,394; and Priority 3 (need in more than five years) at 4,772.

The General Assembly in 2024 approved a phased approach adding 3,440 waiver slots and increased provider rates. Norton said the state allocates 1,720 slots per fiscal year in quarterly tranches. For FY25 she reported Q1 assigned 463 of 463 slots, Q2 assigned 437 of 437, Q3 assigned 399 of 421, and Q4 had assigned 121 of 399 to date; remaining small allocations are handled regionally when CSBs cannot place assigned slots within a 90‑day period.

Norton explained the slot lifecycle: the department issues quarterly notices to community services boards (CSBs); regional support specialists assist CSBs in convening slot assignment committees that score critical needs and prioritize individuals; once a slot is assigned, a CSB has seven days to notify the family, the family has 15 days to accept, and then 150 days to begin services after acceptance. The department now follows up monthly with families who have accepted but not started services in order to identify systemic barriers and improve access.

She noted turnover also creates openings: roughly 1,000 slots per year become available because of individuals moving out of state, death or other turnover, in addition to newly authorized slots. Norton summarized progress since FY2018 when slot capacity rose from 13,154 to a projected 21,479 by the end of FY2026.

Commissioners asked for clarifications about maintaining eligibility while waiting for a provider. Norton said a 365‑day hold request to CMS had not been approved; instead, the department provides quarterly reporting and follow up to help individuals connect to services more quickly.

No formal commission action was taken; the department answered questions and described ongoing quarterly allocation work.