Opening a DD Waiver provider agency in Virginia means clearing two systems — DBHDS (which licenses and monitors your services) and DMAS (Virginia Medicaid, which pays for them) — plus a newer requirement: a proctored knowledge exam for priority services. Here is the whole path, in order.
Choose which DD Waiver services you intend to offer — for example group home residential, sponsored residential, group day, community engagement, or in-home supports. DBHDS sorts services into review priorities, and Priority 1 and 2 services carry extra requirements (see Step 2) in exchange for an expedited review timeline.
Effective November 7, 2025, applicants for a Priority 1 or 2 service must complete the DBHDS Initial Applicant Orientation (16 self-paced modules on the state TRAIN system) and pass a proctored Comprehensive Knowledge Exam at 85% — before you begin the application. Do this first: applying without it drops you off the priority timeline.
Create an account in the DBHDS CONNECT Provider Portal and complete the initial application, uploading your governance documents, policies, and other required items. A Policy Review Specialist reviews the packet and requests any corrections, so monitor CONNECT and respond promptly.
Your written policies must satisfy 12VAC35-105 (licensing) and 12VAC35-115 (human rights) — covering governance, personnel, health and safety, serious incident reporting, individual rights, and quality improvement. This is where most first-time applicants get sent back for revisions, so build it carefully.
Licensure through DBHDS and payment through DMAS are separate steps. To bill for waiver services you must enroll as a Virginia Medicaid provider, obtain your NPI, and complete Medicaid enrollment and any required revalidation.
A Licensing Specialist conducts an on-site inspection and knowledge-based interviews. New providers are typically issued a conditional license (up to six months) to demonstrate full compliance before a regular license is granted.
Before staff work independently, they must complete orientation and the DBHDS-required training, and you must document it. This is exactly what DSPlife™ TrainingHub is built for — pre-loaded required courses, certification tracking with expiration alerts, onboarding workflows, and audit-ready records.
For a Priority (Level) 1 or 2 service, yes. Since November 7, 2025, you must complete the DBHDS Initial Applicant Orientation and pass the Comprehensive Knowledge Exam (25 questions, 85% to pass) before your application is reviewed on the priority timeline.
It varies with your readiness and DBHDS review times. New providers are usually issued a conditional license (up to six months) to demonstrate full compliance, after which a regular license can be granted. Completing the orientation and exam first, and submitting complete, compliant policies, is the fastest path.
DBHDS licenses and monitors your services for regulatory compliance. DMAS (Virginia Medicaid) enrolls you as a provider so you can bill for waiver services. You need both — licensure alone does not let you bill.
Direct Support Professionals must complete orientation before working independently and ongoing annual training, plus role-specific requirements such as medication administration, human rights, and serious incident reporting. TrainingHub ships with the DBHDS-required courses ready to assign and tracks completion and expirations.
This guide is general information, not legal or regulatory advice. DSPlife™ TrainingHub is not affiliated with DBHDS or DMAS. Always confirm current requirements at dbhds.virginia.gov and dmas.virginia.gov.
TrainingHub ships with the DBHDS-required courses ready to assign, certification tracking, and onboarding workflows. Free to start — no credit card required.
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