![DDA Waivers Compared: Basic Plus vs IFS vs Core [Washington State]](/_next/image?url=%2Fimages%2Fblog%2Fdda-waivers-compared-washington.jpg&w=3840&q=75)
Understanding Washington's DDA Waivers
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If you're helping someone navigate Washington State's developmental disabilities services, you've probably heard the terms Basic Plus, IFS, Core, and CIIBS. But what do they actually mean, and which one is right for your situation?
This guide breaks down each waiver, compares them side by side, and helps you understand how to transition between them when needs change.
Quick Reference: Waiver Comparison
| Feature | Basic Plus | IFS | Core | CIIBS |
|---|---|---|---|---|
| Setting | Family home, own home | Family home, own home | All settings including residential | All settings |
| Budget approach | Individual budget | Self-directed budget | Service-based | Individual budget |
| Self-direction | Some | Maximum | Limited | Some |
| Residential services | No | No | Yes | Limited |
| Employment services | Yes | Yes | Yes | Yes |
| Respite | Yes | Yes | Yes | Yes |
| Nursing | Limited | Limited | Yes | Yes |
| Best for | Moderate support needs | Self-directing families | Comprehensive needs | Intensive behavioral needs |
Basic Plus Waiver
Overview
Basic Plus is designed for individuals with developmental disabilities living with family or in their own homes who need a moderate level of support.
Who Qualifies
- Eligible for DDA services (developmental disability determination)
- Living with family OR in own home/apartment
- Needs more than Basic waiver (if available) but less than Core
- Medicaid eligible
Services Available
Personal care:
- Help with daily living activities (bathing, dressing, eating)
- Household tasks
- Community accompaniment
Employment & day services:
- Supported employment
- Community inclusion
- Pre-vocational services
Support services:
- Respite care (relief for family caregivers)
- Specialized medical equipment
- Environmental modifications (home adaptations)
- Transportation
Budget Structure
Basic Plus uses an individual budget calculated based on assessed need. You work with your case manager to allocate your budget across available services.
Typical monthly budgets: $2,000-$6,000 (varies significantly by assessed need)
Pros and Cons
Pros:
- Flexible individual budget
- Good balance of structure and choice
- Covers most community-based needs
- Can use agency or individual providers
Cons:
- Cannot access residential habilitation
- Limited nursing services
- Budget may not cover intensive needs
- Waitlist may apply in some situations
Individual and Family Services (IFS) Waiver
Overview
IFS offers the most self-direction of any Washington DDA waiver. It's designed for individuals and families who want maximum control over how services are delivered.
Who Qualifies
- Eligible for DDA services
- Living with family OR in own home
- Willing and able to direct services (or have representative)
- Medicaid eligible
Services Available
Self-directed options:
- Personal care (you hire and manage workers)
- Respite
- Community engagement
- Skills training
Professional services:
- Behavior support
- Therapies (OT, PT, speech)
- Nursing (limited)
Goods and equipment:
- Specialized equipment
- Environmental modifications
- Technology aids
Budget Structure
IFS provides a budget amount, and you decide how to spend it within guidelines. This "participant direction" means:
- You can hire family members (with some restrictions)
- You manage worker schedules
- You decide service priorities
- Financial management services handle payroll
Typical monthly budgets: $1,500-$5,000 (varies by assessment)
Pros and Cons
Pros:
- Maximum flexibility and control
- Can hire family members (within rules)
- Budget can cover creative solutions
- Empowers individual/family decision-making
Cons:
- Requires management capacity (or representative)
- No residential services
- Limited nursing coverage
- Paperwork burden on family
- May have lower overall budget than other waivers
Core Waiver
Overview
Core waiver is Washington's comprehensive waiver for individuals needing the highest level of support, including residential services.
Who Qualifies
- Eligible for DDA services
- Assessed as needing intensive support
- May need residential habilitation
- Medicaid eligible
Services Available
Residential:
- Supported living (own apartment with staff support)
- Group home/residential habilitation
- Alternative living (adult family homes)
- Companion homes
Personal care:
- All daily living support
- 24/7 care when needed
- Skilled nursing
Day and employment:
- Community inclusion
- Supported employment
- Day programs
- Pre-vocational services
Professional services:
- Behavior support
- Therapies
- Nursing
- Specialized assessments
Budget Structure
Core waiver is service-based rather than budget-based. Services are authorized based on assessed need rather than a fixed dollar amount.
This means:
- Care levels determine staffing ratios
- Residential providers receive rates based on need
- Individual doesn't manage a specific budget
- Comprehensive support is available when needed
Pros and Cons
Pros:
- Access to residential services
- Most comprehensive coverage
- 24/7 support available
- Professional nursing included
- No need to manage budget (provider-arranged)
Cons:
- Less individual control
- May require moving from family home
- Waitlist for residential slots
- Provider availability varies by region
CIIBS (Community Inclusion and Individual Behavioral Support)
Overview
CIIBS is designed specifically for individuals with intensive behavioral support needs who can live in the community with appropriate services.
Who Qualifies
- Eligible for DDA services
- Has intensive behavioral support needs
- Assessed as appropriate for community living with support
- Medicaid eligible
Services Available
Behavioral support:
- Positive behavior support planning
- Crisis intervention
- Skill building
- Staff training
Community support:
- Personal care
- Community inclusion
- Employment services
- Day services
Residential (limited):
- Supported living
- Companion homes
- Some residential options
Budget Structure
CIIBS uses an individual budget with emphasis on behavioral support services.
Typical monthly budgets: $4,000-$12,000+ (intensive behavioral needs = higher budgets)
Pros and Cons
Pros:
- Specialized for behavioral needs
- Intensive support available
- Community-based focus
- Professional behavioral expertise
Cons:
- Specific eligibility (must have behavioral needs)
- Limited residential options
- Provider availability varies
- Requires ongoing behavioral planning
Comparing the Waivers
By Living Situation
| Living Situation | Best Waiver Options |
|---|---|
| Living with parents | Basic Plus, IFS |
| Own apartment with minimal support | Basic Plus, IFS |
| Own apartment with significant support | Basic Plus, Core |
| Group home needed | Core |
| Adult family home | Core |
| Family home with self-direction | IFS |
By Support Need Level
| Support Level | Best Waiver Options |
|---|---|
| Low-moderate | IFS, Basic Plus |
| Moderate-high | Basic Plus, Core |
| High with 24/7 needs | Core |
| Intensive behavioral | CIIBS |
By Control Preference
| Control Preference | Best Waiver |
|---|---|
| Maximum self-direction | IFS |
| Balance of control and support | Basic Plus |
| Provider-managed services | Core |
Transitioning Between Waivers
When to Consider a Change
- Needs have increased (Basic Plus → Core)
- Wants more self-direction (Basic Plus → IFS)
- Moving to residential setting (any → Core)
- Behavioral needs emerging (any → CIIBS)
- Needs stabilizing (CIIBS → Basic Plus)
How to Request a Change
- Talk to your case manager — Share your concerns and reasons
- Request new assessment — Demonstrate changed needs
- Review options together — Understand implications
- Submit waiver change request — Through DDA
- Await approval — May involve waiting period
What to Consider Before Changing
- Budget impact — Different waivers have different budget structures
- Provider continuity — Some providers work with specific waivers
- Service changes — Some services may not carry over
- Waitlists — Some waivers have waiting periods
- Setting requirements — Core requires willingness to consider residential options
Working with Case Managers
Your DDA case manager is essential for navigating waivers:
They can help with:
- Explaining waiver differences
- Assessing your needs
- Recommending appropriate waiver
- Facilitating transitions
- Finding providers
- Authorizing services
Questions to ask:
- Which waiver best fits our current needs?
- What services could we access that we're not using?
- If needs change, what's the transition process?
- Are there waitlists we should be aware of?
- What providers in our area work with our waiver?
Finding Providers
Once on a waiver, you need providers to deliver services.
For Agency-Provided Services
Look for licensed providers who:
- Contract with DDA for your waiver type
- Serve your geographic area
- Have availability
- Match your needs (specialty populations, languages, etc.)
For Self-Directed Services (IFS)
You can hire:
- Individual providers (background checked)
- Family members (with restrictions)
- Contractors for goods/modifications
Use a fiscal intermediary to handle:
- Payroll and taxes
- Worker's comp
- Invoicing DDA
Finding Help
- Ask your case manager for provider lists
- Search Washington's provider directory
- Connect with family support groups
- Use CareCade's provider directory for agencies in your area
Common Questions
Q: Can I change waivers if my needs change?
A: Yes, but it requires reassessment and may involve waiting periods. Work with your case manager to initiate.
Q: What if I'm on a waitlist?
A: While waiting for a waiver, you may qualify for other services (state-only funded services, case management, information and referral).
Q: Can I hire my parent as a caregiver?
A: IFS allows hiring some family members with restrictions. Basic Plus and Core have more limitations. Your case manager can clarify current rules.
Q: What happens when a child turns 21?
A: Transition planning should start years earlier. DDA services continue, but school-based services end. Ensure DDA waiver is in place before transition.
Q: How are budgets determined?
A: Through standardized assessments (currently the Comprehensive Assessment Reporting and Evaluation - CARE) that evaluate functional needs.
Key Takeaways
- Basic Plus — Good middle ground for moderate community-based needs
- IFS — Maximum self-direction for families wanting control
- Core — Comprehensive services including residential when needed
- CIIBS — Specialized for intensive behavioral support needs
The right waiver depends on:
- Where the person lives (or wants to live)
- Level of support needed
- Desire for self-direction vs. provider management
- Specific service requirements
Work closely with your DDA case manager to find the best fit—and know that you can transition as needs evolve.
Find Providers for Your Waiver
Search for home care agencies in Washington that serve DDA clients:
Or contact us with questions about DDA services.