Community Guide
Community Guide at VATN is a short-term, problem-solving service that helps people find and connect with resources in their own communities. A Community Guide works alongside the individual (and their family or support team, if desired) to explore interests, clarify goals, and identify supports that already exist outside of paid services. They help navigate systems, make introductions to community organizations, and build natural support networks so that over time, the person can participate more independently and rely less on formal services.
Community Guide at VATN
Community Guide at VATN provides short-term, targeted support to help individuals identify, access, and navigate community resources that promote self-determination and reduce reliance on paid services. Community Guides work with individuals and their support networks to explore interests, clarify goals, and connect them to integrated housing options, social opportunities, and non-Medicaid community programs that fit their needs and preferences.
We help problem-solve barriers, build natural supports, and coordinate with community partners so that people can participate more independently in the life of their community, with services phasing back as natural and unpaid supports grow.
What community guide can support:
Finding social and recreational groups
A Community Guide helps identify clubs, classes, and interest-based groups (like art, sports, or gaming) that match the person’s interests, and supports them in getting connected and started.
Exploring volunteer and civic opportunities
The Guide helps the person explore volunteer roles, community projects, and neighborhood activities where they can give back, build a routine, and take on meaningful roles.
Navigating transportation options
The Guide supports learning how to use public transit, paratransit, or ride services to safely get to community activities, work, or appointments, including helping set up accounts and schedules.
Connecting with faith and cultural communities
The Guide assists individuals in exploring and connecting with faith communities, cultural groups, or identity-based spaces where they feel welcomed and included.
Locating fitness and wellness resources
The Guide helps find accessible gyms, walking groups, adaptive sports, and wellness classes that fit the person’s abilities, interests, and schedules.
Accessing local education and skill-building classes
The Guide supports identifying community college courses, library workshops, or community center classes that align with the person’s learning or career goals and helps with enrollment steps.
Building natural supports and friendships
The Guide helps the person practice introductions, follow-up, and communication in real settings so they can form and maintain relationships with neighbors, peers, and community members.
Problem-solving barriers to participation
The Guide works with the person to identify what gets in the way of joining community life (like anxiety, transportation, or accessibility) and helps find creative, community-based solutions.
Learning about local resources and benefits
The Guide helps the person understand and connect to non-waiver resources such as food banks, recreation programs, libraries, community centers, or civic resources that match their needs.
Transitioning away from paid supports
As natural supports grow, the Guide helps plan how to fade back formal services, ensuring the person knows who they can call, where they can go, and how to stay connected in the community.
Throughout, our team provides routine and safety supports with transportation to and from community locations, within waiver guidelines.
Who community guide is for:
Community Guide might be a good fit if:
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You want to be more involved in your community but aren’t sure what is available or how to get started.
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You have goals like “I want more to do,” “I want to meet people,” or “I want to be more independent,” and need help turning those ideas into an action plan.
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You are interested in building natural supports—friends, neighbors, and community connections—so you can rely less on paid staff over time.
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You are in a transition (finishing school, changing services, moving, or considering different day options) and need short-term help exploring community resources and next steps.
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You and your support team want creative, community-based solutions to barriers like isolation, transportation, or limited meaningful activities.
Community Guide is available to people enrolled in Virginia’s developmental disability waivers and is designed as a short-term, consultative service that works alongside your other home- and community-based supports to increase self-direction and connection to unpaid, community resources.
COMMUNITY GUIDE INTAKE PROCESS
Authorization
After submitting your intake forms, we’ll work alongside your Support Coordinator to gather all documentation needed for service authorization. Our team prepares a comprehensive support plan and submits the authorization request to the Department of Behavioral Health and Developmental Services (DBHDS) for review. DBHDS carefully evaluates your submitted information to ensure all clinical qualifications, regulations, and documentation requirements are met before approving services; you and your coordinator will be promptly informed once authorization is granted so you can begin your customized treatment journey.
Assessment & Support Plan
Using information from your SIS® or other DBHDS-approved assessments, along with your goals and preferences, we develop a Plan for Supports. This plan names specific skills to work on, types of community activities to pursue, and how we will support you in building natural relationships.
Begin Services
You participate in community outings in a group of no more than three individuals per DSP. Activities are planned with you, occur mostly in the community (with minimal planning time in a central location), and are designed to give you repeated practice in the skills and settings that matter most to you.
FREQUENTLY ASKED QUESTIONS
What is Community Guide service?
Community Guide is a short-term, waiver-funded service that helps individuals identify, access, and use community resources so they can build natural supports, explore interests, and rely less on paid services over time.
Who can receive Community Guide through the waiver?
Community Guide is available to individuals enrolled in Virginia developmental disability waivers (such as CL, FIS, or BI) who have goals related to increasing community involvement, building natural supports, or expanding unpaid resources, and for whom this service is authorized in their plan.
How is Community Guide different from Community Coaching or Community Engagement?
Community Guide focuses on short-term problem-solving, mapping out options, and connecting people to existing community resources and natural supports, rather than providing ongoing skill teaching (Community Coaching) or regular, staffed participation in community activities (Community Engagement).
How long can someone use Community Guide services?
Community Guide is intended to be time-limited and goal-focused. The length of service is based on the individual’s needs and approved units in their plan, with the expectation that supports will fade as connections are made and natural supports increase.
How do I request or add Community Guide to a waiver plan?
Individuals and families can talk with their support coordinator/case manager about whether Community Guide is a good fit for their goals. If appropriate, the support coordinator will include Community Guide in the person-centered plan, complete any required documentation, and submit it for authorization through the waiver.