A Medicaid waiver does not have the same rules that normally apply to the Medicaid program. The Medicaid waiver program allows states to expand coverage, reduce costs, and improve care for people who would otherwise be in an institution, hospital, or nursing home. As a result, Medicaid members can make the choice to remain home with family, and caregivers can receive help with care services.
For Medicaid members living at home, like seniors, people with disabilities, and children with serious emotional disorders who require assistance, there are four waiver programs available.
Aged and Disabled Waiver (ADW)
The Aged and Disabled Waiver (ADW) program is a long-term care option that provides in-home care and community help. It allows a person to remain at or return home instead of receiving nursing home care. Services in the program promote choice, self-reliance, respect and community care.
Children with Serious Emotional Disorder Waiver (CSEDW)
The CSEDW program provides additional Medicaid support to children from ages three to 21 with serious mental, behavioral, or emotional health needs. The program helps keep children with their families at home or in the community instead of going to a care facility or a group home. While they are at home or in the community, they receive services to improve their condition.
CSEDW is a West Virginia Medicaid Home and Community Based Services (HCBS) waiver program that allows children with serious emotional disorders receive additional services based on the National Wraparound Initiative model. This model uses the strengths of families and each person to start growing and changing. This model also helps the child and their family get the skills they need to deal with challenges and helps keep the child stable at home.
The model also focuses on the child's needs and their family. A child who has challenging behaviors is the center of the process. They are involved in the plan to help develop the skills that are required to get stable and improve their ability to deal with the situation. The goal is to give the child the ability to reach their personal goals.
Intellectual/ Developmental Disabilities Waiver (IDDW)
The Intellectual/Developmental Disabilities Waiver (IDDW) program is for children and adults with disabilities. The program provides services that help to teach, train, support, guide and assist members reach the highest level of independence possible in their lives.
The IDDW program, formerly MR/DD Waiver program, provides these services in homes and areas where the member lives, works, and shops instead of in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).
Traumatic Brain Injury Waiver (TBIW)
The Traumatic Brain Injury Waiver (TBIW) program provides support at home for members three years and older with a traumatic brain injury. It waives some of the rules to allow people who live in West Virginia to receive support to live at home. Home and Community-Based Waiver Services are for people who meet the medical and financial requirements for the program. The program promotes choice, independence, respect, dignity and involvement with the community.
Behavioral Health and Long-Term Care Services
The Behavioral Health and Long-Term Care Services Unit focuses on ensuring that Medicaid members receive appropriate services to ensure a better quality of life. The unit provides policy and support to Medicaid members and providers to ensure services are in place to meet their physical health, behavioral health and long-term care needs.
Nursing Services
The Bureau for Medical Services Offers the following in-home and out-of-home nursing services to members who are medically eligible for the services.
Take Me Home Transition Program
The Take Me Home (TMH) West Virginia Transition Program, administered by the Bureau for Medical Services, helps Medicaid members living in long-term care facilities return to their homes and communities with the services and support they need. TMH field staff work one-on-one with participants to create personalized transition plans that ensure safe, successful moves. The program also strengthens West Virginia’s long-term care system by expanding home and community-based service options.
Personal Care Services
The West Virginia Medicaid Personal Care Services Program is an in-home care program for West Virginia Medicaid members who may need help with their Activities of Daily Living (ADL). Trained direct-care workers come to your home, place of employment, or community to asssit with ADLs and other areas of personal care to help you live independently.
Pathways to Professional In-Home Care
West Virginia Pathways to Professional In-Home Care is a free program designed to train individuals for a rewarding career as a direct-care professional. Participants must be 18 years or older and a resident of West Virginia. After completing the program, participants receive compensation for the time spent in training. The program is a West Virginia Department of Human Services (DoHS) initiative to help with the shortage of direct-care professionals in West Virginia. Funding for the program is provided by the American Rescue Plan Act (ARPA).
