West Virginia currently has four Medicaid waivers/programs that can serve children, including a TEFRA program and three home and community based 1915(c) waivers. This includes a newer program for children with Serious Emotions Disorder that was started in 2020. The TEFRA program is based only on child income without regard to parent income, while the DD and TBI waivers do count parent income. For more information, see West Virginia’s Medicaid Waivers page.
Advocacy Organizations in West Virginia:
- West Virginia UniversityCenter for Excellence in Disabilities
- West Virginia Parent Training and Information, Inc.
- Disability Rights West Virginia
- Arc of West Virginia
Last updated 11/6/23
Programs in West Virginia
- Target Population: Children who would otherwise require care in an institution with any type of disability, including medical, developmental, intellectual, or psychiatric conditions.
- Ages: 0-18
- Levels of Care: Intermediate Care Facility, Nursing Facility, Hospital
- Income Waiver: Yes, the program is based on the child’s income only. Parent income is not counted.
- Waiver Type: TEFRA
- Spots: unlimited
- Expiration Date: NA
- Description: Provides Medicaid coverage only.
- Online State Information: Children with Disabilities Community Service Program and brochure
- How to Apply: Contact the Program at 304-776-7230 or apply through PCA Solutions
- Waiting List: none
- Target Population: Children and adults with developmental or intellectual disabilities.
- Ages: 3+
- Levels of Care: Intermediate Care Facility
- Income Waiver: none
- Waiver Type: 1915(c)
- Spots: 5964
- Expiration Date: 6/30/2025
- Description from medicaid.gov: Provides facility based day hab, home-based agency person-centered support, in-home respite, prevocational, service coordination, supported employment, dietary therapy, OT, PT, speech therapy, participant-directed goods and services, behavior support professional, crisis intervention, crisis site person-centered support, electronic monitoring, environmental accessibility adaptations, family person-centered support, job development, licensed group home person-centered support, out-of-home respite, skilled nursing by a LPN, skilled nursing a RN, transportation, unlicensed residential person-centered support for individuals with ID/DD, ages 3 – no max age.
- Online State Information: Intellectual/Developmental Disabilities Waiver
- Official Federal Information
- How to Apply: Contact at 304-558-1700 or follow these application instructions. Evaluation is through Kepro.
- Waiting List: There are 526 people with developmental disabilities on West Virginia’s waiting list.
- Target Population: Children and adults with traumatic brain injuries.
- Ages: 3+
- Levels of Care: Nursing Facility
- Income Waiver: none
- Waiver Type: 1915(c)
- Spots: 90
- Expiration Date: 6/30/2025
- Description from medicaid.gov: Provides case management, personal attendant services, community transition services, pre-transition case management, and transportation to individuals with brain injuries, ages 3 – no max age.
- Online State Information: Traumatic Brain Injury Waiver and this brochure
- Official Federal Information
- How to Apply: Contact 304-558-1700 or follow these application instructions. Evaluation is through Kepro.
- Waiting List: There are 526 people with developmental disabilities on West Virginia’s waiting list.
- Target Population: Children, including foster children, with serious emotional disturbance or mental illness
- Ages: 3-21
- Levels of Care: Hospital (PRTF)
- Income Waiver: unknown
- Waiver Type: 1915(c) with partial managed care component
- Spots: 2500
- Expiration Date: 1/31/2028
- Description from medicaid.gov: Provides wraparound facilitation, in-home family support, independent living/skills building, job development, respite care (in-home), supported employment-individual, assistive equipment, community transition, family therapy, mobile response, non-medical transportation, peer parent support, respite care (out-of-home), and specialized therapy services to individuals with mental illness ages 18-21 years and individuals with serious emotional disturbance ages 3-17 years who meet a hospital level of care. This waiver operates with a concurrent 1915(b)(1) and 1115 authority.
- Online State Information: Children with Serious Emotional Disturbance Waiver
- Official Federal Information
- How to Apply: Contact the program at 844-HELP4WV or follow the instructions on this page. Evaluation is performed by Kepro.
- Waiting List: none
Additional Information
- West Virginia’s Early Intervention Program: Birth to Three
- West Virginia’s Title V Program: Children with Special Health Care Needs (CSHCN) Program
- In the Intellectual and Developmental Disabilities Waiver, “The legally responsible adult may only provide services that have been identified as necessary in the Extraordinary Care Assessment which is completed initially and at the annual reevaluation of eligibility by the UMC. For individuals who self-direct through Personal Options, a program representative cannot serve in the dual role as the program representative and a paid service provider. The rural nature of the state of West Virginia also makes it problematic for behavioral health agencies to recruit appropriate staff so legal guardians may be paid employees, but someone else will have to serve as the program representative for purposes of self-direction. For children eligible to receive public education services/home schooling/other education alternatives, person-centered support services cannot exceed 7,320 15-minute units per IPP year. The legal guardian of a person who is not eligible for public education services/home schooling/other educational alternatives, is limited to 11,680 15-minute units of person- centered support services. A spouse is not allowed to provide person-centered support services….Any qualified relative/legal guardian living in the person’s home except for a person’s spouse may provide Family Person-Centered Support services, both through the Traditional Option and the self-directed program, Personal Options. Any qualified relative except for a person’s spouse or legal guardian may provide respite as long as they do not reside in the home with the person and are not the individual’s parent or step-parent. Any qualified relative/legal guardian may provide transportation provided they meet qualifications in the IDDW policy manual.”