Medicaid In-Home Programs


Three programs are available for Medicaid beneficiaries who wish to remain at home.

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Medicaid Aged and Disabled Waiver (ADW)

The Medicaid Aged and Disabled Waiver (ADW) Program provides in-home and community services to individuals 18 years of age and older who are medically and financially eligible.

Services include:

case management – a case management agency-developed service and support plan that
  reflects the wishes and preferences of the ADW member;

consumer-directed case management – ADW member-directed personal case
  management;

homemaker – long-term direct care and support services (assistance with personal
  hygiene, nutritional support, and light housekeeping) necessary for an individual to remain at
  home rather than enter a long-term care facility;

transportation – transit to services and activities in the community;

RN assessment and review – availability of a registered nurse to complete assessments
  of an ADW member at regular intervals to ensure the member’s plan of care meets his/her 
  needs;

personal options – ADW members’ employment of caregivers/employees and purchase of
  needed ADW services to assist with activities of daily living. (See below.)


Eligibility

Medical eligibility is based on a medical professional’s functional assessment. (An applicant and the applicant's physician must complete a Medical Necessity Evaluation Request.) Your county Department of Health and Human Resources offices determine your financial eligibility. Assets cannot exceed $2,000. In 2011, income could be no more than $2,022 per month.
The Bureau for Medical Services’ Aged and Disabled Waiver Manual describes the policies.

Payment

The Aged and Disabled Waiver Program is free to those who qualify.

Contact

For more information about the Aged and Disabled Waiver Program, contact the Aging and Disability Resource Center in your area, click here, or call the Bureau of Senior Services’ Medicaid Helpline at 1-866-767-1575.


Personal Options

The Aged and Disabled Waiver Program allows you to manage the care you receive through its Personal Options. You will have a monthly budget to hire people who can care for you at home and to purchase needed services to help you with daily living activities, such as bathing, grooming, and dressing.

You may hire a service company, friends, or family members as your employees. You cannot hire a spouse, legal guardian, or legal representative to act as decision-maker on your behalf. All employees must meet certain requirements, such as first-aid training, CPR training, and criminal background checks.

You also may spend a maximum of $1,000 each year for goods and services that promote your health and safety or reduce your need for additional Medicaid services. These goods and services must be approved before you spend the money.

Because you will be an employer, you will have the support of two consultants:

• a resource consultant who can help you prepare a budget and assist you with filing
  appropriate state and federal forms; and

• a fiscal/employer agent who will write payroll checks to your employees, pay invoices, and
  assist with payroll taxes.


You do not handle any of the money!

Eligibility

To be eligible for Personal Options, you must enroll in the Aged and Disabled Waiver Program.

Payment

The Personal Options program is free to those who qualify.

Contact

Please call the West Virginia Bureau of Senior Services at 1-866-767-1575 for information about Personal Options.

Related Links


West Virginia Medicaid Aged and Disabled Waiver Overview of Personal Options


Medicaid Personal Care

The Medicaid Personal Care Program includes hands-on, in-home services provided to those who are medically and financially eligible. Personal care agencies provide the services.

Services include:

• personal hygiene;

• dressing, feeding, nutrition;

• light housekeeping; and

• health-related tasks.


The Bureau for Medical Services’ Personal Care Manual describes the policies.

Eligibility

A physician must complete a medical assessment. Assets can be no greater than $2,000, and, in 2011, income could be no greater than $674 per month.

Payment

The Medicaid Personal Care Program is free to those who qualify.

Contact


For more information about the Personal Care Program, please contact the Aging & Disability Resource Center in your area, or call the Bureau of Senior Services’ Medicaid helpline at 866-767-1575.


 
 

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