West Virginia Health Care Authority

100 Dee Drive
Charleston WV 25311
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Monday-Friday
8:00am-5:00pm

Phone 304-558-7000
Toll-Free 1-888-558-7002
Fax 304-558-7001


Types of Service

Institutional Services in West Virginia

Adult Family Care

1. Definition: Room, board and supervision with activities of daily living (ADL) is provided in a private home from one to three adults.
2. Eligibility criteria: aged 18+, who are capable of self-preservation.
3. Services: Care management, support, supervision.

Residential Board and Care

1. Definition: Any residence, operated by ownership or management, for payment or not, or not, to provide accommodations, personal assistance and supervision, for a period of more than twenty-four hours, to four to ten persons.
2. Eligibility criteria: 18+; ambulatory; capable of self-preservation, needs assistance with ADLS.
3. Services: Room and board, personal assistance.

Legally Unlicensed (registered) Boarding Care

1. Definition: Personal assistance for one to three consumers.
2. Eligibility Criteria: None
3. Services: Room and board, personal assistance.

Nursing Homes

1. Definition: Skilled Nursing Facilities (SNF) Medicare Nursing Facilities (NF) Medicaid.
2. Eligibility Criteria: Age 18+; Individuals with nursing care or therapy needs.
3. Services: Nursing care and therapies, (a) Hospital-based (distinct part) SNF and NF; (b) Free-standing NF; and (c) State-operated

ICF/MR

1. Definition: Intermediate Care Facilities for the Mentally Retarded (which include institutional or group home settings in which individuals are maintained within on-site.
2. Eligibility criteria: Age 18+; Individual with MR/DD or related conditions in need of active treatment.
3. Services: Active treatment.

Behavioral Health Group Homes

1. Definition: Those services intended to help individuals gain or regain the capacity to function adaptively in their environment, to care for themselves and their families, and to be accepted by society.
2. Eligibility Criteria: Age 18+; 2-17: Individuals with emotional or mental disorder, alcohol or drug abuse problems, and mental retardation or other developmental disabilities: DSM-IV diagnosis.
3. Services: Residential and day habilitation, case management, other professional services as needed.

Specialized Family Care Home

1. Definition: A Community-based, recruited and trained, family home which provides twenty-four hour services to the mentally retarded or developmentally disabled individuals.
2. Eligibility Criteria: Any age: Individuals with Developmental disabilities and/or who need intensive medical and/or behavioral supports.
3. Services: Residential and day habilitation, case management, and other professional services as needed.

State-Operated Facilities

1. Definition: Facilities originally founded as hospitals and which are owned and operated by the State. These institutions are individually approved to provided services ranging form general acute care, extended long term care, nursing home care, personal care, acute and chronic psychiatric care, and intermediate care for individuals who are mentally retarded and developmentally disabled. 2. Eligibility Criteria: 18+: Individuals with nursing care or therapy needs or Individuals with MR/DD or related conditions in need or active treatment (Colin Anderson). 3. Services: General acute care, extended long term care, nursing home care, personal care, acute and chronic psychiatric care, and intermediate care for individuals who are mentally retarded and developmentally disabled. (a) Colin Anderson Center (ICF/MR); (b) Hopemont Hospital; (c) Lakin Hospital; (d) Marion Health Care Hospital; (e) Pinecrest Hospital; and, (f) Welch Emergency Hospital.

 

IN-HOME SERVICES IN WEST VIRGINIA

 
Personal Care*

1. Definition: Community Care Program for the Elderly Admissions through Senior Centers in each county. Medical criteria for these services are less stringent than those for nursing home, home health and aged/disabled waiver services. (This program also serves behavioral health clients, but data indicated on this chart apply to the senior population only).
2. Eligibility: Individuals 60+ who are Medicaid eligible and medically stable.
3. Services:

Aged/Disabled Waiver

1. Definition: Community-based services for those aged/disabled who meet the medical criteria for nursing home admission.
2. Eligibility: Individuals 18+ needing nursing home level care who meet income criteria.
3. Services: Chore, homemaker and case management agencies.

MR/DD Waiver

1. Definition: Requires level of care provided in an Intermediate Care Facility for the MR(ICF/MR). Income of client is no more than 300% of current maximum of SSI payments per month. $2000 asset limit. Care of client must cost no more than if institutionalized.
2. Eligibility criteria Children and adults with developmental disabilities needing ICF/MR level of care.
3. Services: Residential habilitation, day habilitation, case management and respite care provided by community behavioral centers.

Home Health

1. Definition: Medical care under the direction of a physician for those individuals requiring skilled nursing and a rehabilitative service.
2. Eligibility Criteria: Individuals needing skilled level of care.
3. Services: In-home nursing and related services.

Hospice

1. Definition: Care for the dying persons provided by state licensed and medicare certified agencies to individuals with a life-threatening illness with a prognosis of six months or less.
2. Eligibility Criteria: Life threatening illness with prognosis of six months or less.
3. Services: *Previously identified as chore services and Community Care Program (1993)

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