West Virginia I/DD Waiver Program

Intellectual/Developmental Disability Waiver Program

In working with the West Virginia Bureau for Medical Services (BMS), APS-WV has created an innovative and practical means to implement administrative functions for the Intellectual/Developmental Disability (I/DD) program.  In WV, field staff perform unbiased independent annual assessments for each program member.  Taking the results of that assessment, WV uses a statistical budgeting model to determine the funds available.  Providers and members, using an interdisciplinary team approach, have the responsibility to utilize the clinical data from assessments and the available funds to develop an individualized service plan for each member.  Providers enter services from that plan into the CareConnection® at which point APS-WV Registration Coordinators review to ensure health and safety needs are met by the team.  Prior authorization is issued and the provider may bill for services provided.  Below is an overview of APS-WV’s role with the I/DD Waiver program.

• Individualized assessments incorporate training/education with every member of the program to:  empower the member to incorporate a person-centered planning philosophy into the team process, learn about their rights and all available providers.
• Individualized budgets are based on member need and the statistical methodology employed assists the state in managing costs associated with this costly long-term care program.
• Registration Coordinator review of the chosen service mix allows for an additional clinical oversight to help verify member health and safety needs are met as well as ensures program policies are met.
• Provider retrospective reviews, training and technical assistance are provided on an ongoing basis to ensure:  clinical necessity for services provided and appropriate documentation of services.
• APS-WV captures data related to the Centers for Medicare and Medicaid Services Quality Improvement (QI) plan. 
• Data from the QI plan is reviewed with BMS and disseminated to stakeholders at a Quality Improvement Advisory Council facilitated by APS-WV.  The council makes recommendations to BMS about ways to improve the quality of I/DD Waiver services.
• APS-WV develops and conducts training for providers and other stakeholders to improve systemic and provider-specific quality of care and regulatory compliance.  This training effort also serves to improve relations with stakeholders, which has been imperative to APS-WV I/DD Waiver success.

For more information, please call APS - West Virginia at 866-385-8920.