What is the Aged and Disabled Waiver?
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.
The ADW program is for people who:
- Are 18 years and older
- Live in West Virginia
- Meet the West Virginia Medicaid waiver financial eligibility rules that are decided by the West Virginia Department of Human Services (DoHS) county office or the Social Security Administration.
- Approved for a nursing home level of care based on a medical assessment completed by a nurse.
- Choose to take part in the ADW program instead of entering a nursing home.
- Have needs in at least five areas of daily living:
- Eating
- Bathing
- Dressing
- Grooming
- Move around your home and community
- Restroom help
- Other areas of need
- Have a place that is safe to work for ADW program staff and personal agency staff, registered nurses and case managers.
ADW members cannot be paid caregivers in another waiver program or the West Virginia Medicaid Personal Care Services program.
Once someone is accepted, an opening for the program must be available to participate in the program.
The ADW Program Services include:
- Personal attendant services – A trained staff member will help you with bathing, dressing, grooming, eating, fixing your meals, or other personal care needs
- Case management services – A trained person with a degree who helps you identify your needs and plans for your care, talks with you about your needs, and connects you with help or resources in your area
- Skilled nursing – A trained nurse will do an assessment and monitor your care
- Non-medical transportation services – Transportation to community activities and errands such as grocery shopping, picking up prescriptions etc.
- Personal Emergency Response System (PERS) – A tool that will allow you to ask for emergency help if needed
You may get help through a Traditional (Agency) that will provide your case management services and personal attendant services, or you may choose to self-direct your personal attendant services (Personal Options), which means your staff is hired by you and work directly for you.
To start the ADW application process, you must fill out a Medical Necessity Evaluation Request (MNER) form. Have your doctor (doctor of medicine (MD) or doctor of osteopathic medicine (DO)), physician’s assistant or nurse complete, sign, and submit it to:
Acentra Health-ADW
1007 Bullitt Street, Suite 200
Charleston, WV 25301
Fax: 866-212-5053
If you have questions about the application, please call the West Virginia Bureau of Senior Services at 1-866-767-1575.
You must sign up for both financial and medical eligibility. Once you establish your financial and medical eligibility, an opening must be available for services to begin.
The ADW...
Bureau of Senior Services (BoSS)
1900 Kanawha Blvd. East, Charleston, WV 25305
Phone: (304) 558-3317 or 1-866-767-1575
Fax: (304) 558-6647
Website: www.wvseniorservices.gov
Incident Management Monitor
Eric Thomas
Phone: (304) 558-3317 ext. 56085
Email: eric.w.thomas@wv.gov
BoSS Department Contacts:
Director of Medicaid Operations
Susan Silverman
Phone: (304) 558-3317 ext. 56108
Email: susan.r.silverman@wv.gov
(Self-Direction in the ADW) Information
Gina Tinsley
Phone: (304) 558-3317 ext. 56111
Email: gina.m.tinsley@wv.gov
Director of Nursing
Sherry Wooten, RN
Phone: (304) 558-3317 ext. 56113
Email: sherry.l.wooten@wv.gov
ADW Hearings
Tammy Grueser, RN
Phone: (304) 558-3317 ext. 56092
Email: tamra.r.grueser@wv.gov
Quality Assurance Nurse Monitor/LMS/PC Closures
Shannon Davis, RN
Phone: (304) 558-3317 ext. 56088
Email: shannon.m.davis@wv.gov
Transfers/ADW Closures
Pat Meade
Phone: (304) 558-3317 ext. 56096
Email: patricia.j.meade@wv.gov
Quality Initiatives, Quality Council and Complaints
Mark Fordyce
Phone: (304) 558-3317 ext. 56089
Email: mark.e.fordyce@wv.gov
ADW Participant Enrollment
Barbara A. Paxton
Phone: (304) 558-3317 ext. 56098
Email: barbara.a.paxton@wv.gov
ADW Continuing Certification
Jennifer Fazzolari
Email: jennifer.j.fazzolari@wv.gov
ADW Utilization Management Contractor (UMC):
Acentra Health
1007 Bullitt Street, Second Floor
Charleston, WV 25301
Phone: (844) 723-7811
Fax: (866) 212-5053
Email: WVADWaiver@kepro.com
Website: https://wvaso.kepro.com
Authorization Verification
Acentra Health at (844) 723-7811
For information regarding the Pre-Admission Screening process or to schedule an appointment, contact:
Acentra Health at (844) 723-7811
ADW Managed Enrollment List Questions/Training
Phone: (844) 723-7811
Billing Questions
Gainwell Technology (formerly DXC Technology and Molina Healthcare Solutions)
Phone: (304) 348-3360 or (888) 483-0793
Can I apply for ADW services while on another waiver waitlist?
Yes. However, you cannot be on multiple waivers at the same time. You can be on ADW and State Plan Personal Care at the same time if you qualify but not another waiver.
How long does the ADW last?
Medical and financial eligibility must be re-established annually. If the member is eligible in both categories each year, there is no limit to how long someone can remain on the program.
How long does it take to go through the ADW referral process?
The ADW application process, i.e., submission of MNER, financial determination, medical eligibility, and activation can take on average 56 days. The average time on the ADW waitlist last fiscal year was 44 days.
Are there any services I can use while I am on a waitlist for the ADW?
Yes. If you have the appropriate West Virginia Medicaid coverage, you may be eligible to receive help through Medicaid's Personal Care Program. This program includes hands-on, in-home services, including help with dressing, eating, bathing, and other areas of need.
Other services while on the ADW waitlist include:
- The Lighthouse Program is for people who are at least 60 years and need basic help in their homes, but whose income or assets disqualify them from Medicaid services. The Lighthouse Program, available in each county, is paid for by state funds and provides support in four areas: personal care, mobility, diet, and environmental. Openings may change by county, and services are paid based on a person's income.
- People with Alzheimer's disease or related dementia may qualify for the FAIR (Family Alzheimer's In-Home Respite) program, which is available in all West Virginia counties. Caring for individuals with Alzheimer's disease and dementia can be stressful and the FAIR program offers help to family caregivers and, at the same time, provides one-on-one attention and personal activities for people with a written diagnosis of Alzheimer's disease or related dementia. FAIR gives caregivers the time to do things most people do without thinking—like running errands, keeping appointments, visiting family and friends, shopping for groceries, or even taking a nap. Family caregivers can get up to sixteen hours of relief per week, based on their need and based on the availability of hours and trained staff. The cost for FAIR services depends on the income of the person with dementia.
- For more information about these and other programs for individuals who are least 60 years old or at least 18 years old with a physical disability, please contact the West Virginia Aging and Disability Network at 1-866-981-2372. This team can help you find the right long-term care service and additional support while on the waitlist.
Our Services
Non-Emergency Medical Transportation Information
Individuals who have a West Virginia Medical Card may be eligible for transportation to and from your routine medical appointments. For more information, call 1-844-549-8353, Monday - Friday between 7:00 am to 6:00 pm
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