BEHAVIOR SUPPORT SERVICES PROVIDER IN WEST VIRGINIA

Fatumata Kaba
2 days ago
4 min read

DELIVERING FUNCTIONAL ASSESSMENTS, POSITIVE BEHAVIOR INTERVENTIONS, AND INDIVIDUALIZED STRATEGIES TO PROMOTE STABILITY, SAFETY, AND INDEPENDENCE

Behavior Support Services in West Virginia are designed to help individuals with intellectual or developmental disabilities, behavioral health needs, or emotional challenges develop adaptive behaviors, manage triggers, and reduce harmful or disruptive actions. These services are an essential part of many Medicaid waiver programs and are delivered by qualified behavior professionals using person-centered strategies.

These supports are funded primarily under the Intellectual/Developmental Disabilities (I/DD) Waiver and the Children with Serious Emotional Disorder Waiver (CSEDW). Service authorizations are approved by Acentra Health (formerly Kepro) and must align with the Individualized Service Plan (ISP) or Person-Centered Service Plan (PCSP). Oversight is provided by the WV Department of Health and Human Resources (WVDHHR) and the Bureau for Medical Services (BMS).

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1. GOVERNING AGENCIES

Agency: West Virginia Department of Health and Human Resources (WVDHHR)

Role: Oversees service guidelines and ensures provider quality under Medicaid waivers.

Agency: Bureau for Medical Services (BMS)

Role: Handles Medicaid billing, waiver compliance, and provider enrollment.

Agency: Acentra Health (formerly Kepro)

Role: Reviews behavior support requests, approves authorizations, and monitors service delivery.

Agency: WV Behavior Analyst Licensure Board

Role: Licenses Behavior Analysts and ensures ethical and professional compliance.

2. BEHAVIOR SUPPORT SERVICES OVERVIEW

Behavior Support Services provide professional consultation and direct intervention to individuals with challenging behaviors that interfere with daily functioning, relationships, safety, or community access. Services are based on Functional Behavior Assessments (FBA) and the development of Behavior Support Plans (BSPs).

Covered services include:

Functional Behavior Assessments (FBA)
Development and implementation of Behavior Support Plans (BSP)
Staff and caregiver training on behavior strategies
Crisis prevention and de-escalation support
Ongoing monitoring and plan revisions
Collaboration with interdisciplinary teams
Direct intervention (when allowed under plan)

All behavior interventions must be positive, non-aversive, and evidence-based, with a focus on increasing the person’s independence and quality of life.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the WV Secretary of State
Obtain a Federal EIN and Type 2 NPI
Apply as a Behavior Support Services provider through WVDHHR
Complete Medicaid provider enrollment through Gainwell Technologies
Employ or contract licensed professionals such as Board Certified Behavior Analysts (BCBAs) or Licensed Behavior Analysts (LBAs)
Submit a Behavior Support Services Policy & Procedure Manual

4. WEST VIRGINIA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN and NPI

Step 2: Apply to become a behavior services provider under the I/DD Waiver or CSEDW

Step 3: Enroll with WV Medicaid via Gainwell Technologies

Step 4: Submit therapist/clinician credentials and license verification

Step 5: Provide a Policy & Procedure Manual outlining behavior assessment and support protocols

Step 6: Receive ISP authorizations and begin services

5. REQUIRED DOCUMENTATION

Business registration and Medicaid provider agreement
BCBA/LBA licenses and certifications
Behavior Support Services P&P Manual, including:
- FBA procedures and plan development workflows
- Consent forms for behavior interventions
- Staff and caregiver training logs
- Data collection and progress review tools
- Behavior incident tracking and crisis debriefing templates
- HIPAA, safety, and restraint policy (if applicable)
- Collaboration forms for interdisciplinary planning
- Billing documentation aligned with service authorization

6. STAFFING REQUIREMENTS

Role: Licensed Behavior Analyst (LBA) / BCBARequirements:

Licensed in WV
Certified by the Behavior Analyst Certification Board (BACB)
WV CARES background check
Trained in abuse prevention, HIPAA, and Medicaid documentation

Role: Behavior Support Technician (if allowed)Requirements:

Works under the supervision of BCBA or LBA
Trained in implementing behavior plans and documenting interventions

All staff must complete:

HIPAA, client rights, and behavioral ethics training
Positive Behavior Support and de-escalation techniques (e.g., MANDT, CPI)
Ongoing CEUs as required by licensure boards

7. MEDICAID WAIVERS THAT COVER BEHAVIOR SUPPORT SERVICES

I/DD Waiver – Covers both FBA and BSP development, along with caregiver and staff training
CSEDW – Allows behavior therapy and parent training for children with serious emotional disorders
TBIW – May approve behavior supports in limited cases based on need
State Plan Medicaid – May fund behavioral health services under EPSDT for youth

Note: All behavior services must be authorized in the ISP, tied to specific behavior goals, and aligned with waiver regulations.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Provider Setup

Timeline: 2–3 weeks

Phase: Medicaid Enrollment & Licensing Documentation

Timeline: 1–2 months

Phase: Policy Manual & Staff Credentialing

Timeline: 30–45 days

Phase: Launch of Services

Timeline: Begins upon plan approval and participant authorization

9. CONTACT INFORMATION

WV Bureau for Medical Services (BMS)

Website: https://dhhr.wv.gov/bms

WV Behavior Analyst Licensure Board

Website: https://behavioralhealth.wv.gov

Acentra Health (formerly Kepro)

Website: https://wv.acentra.com

WV Secretary of State – Business Registration

Website: https://sos.wv.gov

Gainwell Technologies – WV Medicaid Enrollment

Website: https://www.wvmmis.com

BEHAVIOR SUPPORT SERVICES PROVIDER IN WEST VIRGINIA

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WEST VIRGINIA BEHAVIOR SUPPORT SERVICES PROVIDER

WCG helps new and existing providers launch Medicaid-compliant behavior support programs with strong documentation systems and ethical intervention models.

Scope of Work: