DAY FACILITY SERVICES PROVIDER IN WEST VIRGINIA

Fatumata Kaba
2 days ago
4 min read

SUPPORTING COMMUNITY ENGAGEMENT, LIFE SKILLS, AND SOCIALIZATION THROUGH STRUCTURED DAY PROGRAMS FOR INDIVIDUALS WITH DISABILITIES

Day Facility Services in West Virginia offer structured programming during daytime hours for individuals with developmental, intellectual, or behavioral challenges. These programs help participants gain independence, develop new skills, engage socially, and access the community — all while providing family caregivers with reliable daytime support. These services are typically funded under the Intellectual/Developmental Disabilities (I/DD) Waiver and may also be supported by other specialized waivers. Oversight is provided by the West Virginia Department of Health and Human Resources (WVDHHR) and the Bureau for Medical Services (BMS), with service plan authorization handled by Acentra Health (formerly Kepro).

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1. GOVERNING AGENCIES

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

Role: Manages waiver operations and regulates provider standards.

Agency: Bureau for Medical Services (BMS)

Role: Oversees Medicaid funding, waiver billing, and provider credentialing.

Agency: Acentra Health (formerly Kepro)

Role: Authorizes Day Facility Services through the PCSP/ISP and ensures participants receive appropriate care.

Agency: Office of Health Facility Licensure & Certification (OHFLAC)

Role: Licenses day programs providing services to vulnerable adults.

2. DAY FACILITY SERVICES OVERVIEW

Day Facility Services provide skill-building, social interaction, and supervised activities for waiver participants during the day. Services are provided in community-based centers or structured facilities designed to support people with developmental or intellectual disabilities.

Services may include:

Training in activities of daily living (ADLs)
Socialization, recreation, and peer engagement
Community outings and mobility training
Pre-vocational activities and job readiness
Communication and interpersonal skills development
Supervised meals, hygiene assistance, and medication reminders
Behavioral supports and redirection (when outlined in the ISP)

All services must be documented in the Individualized Service Plan (ISP) and focus on person-centered goals.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the WV Secretary of State
Obtain EIN and Type 2 NPI
Enroll as a Medicaid provider via Gainwell Technologies
Apply as a Day Program Provider under the I/DD Waiver
If operating a physical facility, obtain a license from OHFLAC
Develop a comprehensive Policy & Procedure Manual
Meet building, fire safety, and accessibility codes

4. WEST VIRGINIA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain NPI and EIN

Step 2: Apply through WVDHHR to become a Day Facility Services provider under the I/DD Waiver

Step 3: Enroll with Medicaid via Gainwell Technologies

Step 4: Submit your Policy & Procedure Manual and proof of facility readiness

Step 5: Schedule OHFLAC inspection (if required)

Step 6: Hire and train staff per waiver regulations

Step 7: Begin receiving referrals once ISP authorizations are in place

5. REQUIRED DOCUMENTATION

WV business registration and Medicaid provider number
OHFLAC license (if operating a physical day program site)
Day Services Policy & Procedure Manual including:
- Daily program schedules and activity plans
- Staffing ratios and supervision standards
- Participant intake, orientation, and goal tracking
- Medication reminder policies and incident reporting
- Behavioral support and de-escalation protocols
- Emergency evacuation and safety drills
- Staff training, credentialing, and supervision logs
- Service delivery documentation templates

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)

Requirements:

18+ years old
WV CARES background check
CPR/First Aid certified
Trained in participant supervision, documentation, and behavioral supports

Role: Day Program Supervisor / Manager

Responsibilities: Oversees day-to-day operations, schedules, and participant progress tracking

Role: Behavior Specialist or Nurse (if applicable)

Requirement: Licensed or credentialed depending on participant needs and service type

All staff must complete:

Annual training in abuse prevention, rights, and HIPAA
Behavioral safety and emergency response training
Documentation and progress note compliance training

7. MEDICAID WAIVERS THAT COVER DAY FACILITY SERVICES

I/DD Waiver – Primary waiver covering Day Habilitation or Day Program Services
CSEDW – May authorize limited structured daytime services for children
TBIW – Case-by-case day service approval depending on participant goals

Services must align with ISP goals and be authorized and billed per waiver guidelines. Daily or hourly billing units are based on participant attendance and staff ratios.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Facility Setup

Timeline: 2–4 weeks

Phase: Medicaid Waiver Application & Manual Submission

Timeline: 1–2 months

Phase: OHFLAC Licensure & Staff Onboarding

Timeline: 30–60 days

Phase: Launch of Services

Timeline: Begins after provider approval and ISP service authorization

9. CONTACT INFORMATION

WV Bureau for Medical Services (BMS)

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