INDIVIDUAL AND FAMILY SUPPORT SERVICES PROVIDER IN WEST VIRGINIA

Fatumata Kaba
2 days ago
3 min read

EMPOWERING FAMILIES TO THRIVE BY PROVIDING TRAINING, COUNSELING, AND IN-HOME SUPPORTS THAT STRENGTHEN CAREGIVER CAPACITY AND FAMILY STABILITY

Individual and Family Support Services in West Virginia are designed to support caregivers, parents, guardians, and other family members of individuals receiving waiver services. These services focus on education, emotional support, skill-building, and respite, enabling families to sustain their caregiving role while promoting their own well-being and stability. These supports are authorized under Medicaid waivers, including the Children with Serious Emotional Disorder Waiver (CSEDW), Intellectual/Developmental Disabilities (I/DD) Waiver, and Traumatic Brain Injury Waiver (TBIW). The services are person- and family-centered and must be tied to the participant’s Individualized Service Plan (ISP).

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1. GOVERNING AGENCIES

Agency: WV Department of Health and Human Resources (WVDHHR)

Role: Administers Medicaid waivers and ensures provider compliance with HCBS rules.

Agency: Bureau for Medical Services (BMS)

Role: Oversees Medicaid billing, provider enrollment, and waiver policy compliance.

Agency: Acentra Health (formerly Kepro)

Role: Approves service authorizations based on individual and family needs outlined in the ISP.

2. FAMILY-FOCUSED SERVICES OVERVIEW

Family Support Services aim to reduce caregiver burnout, improve family functioning, and provide education around the individual’s diagnosis, behavior, and daily needs. Services must be evidence-based and promote self-determination, family empowerment, and long-term care planning.

Covered services may include:

Family and Caregiver Training on conditions, medication management, or behavior support
Counseling Services for caregivers or families
Peer Mentorship or Support Groups facilitated by professionals
Crisis Planning and Emotional Support
Navigation of Community Resources and Benefits
Family Integration Activities tied to ISP goals
In-Home Family Support to improve daily routines, care techniques, and communication

All services must be documented, delivered according to Medicaid rules, and directly support the participant’s goals and outcomes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register with the WV Secretary of State
Obtain a Federal EIN and Type 2 NPI
Apply to become a Medicaid waiver provider through BMS
Submit a Policy & Procedure Manual for Individual & Family Services
Hire or contract qualified professionals (counselors, family trainers, peer specialists)
Complete enrollment via Gainwell Technologies

4. WEST VIRGINIA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and secure an EIN/NPI

Step 2: Apply to become a Family Support provider with the appropriate waiver authority

Step 3: Complete Medicaid provider enrollment via Gainwell Technologies

Step 4: Submit Policy & Procedure Manual and staff credentials

Step 5: Complete any site or compliance reviews

Step 6: Begin services upon ISP authorization and family referral

5. REQUIRED DOCUMENTATION

Business registration, waiver service approval, and Medicaid provider number
Family-Focused Services P&P Manual, including:
- Consent and confidentiality forms for caregivers
- Training outlines and educational materials
- Crisis planning and de-escalation protocols
- Documentation of family participation and satisfaction
- Grievance procedures for caregivers
- Cultural competence and trauma-informed care policies
- Billing documentation and service verification tools

6. STAFFING REQUIREMENTS

Role: Family Trainer / Counselor / Peer Specialist

Requirements:

Clinical licensure (LPC, LCSW) for counseling services
Relevant certification or experience for peer support and family education
WV CARES background check
Training in HIPAA, trauma-informed care, and family-centered planning

All staff must complete:

Documentation and service note training
Person- and family-centered practice principles
Crisis management and reporting
Cultural and linguistic competence education

7. MEDICAID WAIVERS THAT COVER FAMILY SUPPORT SERVICES

CSEDW – Family training, counseling, and crisis support for caregivers of children with serious emotional disorders
I/DD Waiver – Peer support, family integration, and caregiver skill-building
TBIW – Family supports tailored to injury-related cognitive and behavior changes
EPSDT (State Plan) – May support some counseling services for minors

All services must be ISP-authorized, family-directed, and promote long-term family stability and participant success in the community.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Documentation Prep

Timeline: 2–4 weeks

Phase: Medicaid Enrollment & Waiver Application

Timeline: 4–6 weeks

Phase: Staff Hiring & Manual Submission

Timeline: 30–45 days

Phase: Launch of Services

Timeline: Begins after ISP approval and participant referral

9. CONTACT INFORMATION

WV Bureau for Medical Services (BMS)

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

Acentra Health (formerly Kepro)

Website: https://wv.acentra.com

WV Secretary of State – Business Services

Website: https://sos.wv.gov

Gainwell Technologies – Medicaid Enrollment Portal

Website: https://www.wvmmis.com

INDIVIDUAL AND FAMILY SUPPORT SERVICES PROVIDER IN WEST VIRGINIA

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

WCG helps providers launch compassionate, family-centered services that build resilience and capacity among caregivers while meeting Medicaid documentation and service standards.

Scope of Work: