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West Virginia - Transitional Assistance Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

West Virginia funds one-time institutional discharge expenses through the state-funded Olmstead Transition and Diversion Program and the federal Take Me Home Transition Program, managed by the Bureau for Medical Services (BMS). These programs cover security deposits, essential household furnishings, utility set-up fees, and moving expenses for individuals leaving nursing facilities or Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).

Approval to coordinate these funds requires an existing Medicaid enrollment as a waiver case management or transition coordination agency, as standalone transition brokers are not separately licensed by the Office of Health Facility Licensure and Certification (OHFLAC). Providers must submit bulk upload templates or individual applications through the WVMMIS Health PAS-OnLine portal managed by Gainwell Technologies.

1. Service Definition and Scope

In West Virginia, transitional assistance is not a standalone waiver service but is administered via the Take Me Home Transition Program and the Olmstead Transition and Diversion Program. These programs provide one-time start-up funding to assist people with disabilities to return to or remain in the community.

The service covers reasonable and necessary costs to support transition and diversion needs not otherwise covered by Medicaid, Medicare, or other State programs.

2. Regulatory and Oversight Agencies

The primary oversight for Medicaid waiver and transition programs in West Virginia is the Bureau for Medical Services (BMS). BMS contracts with Gainwell Technologies for provider enrollment and claims processing.

The West Virginia Olmstead Office manages the state-funded grant portion of the transition and diversion program.

3. Gatekeeping Prerequisites: Who Can Even Apply

West Virginia does not issue a distinct facility or agency license for "Transitional Assistance Services." Instead, providers must already be established and enrolled as Case Management or Transition Coordination agencies under the Intellectual/Developmental Disabilities Waiver (IDDW), Aged and Disabled Waiver (ADW), or Traumatic Brain Injury (TBI) Waiver.

An applicant cannot enroll as a standalone transition provider without first holding the underlying waiver provider status and OHFLAC licensure for behavioral health or home health services.

4. Licensure and Certification Requirements

Because transition services are coordinated by existing waiver providers, the licensure requirements default to the provider's primary service type. For IDDW providers, this typically means maintaining a Behavioral Health Center license through OHFLAC.

OHFLAC conducts licensure reviews at a CMS-mandated minimum of every two years to ensure compliance with state rules.

5. Medicaid Provider Enrollment

Providers enroll through the WVMMIS Health PAS-OnLine portal. West Virginia Medicaid utilizes a phased-in approach for enrollment and revalidation, managed by Gainwell Technologies.

Waiver agencies can enroll healthcare providers using the Bulk Upload Template and the Waiver Agency Template User Manual available on the portal.

6. Staffing, Training and Background Checks

Staff coordinating transition services must meet the qualifications outlined in the specific waiver manual (e.g., Chapter 513 for IDDW). This generally requires a degree in a human services field and specific training in person-centered planning.

All direct care and coordination staff must undergo state and federal background checks before providing services.

7. Documentation, Policies and Records

Providers must maintain detailed records of all transition expenses, including receipts for security deposits, furnishings, and moving costs. These records are subject to review by BMS and the Payment Error Rate Measurement (PERM) contractor.

The transition plan must be documented in the participant's person-centered service plan and approved by the interdisciplinary team (IDT).

8. Billing, Rates and Claims

Transition expenses are typically billed as one-time costs up to a maximum cap established by the Take Me Home or Olmstead programs. Claims are processed through the WVMMIS portal.

Providers must ensure that expenses are not otherwise covered by Medicaid State Plan services or Medicare before billing the transition program.

9. Approval Sequence and Timeline

The approval process begins with obtaining the necessary OHFLAC licensure for the underlying agency type. Once licensed, the agency applies for Medicaid enrollment through Gainwell Technologies.

After Medicaid enrollment, the agency must coordinate with the WV Olmstead Office or the Take Me Home program to authorize specific transition funding for individual participants.

10. Common Denials and Survey Findings

Applications for Medicaid enrollment are frequently delayed due to missing original signatures on supporting documentation or failure to complete the Provider Enrollment Checklist.

During PERM audits or OHFLAC surveys, providers are commonly cited for failing to maintain original receipts for transition purchases or lacking documentation of the participant's choice of setting.

11. Key Contacts and Resources

Providers should utilize the WVMMIS portal for enrollment forms, manuals, and announcements. The Bureau for Medical Services provides policy manuals for all waiver programs.

For specific questions regarding the Olmstead Transition and Diversion Program, providers should contact the WV Olmstead Office directly.

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