Programs

Intellectual/Developmental Disabilities Waiver

The Intellectual and Developmental Disabilities (I/DD) Waiver Program is intended to provide services to support and assist members to live and be as independent as possible. These services are provided in natural settings, such as the home and community.

The WV I/DD Waiver Program is a federally approved program for individuals with Intellectual and Developmental Disabilities. The program is operated in WV by the Bureau for Medical Services (BMS), who contracts with KEPRO as the Utilization Management Contractor (UMC).

KEPRO is responsible for the day-to-day operations and oversight of the I/DD Waiver program. This includes conducting Annual Functional Assessments, which are used to determine member yearly budgets and by the Medical Eligibility Contract Agent to determine eligibility. In addition, KEPRO conducts provider reviews, offers training and education to providers, members, and other stakeholders, and reviews requests for prior authorization if I/DD Waiver services.

I/DD Waiver CareConnection©

KEPRO provides a comprehensive CareConnection© system for data collection and submission. The system accommodates various user roles and even supports work performed by other BMS contractors.

Consumer Education Goals

KEPRO Consumer/Family Educators and other staff are available for training and technical assistance, receiving complaints about I/DD Waiver service provision and to conduct the Participant Experience Survey.

Empowering persons receiving services with information about their rights and responsibilities in communicating with providers and a utilization management contractor
Informing members of their rights and responsibilities within the I/DD Waiver program
Informing members of their role/choice in accessing services through Waiver verses an institution, choice in service delivery model, and service providers
Serving as a resources to assist consumers, families, providers and stakeholders with information about alternative resources, advocacy, transitional living homes, food pantries and more.
Resources:

Provider Education Goals

KEPRO Provider Educators and other staff are available for training and technical assistance to I/DD Waiver providers.

Educating providers about their duties to consumers, families and other stakeholders
Completing on-site utilization management and quality outcomes reviews to gather data and provide training/technical assistance to improve the quality of service documentation, services provided and consumer outcomes
Assisting providers with proper submission of requests for prior authorization
Educating providers about I/DD Waiver policy
- UPDATED**I/DD Waiver Provider Review Tool
- UPDATED**I/DD Waiver Provider Self Review Tool
- UPDATED**I/DD Waiver Provider Manual

I/DD Waiver Department Contacts

Toll-Free: 866.385.8920
Phone: 304.380.0617
Fax: 866.521.6882
General Email: WVIDDWaiver@kepro.com

Additional Resources

Bureau for Medical Services I/DD Wavier Program (for policy/forms, rates FAQs, etc.)

Website: http://www.dhhr.wv.gov/bms/Programs/WaiverPrograms/IDDW/Pages/default.aspx
350 Capitol Street, Room 251
Charleston, WV 25301
Phone: 304.558.1700
Fax: 304.558.4398

Fiscal Employer Agent (Personal Options)

Public Partnerships, LLC (PPL)
Website: http://www.publicpartnerships.com/programs/WestVirginia/WVIDD/index.asp
Phone: 877.908.1757
Efax: 877-567-0071

Claims Processing

Molina Medicaid Solutions
Website: https://www.wvmmis.com/default.aspx
For Providers: 888.483.0793
For Members: 304.343.3380
Fax: 304.348.3380

West Virginia Protective Services

Website: http://www.dhhr.wv.gov/bcf/Services/Pages/default.aspx
Phone: 800.352.6513

Office of Health Facility Licensure and Certification (OHFLAC)

Website: http://ohflac.wvdhhr.org

408 Leon Sullivan Way
Charleston, WV 25301
Phone: 304.558.0050
Fax: 304.558.2515

WV CARES

Website: https://www.wvdhhr.org/oig/wvcares.html
Phone: 304.558.2018
WV CARES Helpful Tips