1. Program Definition and Services

Personal Attendant Services (PAS) in West Virginia offer non-medical, hands-on assistance to Medicaid-eligible adults who are elderly or disabled. Services focus on facilitating independent living within the client's home through two distinct operational frameworks:

• Traditional Agency Model: Agencies employ, train, schedule, and supervise personal attendants who deploy to client residences
• Personal Options (Self-Directed Model): Participants directly recruit, manage, and schedule their own care workers, utilizing a Financial Management Services (FMS) fiscal agent (Palco) to handle tax and payroll compliance

2. Regulations

• West Virginia DoHS BMS Provider Manual Chapter 501: Establishes overarching administrative, clinical, and billing criteria for the Aged and Disabled Waiver (ADW)
• WAC Code / WV Legislative Rule: Sets regional standards regarding the provision of consumer-directed and agency-based home care alternatives

3. Licensing or Certification

Operating agencies do not require a specialized medical facility license, but they must secure official ADW Personal Attendant Agency Certification from the West Virginia Department of Human Services (DoHS) Operating Agency.

4. Responsible State Agency

Three main administrative units co-manage program compliance:

• WV Department of Human Services (DoHS) – Bureau for Medical Services (BMS): Sets state Medicaid fiscal directives, manages provider enrollment, and enforces compliance
• Acentra Health: Serves as the state's Utilization Management Contractor (UMC), executing independent medical necessity evaluations via the Pre-Admission Screening (PAS) tool
• Gainwell Technologies: Functions as the state's MMIS platform vendor, processing digital provider credentials and processing billing submissions

5. Application Process

Applicants complete corporate organization, secure a physical, ADA-compliant office location within West Virginia, and submit an ADW Personal Attendant Agency Application to the state Operating Agency. Once the programmatic vetting clears, the provider registers as a waiver vendor via the Gainwell Technologies ProviderOne-equivalent MMIS portal. 

6. Required Documentation

• West Virginia Secretary of State business registration (UBI equivalent) and an organizational Type 2 National Provider Identifier (NPI) mapped to a personal care or home health taxonomy
• Signed Attendant Agency Certification Agreement from the DoHS Operating Agency
• An Operational Policy Manual featuring client intake workflows, RN supervisory visitation guidelines, emergency backing schemas, and grievance policies
• Verified criminal background tracking clearance logs from the West Virginia Clearinghouse for Affordable and Reliable Employee Screening (WV CARES) for all employees
• A formal integration plan with an approved state Electronic Visit Verification (EVV) vendor (HHAeXchange) to log staff shift hours

7. Timeline for Approval

Corporate foundation setup, securing commercial liability, and setting up an ADA-compliant physical office takes 2 to 4 weeks. Vetting the agency application and clearing digital Medicaid enrollment through Gainwell Technologies averages 4 to 6 weeks. 

8. Pre-Application Process

Prospective providers must build their complete corporate framework before applying for state waiver access. This requires legally incorporating with the Secretary of State, activating specific business tax accounts with the State Tax Department, obtaining a Federal Employer Identification Number (EIN), and establishing a brick-and-mortar office location (P.O. boxes or commercial mailboxes are strictly prohibited under Chapter 501).

9. Pre-Application Training

While founders do not undergo a protracted multi-day state academy, hired personal attendants must complete baseline core competencies before field assignment. Attendants must complete verified modules covering CPR/First Aid, universal infection control precautions, HIPAA privacy constraints, EVV logging mechanics, and mandatory elder abuse reporting within their first 60 days of employment.

10. Additional Notes

•  An approved West Virginia ADW agency office site can serve no more than eight contiguous (bordering) counties. Expansion requests must be filed in writing and are only approved twice per year (June 30 and December 31)
• To receive authorized Personal Attendant Services, Acentra Health must verify via the Pre-Admission Screening (PAS) that the applicant possesses functional deficits in at least five distinct Areas of Daily Living (ADLs) to meet Nursing Facility Level of Care (NFLOC)
• All traditional agency plans must be overseen by a licensed Registered Nurse (RN) who reviews the PCSP, translates it into an actionable Personal Attendant Log (PAL), and conducts ongoing programmatic field assessments
• Under the Personal Options self-directed budget framework, participants may hire friends and select relatives (such as adult children) to act as paid caregivers; however, hiring a legal spouse or a court-appointed legal guardian is strictly prohibited

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

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