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WV Medicaid Personal Care Services Program

West Virginia
Medicaid Personal ​​Care Services Program


What is the West Virginia Medicaid Personal Care Services Program?

The West Virginia Medicaid​​ Personal Care Services Program is an in-home care program for West Virginia Medicaid members who may need help with their Activities of Daily Living (ADL). Trained direct-care workers come to your home, place of employment, ​or community to asssit with ADLs and other areas of personal care to help you live independently.​

src="https://dhhr.wv.gov/bms/Programs/PCS/PublishingImages/pcsimage.jpg" alt="Personal Care Services Program"

​​Individuals eligible to receive this service must have a West Virginia Medicaid card. When you first apply for the Personal Care Services Program, a registered nurse will contact you to complete an evaluation in your home for medical eligibility. To be eligible, you must have needs in at least three areas of ADLs, such as eating, bathing, transferring, walking, and dressing. Medical eligibility is based on a medical professional's assessment of how well you can perform ADLs.  

If you are eligible, a trained direct-care worker can assist you with services in your home, community or place of employment such as:

  • Eating
  • Showering or bathing
  • Grooming (brushing hair, clipping nails, shaving, etc.)
  • Mobility
  • Toileting
  • Other personal care needs

 

Please note that this is not a complete list of services a direct care worker can provide. If you have questions regarding a specific service, please contact the West Virginia Department of Health and Human Resources, Bureau for Medical Services at 304-558-1700. 

 

Personal Care Services do not include:

  • Skilled nursing care
  • Administering medication
  • Wound care
  • Injections
  • Housecleaning as the only service

 ​

To apply for the Personal Care Services Program, you must fill out and sign a Personal Care-Medical Necessity Evaluation Request form.​ You then provide this form to your doctor (doctor of medicine (MD) or doctor of Osteopathy (DO)), physician’s assistant, or registered nurse to complete, sign, and submit the form to: ​
​KEPRO-PC
1007 Bullitt St., 2nd Floor
Charleston, WV 25301
Toll-Free: 1-866-385-8920
Fax: 1-844-794-6729
A KEPRO registered nurse will contact you to schedule a medical eligibility assessment in your home.

For more information on the Personal Care Services Program, please contact:


West Virginia Medicaid Personal Care Services
Teresa McDonough, Program Manager
West Virginia Department of Health and Human Resources
Bureau for Medical Services
350 Capitol Street, Room 251
Charleston, WV 25301
Phone: (304) 352-4240
Email: Teresa.M.McDonough@wv.gov  

 

Personal Care Contracted Operations Agency

Bureau of Senior Services

Susan Silverman, Director of Medicaid Operations

1900 Kanawha Blvd., East

Charleston, WV 25305

Phone: (304) 558-3317

Fax: (304) 558-6647

Email: Susan.R.Silverman@wv.gov

 

Utilization Management Contractor

KEPRO

1007 Bullitt Street, Second Floor

Charleston, WV 25301

Phone: (844) 723-7811 or (304) 343-9663

Fax: (866) 212-5053

Email: WVPersonalCare@kepro.com

Q: What are the steps to apply for and enroll in the West Virginia Medicaid Personal Care Services Program?

 

A: The application through enrollment process has five stages. For a full explanation of each stage, visit West V​irginia Personal Care Application Through Enrollment Process.

 

Q: How do I apply for the Personal Care Services Program?

 

A: Download a one-sheet guide that explains the application steps and complete the Personal Care Application form

​​


West Virginia Medicaid Personal Care Services Application

Download

Info for Members

Find additional information and resources for West Virginia Medicaid home and community-based services​

Fact Sheet

Click here ​for the Personal Care Services Fact Sheet

Non-Emergency Medical Transportation Information

West Virginia Medicaid cardholders may be eligible for transportation to and from routine medical appointments. For more information, call 1-844-549-8353, Monday - Friday between 7:00 am to 6:00 pm. To learn more, please click here.​​