Care at Home

for Mem​​bers with a Traumatic Brain Injury

The TBIW is for ​members who meet the following requirements:

• Is at least three years old and ​​have a documented traumatic brain injury that is caused by physical force leading to total or partial disability and/or difficulty participating socially ​​​or an injury causing lack of oxygen due to near-drowning, and who meets the medical requirements to receive a nursing home level of care. 
  
• Is a permanent resident of West Virginia and available for the required services.
  
• Meet the financial requirements for the Medicaid W​​aiver program determined by the West Virginia Department of Human Services (DoHS) county office.
  
• Score at a Level VII or below on the Rancho Los Amigos Levels of Cognitive Functioning Scale. 
  
• Ages three to 17 years must score at a Level II or higher on the Rancho Los Amigos Pediatric Level of Consciousness Scale.
  
• ​Is an inpatient in a licensed nursing facility, hospital or licensed rehabilitation facility to treat traumatic brain injury or living in a community setting at the time of application.
  
• Choose to take part in the TBIW program instead of ​care at a nursing facility.
  
• Can provide a safe workplace for TBIW program and agency staff. ​

The TBIW...

• Case Management Services: A professional who helps coordinate and advocate for services, performs evaluation, identifies needs, develops person-centered service plans, and connects the member with services or resources in the community.
  
• Personal Attendant Services: Someone who assists you in your home and community with activities of daily living (eating, bathing, dressing, grooming, mobility and toileting).*
  
• Environmental Accessibility Adaptations (EAA) home/vehicle): Physical adaptations to the home or vehicle that maximize accessibility allowing you to function with more independence.​
  
• TBIW Non-Medical Transportation: Your personal attendant can take you to do essential errands and community activities listed on your Person-Centered Service Plan.*
  
• Personal Emergency Response System (PERS): A device used to request help from a monitoring center in the event of an emergency. 
  

1. Can I apply for TBIW services while on another waiver waitlist?
   Yes. However, you cannot be on multiple waivers at the same time. You can be on TBIW and State Plan Personal Care at the same time if you quality, but not another waiver.
   
   
2. How long can someone remain on the TBIW?
   Medical and financial eligibility must be re-established annually. If a member is eligible in both categories each year, there is no limit to how long someone can remain on the program.
   
   
3. How long is the TBIW referral process?
   Medical eligibility determination cannot begin until the financial eligibility has been approved. Once that has been completed, medical eligibility is determined within 45 days. If a slot is not immediately available, the approved applicant will be placed on a managed enrollment list (waitlist), which can add to the time before receiving TBIW services.
   
   
4. Are there any services I can use while I am on a waitlist for the TBIW?
   Yes. If you have the appropriate West Virginia Medicaid coverage, you may be allowed to receive help through the Medicaid Personal Care Program. This program includes hands-on, in-home services, including help with daily living, dressing, eating, bathing, and other areas of need. To be eligible for this program, you must be able to perform specific tasks that a medical professional will give you. You must also be financially eligible, which your local DoHS office will determine. For more information, please visit the Personal Care Services website or call the West Virginia Bureau of Senior Services at 866-767-1575.