WV Long Term Care Programs

WV Long Term Care Programs 2017-08-31T19:23:26+00:00

WV Long Term Care Programs

PC&A has provided consultative services to the Bureau for Medical Services since 1983. Currently PC&A manages or helps to manage four separate Medicaid Programs.  These programs are the ICF/IID Program, the CDCSP program, the I/DD Waiver program and the PASRR program.  Since 2008, the management of the ICF/IID program, including initial eligibility determinations and annual redeterminations, review of ICAPs for accuracy, notifications to members and providers, training, data retention, etc. has been provided. Additionally, the CDCSP program has been managed through PC&A. Eligibility determinations, annual redeterminations, notifications to family members, data retention, and all other aspects of the program have been managed through PC&A. Since 1985, it has been the responsibility of PC&A to make eligibility determinations and redeterminations for the I/DD Waiver program. Our office works cooperatively with the Administrative Services Organization (ASO) in rendering these decisions.  We also participate in fair hearings for adverse decisions for all of the programs.  We have also designed, developed, recruited, and coordinate the Independent Psychologist Network that completes the I/DD Waiver evaluations. Additionally, we have designed, developed, recruited, and coordinate the PASRR Level II evaluators for the PASRR Level II program. The staff at PC&A also completes desk reviews and other Level II evaluations as needed.

CDCSP

The CDCSP (Federal Title “Disabled Child In-Home Care Program” otherwise known as The Katie Beckett Waiver) allows children who require a nursing level of care, acute care hospital level of care or an intermediate care facility for individuals with intellectual disability level of care to receive a West Virginia Medicaid card so …

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ICF/IID

ICF/IID are group homes located in communities throughout West Virginia. Each group home houses between four and nine individuals who have an appropriate diagnosis of an Intellectual Disability or a severe Related Condition. The group homes are staffed to meet the needs of all of the ICF/IID members who reside in the home.

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I/DD Waiver

The I/DD Waiver program provides home and community based services for individuals with Intellectual Disability or a severe Related Condition. The individuals must require the level of care and active treatment provided to individuals in ICF/IID group homes. PC&A Responsibilities – PC&A is the …

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PASRR

PASRR is a federally mandated program that functions to determine if patients are eligible for nursing facility care. Following completion of a pre-admission intake by a physician, hospital, and/or nursing home, a Level I is utilized to determine functional deficits that would necessitate a nursing facility level of care.

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