West Virginia Department of Health & Human Resources - Bureau for Medical Services

The Challenge:
The West Virginia Medicaid Aged & Disabled Waiver Program provides home and community based services to over 4,500 seniors and adults with disabilities who qualify for nursing facility level of care. In 2002, West Virginia received a Cash & Counseling Expansion grant from the Robert Wood Johnson Foundation to implement a self-directed service model within the AD Waiver program. West Virginia was selected to pilot the Consumer Direction Module (CDM), a Web-based application designed to support self-direction. The Bureau was looking for a single statewide contractor with a physical presence in West Virginia to provide bundled financial management and resource consulting services utilizing a Government Fiscal/Employer Agent model. In 2006, WVDHHR amended its existing contract with PCG (PPL’s parent company), to engage PPL’s services.

The PPL Approach:
PPL took the following steps to implement the project:

• Established a local office in Morgantown, West Virginia to implement resource consulting (support broker) services;
• Recruited and trained qualified resource consultants;
• Developed materials and processes to support AD Waiver participants;
• Entered into a teaming agreement with a national company to conduct required criminal back ground checks on participant-employed providers;
• Customized business systems and processes to perform payroll services, accounts payable services, and customer services; and
• Customized information technology platforms to meet program requirements, including verification of provider qualifications.

The Result:

Since the projects launch in May 2007 the project team has:

• Enrolled over 200 participants (12.7% of Waiver applicants);
• Provided payroll for over 300 participant-employed providers;
• Provided national leadership in testing and adaptation of the Consumer Direction Module (CDM);
• Provided consultation on expansion of self-direction to MRDD Waiver; and
• Co-presented with client at national conferences highlighting the program’s success.