Getting paid to care for a family member in West Virginia
Depends.
In West Virginia, whether a family member can be paid depends on the program's rules, which are below with their sources.
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Medicaid waiver
Aged and Disabled Waiver (ADW)
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Who qualifies
People 18 or older who are permanent residents of West Virginia, meet the Medicaid waiver financial rules, are approved as medically eligible for nursing home level of care and in need of services, and choose the waiver instead of nursing home care. Gross monthly income may not exceed 300% of the current maximum SSI payment.
You must have five deficits on the medical assessment (the PAS) to qualify medically. If no funded slot is open, eligible applicants go on a Managed Enrollment List in the order their completed medical request was received.
Under the Traditional (agency) model, monthly hours depend on your service level: Level A 0 to 62 hours, Level B 63 to 93, Level C 94 to 124, Level D 125 to 155. Under Personal Options you get a budget based on your assessed level of need.
Aged and Disabled Waiver members who choose to self-direct. You are the employer of the personal attendants you hire, and you hire, train, supervise and if needed let go of your own workers within a budget set from your assessed level of need. A fiscal/employer agent runs payroll, and a resource consultant helps with hiring.
You may appoint a program representative to help with employer tasks, but that representative cannot also be your paid attendant.
Depends.
Yes, with limits. The approved waiver says relatives may be paid for Personal Attendant and Transportation services, excluding the person's legal guardian and spouse, and the services must be for the sole benefit of the member. If you self-direct and need a program representative, that representative may not be a paid employee.
The BMS Chapter 501 manual (effective June 1, 2026) adds that a medical power of attorney, power of attorney, healthcare surrogate or other legal representative may be paid only if they work for an ADW provider agency or, when the member self-directs, the member has a program representative who is someone else. A relative who holds your power of attorney falls under this rule.
No.
No. Court-appointed legal guardians are prohibited from being paid caregivers.
A medical power of attorney, power of attorney, healthcare surrogate or other legal representative may be paid, but only if they work for an ADW provider agency or, when you self-direct, you have a separate program representative.
Have your treating physician, advanced practice registered nurse or physician assistant complete and sign a Medical Necessity Evaluation Request (MNER) form. You, a family member or the clinician can send it to the program's Utilization Management Contractor by fax, mail or electronically. You then get a Long-Term Care financial application, which you have 60 days to complete. Once financial eligibility is set, the Utilization Management Contractor contacts you to schedule an assessment (the PAS) of your medical eligibility.
Once you are on the waiver, choose the Personal Options model instead of the Traditional (agency) model. You elect the member-directed option, then work with your resource consultant to enroll, add your personal attendants, build a spending plan for your budget and make a backup plan for staffing.
