The TBIW Program is a Medicaid program. This program provides community-based supports and services for people with traumatic brain injury (TBI). These services are provided in combination with support and help from family, friends, and other caregivers.

West Virginia law says that “traumatic brain injury” is an acquired injury to the brain. This includes brain injuries caused when there is a lack of oxygen to the brain due to near drowning.

“Traumatic brain injury” does not include:

• brain dysfunction caused by congenital (present at birth),
• degenerative (gets worse over time) disorders, or
• birth trauma.

TBIW services include:

•  Case Management – help with getting needed services and community supports
• Personal Attendant Services – help with daily living activities in the home and community
• Transportation – reimbursement for personal attendants to perform essential errands for participants

The TBIW Program provides services to West Virginia residents who are both medically and financially eligible.

To be eligible, an applicant must:

• Be 3 years of age or older
• Be a resident of West Virginia
• Have a traumatic brain injury with total or partial functional disability and/or psychosocial impairment
• Meet the Medicaid Waiver financial eligibility
• Require the same level of care provided in a nursing facility
• Individuals 18 years or older must score at a Level VII or below on the Rancho Los Amigos Levels of Cognitive Functioning Scale
• Individuals ages 3 to 17 years old must score at a Level II or higher on the Rancho Los Amigos Pediatric Level of Consciousness
• Choose to participate in the program as an alternative to a nursing facility

• Complete a Medical Necessity Evaluation Request (MNER) form.
  • The form must be filled out by the applicant or legal representative and a physician, physician assistant, nurse practitioner, or neuropsychologist.

• Submit the MNER form by mail or email to:
  • KEPRO, 100 Capitol Street, Suite 600 Charleston, WV, 25301
  • E-mail: wvtbiwaiver@kepro.com
  • Phone: 866-385-8920

• Participate in a medical eligibility assessment after financial eligibility has been established.

The form can be found on the West Virginia Department of Health and Human Resources website.

For more information on the TBIW Program, contact the TBIW Program Manager:

TBIW Waiver Program Manager
Bureau for Medical Services
350 Capitol Street, Room 251
Charleston, WV 25301
Phone: (304) 352-4240
Fax: (304) 558-4398

DHHR TBIW Program Website