Mountain Health Promise

Frequently Asked Questions

Click here for answers to commonly asked questions . If your question and answer is not included below, call Member Services Department at 1-888-348-2922 TTY: 711 24 hours a day, 7 days a week for help.

Contact Information

Many people play important roles to help care for your child. Here is a list of agencies that may reach out to you and who you can talk to if you have questions

The Children with Serious Emotional Disorder Waiver (CSEDW) is a Medicaid Home and Community Based Services (HCBS) waiver program authorized under §1915(c) of the Social Security Act. This waiver provides services (that are additions to services available through the Medicaid State Plan) for children and youth ages three through their 21st birthday who are enrolled in the CSEDW program. The CSEDW allows West Virginia to provide a range of home and community-based services that allows children or youth who would otherwise require institutionalization to stay in their homes and communities.

By offering services in your home and community, West Virginia hopes to see fewer children and youth receive treatment in residential treatment facilities and psychiatric rehabilitation treatment facilities. Additionally, for children and youth coming home from placement, this waiver will allow for services and supports to continue in the child’s home and community.

Children and youth who are enrolled in the CSEDW program must enroll with Aetna Better Health as the Managed Care Organization. Individuals who are not willing to enroll with Aetna are not eligible to enroll in the CSEDW program.

CSEDW Eligibility Criteria

For your child to be found eligible for the CSEDW program, your child must:

  • Be an eligible West Virginia Medicaid member. Medicaid eligibility is independent of medical eligibility for the CSEDW and is not impacted by enrollment in the CSEDW
  • Choose to receive services in the home and community over receiving services in an institutional setting
  • Choose to enroll with Aetna Better Health
  • Meet CSEDW medical eligibility
  • Be at least three years of age and not yet 21
  • Be a resident of West Virginia, even if presently living out of state in a Psychiatric Residential Treatment Facility (PRTF), and
  • Be able to provide proof of residency upon application to the waiver

Enrollment in the CSEDW program is dependent upon the availability of a funded CSEDW slot.

Initial medical eligibility is determined through review of an Independent Psychological Evaluation (IPE) report completed by a Psychologist, who is a member of the Independent Psychological Network (IPN); which must include background information, mental status examination, a measure of intelligence, adaptive behavior, achievement and any other documentation deemed appropriate.

 

 

Services Available Under the CSEDW Program

  • Case Management
  • Independent Living/Skills Building
  • Job Development
  • Supported Employment, Individual
  • In-Home Family Therapy
  • In-Home Family Support
  • Respite, In-Home and Out-of-Home
  • Specialized Therapy
  • Assistive Equipment
  • Community Transition
  • Mobile Response
  • Non-Medical Transportation
  • Peer Parent Support

 

Inquiries into the CSEDW program can be sent to Jennifer Eva, CSEDW Project Manager by emailing evaj@aetna.com.

For complete information about the CSEDW program, please refer to Chapter 502: Children with Serious Emotional Disorder Waiver (CSEDW), which can be found here:

SCED Waiver