Brain injury waiver program enrollment falls far below target

The state Department of Health and Human Resources is paying $1.5 million a year to oversee a brain injury program that so far has benefited just three people.

The 9-month-old Traumatic Brain Injury Waiver Program is meant to keep Medicaid-eligible West Virginians with brain injuries in their homes and out of institutions.

The state planned for 75 people to use the program in its first year, according to documents submitted to the federal government. Enrollment opened Feb. 1.

But so far only 28 people have applied for the program and only three have received services.

In the meantime, the state is paying New York-based APS Healthcare $1.5 million a year to administer the program. Most of that is federal Medicaid money spent by DHHR. The state's annual share is $375,000.

The state awarded a contract to APS to oversee the program in fall 2011. It's worth up to $4.7 million over three years.

"It was intended to build the program," DHHR spokeswoman Marsha Dadisman said Tuesday.

The state told the U.S. Centers for Medicare & Medicaid Services that each person in the program would cost about $36,000 to care for. If that's true, the state is on track to spend $1.5 million to oversee a program that is currently spending a little more than $100,000 to care for West Virginians with brain injuries.

The program was supposed to provide up to $27 million a year in benefit to patients. So the $1.5 million overhead isn't that much - except that less than a handful of West Virginians are actually benefiting from it now.

Kanawha Circuit Judge Duke Bloom heard an update on the program last week. Bloom was getting a number of updates on the so-called Hartley Case, a 1981 case that remains open and centers on the treatment of mental health patients in the state.

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Brain injury waiver program enrollment falls far below target