West Virginia Personal Options allows qualifying individuals to self-direct their care through the ADW, IDD, and TBI waivers. The Personal Options program gives participants more choice and control over their care and services they receive.
Participant Forms
Caregiver Forms
- Worker Intake Form
- Worker Enrollment Packet
- Criminal Background Check Scheduling Packet
- Change of Information
- IRS W-4 Federal Withholding
- WV State Withholding
- Notice of Privacy Practices
- Worker Rate of Pay Information
- Medicaid Provider Agreement
- Pay Selection & Direct Deposit Agreement
- Payroll Information Worksheet
- Income Verification Request
- 2026 Payment Schedule ADW
- Paper Timesheet (EVV Exempt Only)
- Mileage Reimbursement Form
- Verification of City Service Withholding Authorization
- Stop Payment Request
Resources
- PO Employer Training Guide
- PO Worker Training Guide
- STP Brochure
- Employer Training Verification Attestation Form
- Worker Additional Training Hours Resource
- Initial Test
- STP Initial Test
- Initial Training Verification Form
- Annual Test
- Annual Training Verification Form
- Time Entry User Guide
- Worker Backup Plan
- WV Pre-Approved CPR and First Aid Providers
Palco Connect EVV Resources
Participant Forms
Caregiver Forms
- Worker Intake Form
- Worker Enrollment Packet
- Criminal Background Check Scheduling Packet
- Change of Information
- IRS W-4 Federal Withholding
- WV State Withholding
- Notice of Privacy Practices
- Worker Rate of Pay Information
- Medicaid Provider Agreement
- Pay Selection & Direct Deposit Agreement
- Payroll Information Worksheet
- Income Verification Request
- 2025 Payment Schedule – IDD/TBI
- 2026 Payment Schedule – IDD/TBI
- Paper Timesheet (EVV Exempt Only)
- Mileage Reimbursement Form
- Verification of City Service Withholding Authorization
- Stop Payment Request
Resources
- PO Employer Training Guide
- PO Worker Training Guide
- Employer Training Verification Attestation Form
- Worker Additional Training Hours Resource
- Initial Training Verification Form
- Annual Training Verification Form
- Time Entry User Guide
- Worker Backup Plan
- WV Pre-Approved CPR and First Aid Providers
Palco Connect EVV Resources
Participant Forms
Caregiver Forms
- Worker Intake Form
- Worker Enrollment Packet
- Criminal Background Check Scheduling Packet
- Change of Information
- IRS W-4 Federal Withholding
- WV State Withholding
- Notice of Privacy Practices
- Worker Rate of Pay Information
- Medicaid Provider Agreement
- Pay Selection & Direct Deposit Agreement
- Payroll Information Worksheet
- Income Verification Request
- 2025 Payment Schedule – IDD/TBI
- 2026 Payment Schedule – IDD/TBI
- Paper Timesheet (EVV Exempt Only)
- Mileage Reimbursement Form
- Verification of City Service Withholding Authorization
- Stop Payment Request
Resources
- PO Employer Training Guide
- PO Worker Training Guide
- Employer Training Verification Attestation Form
- WV TBIW Approved CPR/FA Vendors
- TBIW Initial Test Part One
- TBIW Initial Test Part Two MFWA
- STP Brochure Updated
- Initial Training Verification Form
- Annual Training Verification Form
- TBIW Annual Test Part One
- TBIW Annual Test Part Two MFWA
- Worker Additional Training Hours Resource
- Time Entry User Guide
- Worker Backup Plan
- WV Pre-Approved CPR and First Aid Providers