West Virginia Code of State Rules Agency 197 - Traumatic Brain And Spinal Cord Injury Rehabilitation Fund
Here’s a detailed overview of Agency 197 – Traumatic Brain and Spinal Cord Injury Rehabilitation Fund under West Virginia’s Code of State Rules:
📘 Title 197 – Legislative Rule: Agency 197
Designed to guide the administration of the Traumatic Brain and Spinal Cord Injury Rehabilitation Fund, this title includes two main rule series:
🔹 Series 197‑01: The Rehabilitation Fund (Sections 197‑1‑1 to 197‑1‑5)
Scope & Purpose: Establishes the Fund’s general purpose—to support rehabilitation services for West Virginians with traumatic brain or spinal cord injuries, acting as the payer of last resort and outlining appeal rights (regulations.justia.com).
Key Provisions:
General & Program Description (§197‑1‑1, 197‑1‑2)
Eligibility Criteria & Funding Priorities (§197‑1‑3)
Payer-of-Last-Resort Rule (§197‑1‑4): Funds are only used after all other resources are exhausted (regulations.justia.com, dhhr.wv.gov).
Appeals Process (§197‑1‑5) .
🔹 Series 197‑02: Board Procedural Rules (Sections 197‑2‑1 to 197‑2‑6)
Governance Structure: Defines the Fund Board’s procedural framework, including officer roles, committee formation, meeting schedules, and administrative procedures .
Sections Covered:
197‑2‑1: General provisions
197‑2‑2: Program description
197‑2‑3: Election of officers
197‑2‑4: Committees
197‑2‑5: Meetings
197‑2‑6: Board procedures
These rules are current through Register Vol. XLII, No. 12 (March 21, 2025) (regulations.justia.com, regulations.justia.com).
🛠 Statutory Framework (West Virginia Code § 9‑10‑1 et seq.)
The governing statute outlines the basics of the Fund:
Definitions (§ 9‑10‑1): Clarifies who the Secretary is, defines “traumatic brain injury” and “spinal cord injury” (code.wvlegislature.gov).
Administration & Usage (§ 9‑10‑3):
Fund subject to annual legislative appropriation
Managed by the Department of Health and Human Resources with no administrative fees
Explicitly limited to rehabilitation services—case management, therapies, home modifications, necessary equipment, attendant care, and family support (codes.findlaw.com).
🔍 Practical Highlights from DHHR’s “Funds for YOU” Guidance
Although not codified in the CSR, the DHHR Bureau for Behavioral Health’s FY 2020 “Traumatic Brain Injury Funds for YOU” manual provides practical implementation details:
Eligibility: West Virginia residency, medically confirmed injury, nil availability of other funding (dhhr.wv.gov).
Service Categories & Funding Caps:
Medical, dental, adaptive equipment, therapies, assistive technology, home start-up – generally capped between $500–$2,000 per category per fiscal year (dhhr.wv.gov).
Process Workflow:
Application via the Center for Excellence in Disabilities (CED)
Resource Coordinator oversight
ART (Application Review Team) reviews bi-monthly
Payment via vendors, post-approval, with receipts and audits (dhhr.wv.gov).
✅ Summary Table
| Element | Content |
|---|---|
| Purpose | Provide last-resort rehabilitation support for TBI/SCI survivors |
| Rule Structure | Series 197‑01 (eligibility, appeals); Series 197‑02 (board governance) |
| Statute | § 9‑10‑1 confirms definitions; § 9‑10‑3 outlines use and admin |
| Administration | DHHR manages; Board procedures ensure oversight |
| Funding Limits | Capped payments (e.g., $2,000 medical per year; up to $2,300 total annually) |
| Process | Apply via CED → Coordinator → ART → Approvals → Vendor payments → Appeals available |
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