The program requires patients to be in a licensed nursing facility, inpatient hospital or licensed rehabilitation facility when they apply for the waiver.
Beane said the state wanted to target the people who need the waiver most. If there are fewer than 75 people who apply for the waiver while in hospital, nursing home or rehabilitation center care, the requirements could be revised to allow others to apply, she said.
Davis also criticized the amount of training required for direct patient care. The waiver requires direct care staff to have at least eight hours of training working on direct care service delivery to people with TBI -- which Davis says isn't enough.
"To not require that people have that basic level of understanding about brain injury is ludicrous," he said. "We've fought for 25 years [for a TBI waiver]. Judge Bloom has mandated this. This is the only person that's come and really advocated to get it done and now they're going to implement something that can't even be utilized."
It also requires training in CPR training, first aid, federal Occupational Safety and Health Administration rules, crisis intervention training and other training.
Beane said she would need to review the waiver to comment on the training requirements.
Also, Davis said, the requirements for cognitive therapists, who work to increase brain function after an injury, are so high that no one in the state can provide the therapy.
"It's adding insult to injury when they do this stuff," Davis said of the waiver. "It absolutely pours salt in the wound ... the Bureau for Medical Services and the Department of Health and Human Resources is an absolute oxymoron. There's no health and humanness to this at all."
Beane said the requirements for cognitive therapists had been brought to the attention of the Bureau of Medical Services, which is revising those requirements.
Ginger Dearth, chairwoman of the West Virginia Traumatic Brain and Spinal Cord Injury Rehabilitation Fund Board, agreed the waiver in its current form is very limited.
"It's not going to meet the needs of all survivors of TBI in the state of West Virginia, as we have determined through multiply needs assessments throughout the state," Dearth said.
Reach Lori Kersey at lori.ker...@wvgazette.com or 304-348-1240.