I/DD Waivers in Wyoming

All states: Medicaid disability services map

Wyoming I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Wyoming?

The Wyoming Department of Health (WDH) runs I/DD services through the Home and Community-Based Services (HCBS) Section of its Division of Healthcare Financing (DHCF). The Department is also the state Medicaid agency, so one office both administers Medicaid and operates the two I/DD waivers. Wyoming does not have a separate developmental disabilities department.

• HCBS Section: manages the DD waivers, certifies providers and publishes the waiver documents, service index and reports. It can be reached at (307) 777-7531 or (800) 510-0280.
• Front door: people apply for the Supports Waiver online or on paper, and DHCF Benefits and Eligibility Specialists help applicants across the state. The applicant then picks a case manager to finish the eligibility process.
• Case management: case management is a waiver service provided by case management agencies and case managers that DHCF certifies and the participant chooses. Under Wyoming's conflict-free rules, a case management agency cannot serve anyone it provides any other waiver service to, and a relative or legally authorized representative cannot be the person's case manager.
• Extraordinary Care Committee (ECC): a state committee that approves emergency entry to the Comprehensive Waiver, new host home and Special Family Habilitation Home placements, and reviews budgets that teams say do not meet a person's needs.

What Medicaid waivers and programs serve people with I/DD in Wyoming?

Wyoming has two 1915(c) waivers for people with intellectual or developmental disabilities: the Supports Waiver and the Comprehensive Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Both waivers serve people of all ages with I/DD who meet the level of care for an intermediate care facility, and both also serve adults 21 and older with an acquired brain injury. The current five-year waivers took effect April 1, 2024, and both were amended effective July 22, 2026.

• Supports Waiver (1915(c), control number WY.1060): a waiver with a capped yearly budget for each person. The budget is $27,010 a year for adults not in school services and $23,171 for participants 21 and under who are still eligible for school services under the Individuals with Disabilities Education Act (IDEA). Emergency increases are possible up to the waiver cost limit of $36,220. A person whose needs go past that limit stays on the Supports Waiver and is evaluated for the Comprehensive Waiver. Services include Community Support Services, Adult Day Services, Supported Employment, Individual Habilitation Training, Child Habilitation Services, Personal Care, Companion, Homemaker, Respite, behavioral and crisis supports, case management, skilled nursing and therapies, equipment, home changes and transportation. The state counted 1,231 participants (including people offered funding) on September 30, 2026.
• Comprehensive Waiver (1915(c), control number WY.1061): the waiver for people who need more support, including 24-hour residential services. Each person's individual budget amount is set from an assessed Level of Service score, their living situation and age. It covers the Supports Waiver services plus tiered Community Living Services (residential habilitation, including host homes) and Special Family Habilitation Homes for children. Each year it reserves slots for 15 youth aging out of state custody, 25 emergency cases, 25 people moving out of state-funded institutions and 7 military dependents. The state counted 1,678 participants (including people offered funding) on September 30, 2026.

The waivers refer to a state-funded intermediate care facility for individuals with intellectual disabilities (ICF/IID) as the institutional option they are an alternative to. We did not find any other Medicaid authority used for I/DD services in Wyoming, such as a 1915(i) state plan option, 1915(k) Community First Choice or an 1115 demonstration.

Does Wyoming pay for I/DD services through managed care?

No. Wyoming pays for DD waiver services fee-for-service, meaning providers bill the state Medicaid program directly for each service. We did not find any managed care arrangement for I/DD services. Independent, conflict-free case management agencies coordinate each person's services.

• Who pays claims: the waiver documents say claims are paid through the state's Medicaid Management Information System (MMIS). We did not confirm which vendor runs claims processing. Ask the HCBS Section or Wyoming Medicaid provider services.
• Who coordinates services: the participant's chosen case manager, from a DHCF-certified case management agency that does not provide the person's other waiver services.

Is there a waiting list for I/DD services in Wyoming?

Yes, for the Supports Waiver. The state's September 2026 HCBS waiver report showed 597 people on the Supports Waiver wait list on September 30, 2026. The same report says there is no Comprehensive Waiver wait list, because entry there is by emergency approval, reserved slots or moving up from the Supports Waiver.

• How the list works: people are placed on the Supports Waiver wait list first come, first served, and funding goes to whoever has waited longest.
• New slots: the 2026 Legislature funded slots to reduce the wait list. The Supports Waiver's yearly participant limit rises from 1,057 to 1,430 in waiver year 3, 1,517 in year 4 and 1,604 in year 5, with the added slots used for people coming off the list.
• Reserved slots: the Comprehensive Waiver holds slots each year for emergencies, youth aging out of state custody, people leaving state-funded institutions and military dependents.
• People over the Supports cost limit: the Supports Waiver document says these people are evaluated for the Comprehensive Waiver. Ask the HCBS Section how this group is tracked, since the state reports no Comprehensive wait list.

For a person's place on the list, families can call the HCBS Section at (307) 777-7531 or (800) 510-0280, or ask their case manager.

How do people apply for I/DD waiver services in Wyoming, and how are budgets set?

People apply for the Supports Waiver online through the Participant Portal (wyowaiverparticipants.com) or with the paper Supports Waiver application. DHCF Benefits and Eligibility Specialists help with the application, and the applicant then picks a case manager from the list of certified case managers to finish the eligibility process. Comprehensive Waiver budgets are set from the ICAP assessment, while Supports Waiver budgets are capped amounts.

• Eligibility: Medicaid financial eligibility plus clinical eligibility under Medicaid Rules Chapter 46. That means a psychological evaluation no more than five years old that confirms the qualifying diagnosis (a neuropsychological evaluation for brain injury) and ICF/IID level of care on the LT-104 form (nursing facility level of care on the LT-101 form for brain injury). Eligibility is checked again each year.
• Assessment tool: the Inventory for Client and Agency Planning (ICAP), together with other assessment information and past service use, gives each Comprehensive Waiver participant a Level of Service score from 1 to 6.
• Comprehensive Waiver budgets: the Level of Service score, the person's living situation and age set the individual budget amount. The score also sets the tier for residential and day services. Teams can ask the Extraordinary Care Committee to review a budget that does not meet the person's needs.
• Supports Waiver budgets: $27,010 a year for adults not in school services and $23,171 for participants 21 and under still eligible for IDEA school services, with emergency increases up to $36,220.
• Self-direction: both waivers offer participant direction, where the participant or family hires and manages workers (employer authority) and decides how to spend part of the budget (budget authority). ACES$ is the single statewide financial management services provider that handles payroll for these workers. Host home services cannot be self-directed.

What day and residential services can I/DD providers offer in Wyoming?

Providers can offer three day and employment services and three residential options under the DD waivers. All are certified by DHCF under Medicaid Rules Chapter 45, and most are tiered by the person's Level of Service score. Providers whose adult day, case management, community living, community support, companion and supported employment billing together reaches $150,000 a year must earn national accreditation from CQL (The Council on Quality and Leadership) or CARF within 18 months.

Day and employment services

• Community Support Services (CSS): habilitation for adults 18 and older that builds self-help, social and adaptive skills in the community, away from the home. It cannot be limited to a fixed site or group setting. It has basic, intermediate and high tiers, transportation is included in the rate, and it is billed in 15-minute units. The research did not find a published ratio. The tiers set supervision instead, from indirect supervision within hearing distance (basic) to staff in close proximity (high).
• Adult Day Services (ADS): a structured day program with protective oversight, health maintenance and personal care (no more than 20% of the service). The state's service index says it is not a habilitation service. It has three tiers, includes transportation and is billed in 15-minute units. A facility serving four or more adults also needs a state adult day license from WDH Healthcare Licensing and Surveys, and the adult day licensing rule sets a 1:6 staff ratio. The waivers set no ratio of their own.
• Supported Employment: help for adults 18 and older to find and keep competitive integrated work at or above minimum wage. Individual supported employment is 1:1 and includes career planning, discovery, customized employment and self-employment. Small group supported employment covers crews or enclaves of 2 to 8 people per job coach. Supported Employment Follow Along is indirect support of up to 100 units a year. It is billed in 15-minute units (code T2019, with individual and group rates). Vocational Rehabilitation and IDEA services must be used first. Neither waiver lists a separate prevocational service.

For people in Community Living Services Levels 3 to 6, non-residential services are capped at an average of 35 hours a week.

Residential services (certified by DHCF)

• Community Living Services (CLS): residential habilitation for adults 18 and older in a provider-owned or leased home, the person's own home or a family home, with 24-hour or on-call support. It is paid at a daily rate tied to Level of Service tiers (Basic and Levels 3 to 6), and a basic 15-minute unit also exists. People living with family can receive only CLS Basic. CLS other than host homes can be self-directed. New provider-owned or operated settings that serve five or more people will not be certified, and settings need current inspections.
• Host Home (a CLS option, Comprehensive Waiver): one sponsor, an independent certified provider, supports one person living in the sponsor's home and is that person's only residential provider. Parents cannot be sponsors, and new placements need ECC approval.
• Special Family Habilitation Home (Comprehensive Waiver): a host family home for children from birth to age 17 who cannot live with their parents, used as a last-resort placement with the Department of Family Services (DFS) and the Department of Education. New placements need ECC approval, and DFS licensing rules also apply.

How are I/DD provider rates set and how do agencies enroll in Wyoming?

Wyoming uses one statewide fee schedule for both DD waivers, with separate rate columns for agencies and independent providers. Rates are built from provider cost surveys using a rate build-up method (wages, benefits, productivity and overhead), and state law (W.S. 42-4-120(g)) requires a rebase every two to four years, with final rates subject to legislative funding. Agencies enroll by getting DD certification from DHCF and enrolling separately as a Wyoming Medicaid provider.

• Latest rate change: the 2026 Legislature funded higher rates for Case Management and Community Living Services Levels 5 and 6, based on a 2024 rate study, effective July 1, 2026. All other DD rates were last rebased in state fiscal year 2024.
• Tiered rates: residential (Community Living Services) and day services are paid in tiers by the person's Level of Service score.
• Certification: agencies apply for DD certification through the Wyoming Health Provider portal, complete the Division's training modules, CPR and first aid, and background screenings, and enroll as a Wyoming Medicaid provider. The credentialing mailbox is wdh-hcbs-credentialing@wyo.gov. Larger providers must also meet the CQL or CARF accreditation rule described above.
• EVV: Personal Care, Child Habilitation, Companion, Respite and Skilled Nursing require electronic visit verification (EVV). Agencies use the free state system, CareBridge, or a third-party system that integrates with it, according to the state's current providers page. Workers hired through participant direction use the EVV tools of the financial management services provider, ACES$.
• EVV compliance: providers must meet a minimum monthly EVV compliance rate, 75% since September 1, 2026. Manually entered visits count as noncompliant, according to the state's EVV FAQ.

What is changing next for I/DD services in Wyoming?

The next confirmed change is to EVV. The minimum monthly EVV compliance rate for DD waiver providers, 75% since September 1, 2026, rises to 85% by January 1, 2027, according to the state's EVV FAQ. Agencies that rely on manual visit entries will need to move more visits to real-time check-in and check-out.

• More Supports Waiver slots: the Supports Waiver's yearly participant limit grows in each remaining waiver year (1,430, then 1,517, then 1,604), funded by the 2026 Legislature to move people off the wait list.
• Recent changes already in place: both waivers were amended effective July 22, 2026 to add provider funding and wait list funding. Rates for Case Management and Community Living Services Levels 5 and 6 rose July 1, 2026. With the amendment, Comprehensive Waiver case management in 15-minute units is limited to 48 units per person per case manager each plan year, instead of requiring a monthly visit.
• Next rate rebase: state law requires a rebase every two to four years. We did not confirm whether the state will ask the 2027 Legislature to fund new rates. Ask the HCBS Section or watch its reports page.

Wyoming I/DD sources

• Wyoming Department of Health: Comprehensive Waiver (WY.1061), amendment effective July 22, 2026
• Wyoming Department of Health: Supports Waiver (WY.1060), amendment effective July 22, 2026
• Wyoming Department of Health: HCBS waiver summary report, September 2026
• Wyoming Department of Health: Home and Community-Based Services Section
• Wyoming Department of Health: DD Waiver Service Index (effective July 22, 2026)
• Wyoming Medicaid Rules Chapter 45: DD Waiver Provider Certification and Standards
• Wyoming Department of Health: DD provider certification
• Wyoming Department of Health: Current providers (EVV)
• Wyoming Department of Health: EVV FAQ
• Wyoming Department of Health: Participant direction

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Goal Tracking and Strategy Management in Disability Services
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Wyoming EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.