Self-Direction and FMS in Wyoming

All states: self-direction map

Wyoming self-direction at a glance

Last verified against state sources: 2026-10-13.

Which Medicaid programs in Wyoming offer self-direction?

Wyoming offers self-direction in three Medicaid home and community based services waivers: the Community Choices Waiver, the Comprehensive Waiver and the Supports Waiver. The state calls the option Participant-Direction. It is a way of receiving services inside each waiver, not a separate program. In all three the participant side has both employer authority and budget authority.

• Community Choices Waiver (CCW), Participant-Direction option: serves older adults and adults with disabilities (age 19 and up) who would otherwise need nursing facility care. It is run by the Wyoming Department of Health, Division of Healthcare Financing, HCBS Section. The participant has employer authority and budget authority. Since the waiver renewal that took effect July 1, 2026, the services that can be participant-directed are Personal Support Services, Companion, Homemaker (3 hours per week per household), Non-Medical Transportation (4.5 hours per month) and Respite (the equivalent of 30 days per plan year).
• Comprehensive Waiver, Participant-Direction option: serves people of all ages with an intellectual or developmental disability, and adults ages 21 to 64 with an acquired brain injury. It is run by the same HCBS Section. The participant side has employer authority and budget authority. Services that can be participant-directed are Child Habilitation, Community Living, Companion, Homemaker, Individual Habilitation Training, Personal Care, Respite and Supported Employment. On this waiver, participant-directed Personal Care is capped at 7,280 fifteen-minute units and Respite at 5,616 units per plan period, and Child Habilitation at 9,400 units a year.
• Supports Waiver, Participant-Direction option: serves the same groups as the Comprehensive Waiver and is run by the same HCBS Section. The participant side has employer authority and budget authority. It shares one program guidance document and one participant-directed service list with the Comprehensive Waiver. The plan period caps on participant-directed Personal Care and Respite do not apply on the Supports Waiver.

Employer authority means the employer recruits, hires, schedules and supervises the workers. Budget authority means the employer also manages a set amount of money for services. On CCW that amount is a monthly participant-directed budget approved by the state. Wyoming Medicaid pays for these services directly (fee for service), so no managed care plan is involved.

The Comprehensive and Supports waivers are often called the DD waivers, and this page uses that term below. The state's Participant-Direction page lists only CCW and the DD waivers. We did not find any other Wyoming Medicaid program that offers self-direction.

Who handles financial management services (FMS) in Wyoming?

One organization handles financial management services for participant direction in Wyoming: ACES$. The state contracts with a single FMS provider for all three waivers, so participant-employers do not pick among FMS vendors. Wyoming uses a Fiscal/Employer Agent model, which means ACES$ runs payroll and taxes while the participant side stays the legal employer of the workers.

A Fiscal/Employer Agent is the organization that handles the paperwork side of being an employer. It processes timesheets, pays the workers and handles the employer taxes. The employer gets their own Employer Identification Number (EIN) from the IRS, with help from the FMS. ACES$ Wyoming is a program of MyCIL, a nonprofit Center for Independent Living, and has an office in Cheyenne.

• Legal employer on CCW: the participant, or another person age 18 or older that the participant designates, is the Participant-Direction Employer and the common law employer. A participant who has a court appointed representative cannot be the employer.
• Legal employer on the DD waivers: a participant who is 18 or older and has no legally authorized representative is the employer. Otherwise the legally authorized representative is the employer. For a minor, the employer is a parent, step-parent or court appointed representative. Unlike CCW, the participant cannot pick an unrelated person to act as employer.
• Delegate employers: a person who acts as employer for the participant is not paid for that role and cannot be paid to provide waiver services to the participant.
• Vendor by program: ACES$ is the FMS for the Community Choices Waiver, the Comprehensive Waiver and the Supports Waiver.
• Screening: the FMS runs four background screenings on each employee at enrollment and every five years (the OIG exclusion list, the DFS Central Registry, a national criminal check and the national sex offender website). The employer must also run an OIG check on themselves every year.

The employer sets each worker's wage. It must be at least the higher of the federal or state minimum wage and stay within the state fee schedule for the service. The state's Participant-Direction Employer Manual covers both the CCW and the DD waivers. The words Fiscal/Employer Agent come from the state's September 2026 CCW renewal training. For the DD waivers the manual describes the same arrangement without using that term.

Who can be a paid caregiver under self-direction in Wyoming?

An employer can hire any person over 18, including some relatives. The main limit is that the worker cannot be someone who is legally responsible for making decisions or financial decisions for the participant. Beyond that, the rules for spouses and parents differ between the Community Choices Waiver and the DD waivers.

• Community Choices Waiver, spouses: a spouse can be hired as a paid caregiver if the spouse is not the employer and holds no financial authority for the participant, the care goes beyond normal spousal support, and a health and welfare need is documented in the service plan. This started as a temporary allowance on April 1, 2022 and became permanent with a 2024 amendment.
• Community Choices Waiver, who cannot be an employee: the participant's legally authorized representative, anyone with financial authority for the participant, the case manager and the case manager's spouse. Biological, adoptive and step parents cannot provide participant-directed Companion or Homemaker.
• DD waivers, decision makers: a legally authorized representative or decision maker (a parent, step-parent, guardian, spouse or power of attorney) cannot be a paid employee unless the situation is approved in advance through the Division's ECC process. We did not find a published description of how that process works. Ask the participant's case manager or the HCBS Section.
• DD waivers, parents: biological, adoptive and step parents cannot provide participant-directed Companion, Homemaker, Individual Habilitation Training, Personal Care or Respite.

Hours are capped as well. No participant-directed employee can be paid for more than 40 hours in a week (Sunday to Saturday) per employer, so the program has no paid overtime. Training rules also differ by waiver. CCW employees complete four state training modules before they start work and again every two years. DD waiver employees need hands-on CPR and First Aid certification. The details are in the CCW program guidance and the DD program guidance.

Does EVV apply to self-directed workers in Wyoming?

Yes. The Wyoming Department of Health says electronic visit verification (EVV) is a federal requirement for participant-directed employees. The FMS collects the shift information and uses it for timesheets. Employees record shifts with tools that come through ACES$, not through a system the employer picks.

• How shifts are recorded: ACES$ Wyoming offers the CareAttend mobile app and an IVR line, which is a phone system the employee calls from the participant's landline. Employers approve shifts in the app, by IVR or in ACES$ Online. The methods are listed on the ACES$ Wyoming EVV page.
• Community Choices Waiver: all participant-directed CCW services, including Homemaker and Non-Medical Transportation, must be captured with one of the FMS-provided EVV tools. Shifts that are undocumented, or not verified by both the employer and the employee, are not processed for payroll until they are corrected or verified.
• DD waivers: EVV is required for participant-directed employees and is collected by the FMS. The DD Service Index lists Child Habilitation, Companion, Personal Care, Respite and Skilled Nursing as EVV services. We did not find a statement on whether every participant-directed DD service (for example Community Living or Supported Employment) must be recorded in EVV. Ask ACES$ or the HCBS Section.
• Exemptions: the only exemption we found is a case by case exemption that allows paper timesheets. People who already have it can keep it only if a justification is sent to ACES$ every year for state review, according to the state's EVV FAQ. We did not find a published exemption for live-in caregivers.

Two points could not be confirmed. The payroll rule above is stated in the CCW training, and we did not find the same sentence for the DD waivers. We also did not find a statement on whether the EVV compliance percentages the state sets for provider agencies apply to participant-employers. For either question, ask ACES$ or the HCBS Section.

What is changing next for self-direction in Wyoming?

We did not find a dated upcoming change to self-direction in Wyoming as of the last check. The largest recent changes are already in effect. One item is still pending: the state has said more guidance is coming on how case managers should monitor EVV for participant-directed services, with no date given.

• Already in effect, more CCW services: the CCW waiver renewal that took effect July 1, 2026 expanded participant direction beyond Personal Support Services. It added Companion, Homemaker, Non-Medical Transportation and Respite.
• Already in effect, new manual and forms: a new Participant-Direction Employer Manual (PD08), with program guidance attachments for CCW and the DD waivers, took effect in July 2026. Revised CCW delegation and employer agreement forms (PD06 and PD09) took effect at the same time. Current copies are in the state's HCBS Document Library.
• Pending, case manager guidance: the state's EVV FAQ says CCW case managers must monitor EVV compliance for participant-directed services, and that further guidance on how to do that would follow. We did not find that guidance, and the state has not given a date for it.

We did not find a procurement notice or a planned change of FMS vendor. ACES$ is the contracted FMS today. To check for newer guidance, watch the Document Library or call the HCBS Section.

Wyoming self-direction sources

• Wyoming Department of Health: HCBS Participant-Direction
• Wyoming Department of Health: Participant-Direction Employer Manual (PD08, July 2026)
• Wyoming Department of Health: Attachment A, CCW participant direction program guidance (August 2026)
• Wyoming Department of Health: Attachment B, DD waivers participant direction program guidance (August 2026)
• Wyoming Department of Health: 2026 CCW Renewal Participant-Direction Training (September 1, 2026)
• Wyoming Department of Health: EVV FAQ
• Wyoming Department of Health: HCBS Document Library
• MyCIL: ACES$ Wyoming
• MyCIL: ACES$ Wyoming EVV

Related reading

• Self-Directed Medicaid Home Care Services in 2026
• Understanding Self-Direction and FMS
• Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
• 5 Big Challenges in Self-Directed Care And How FMS Providers Can Solve Them
• Self-direction in every state (map)
• Wyoming EVV requirements

Other states with one statewide FMS vendor

Arkansas, Connecticut, District of Columbia, Indiana, Iowa, New Mexico, North Dakota, Oklahoma, South Carolina, Tennessee, Vermont, Washington, West Virginia. See every state on the self-direction map.

Page history

• October 13, 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 FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.