Wyoming DD Waiver Case Manager and Benefits Eligibility Specialist

The Two Key People in Wyoming's Waiver System

Every Wyoming family entering the DD waiver process works with two administrative roles that serve fundamentally different functions. Confusing what each one does — or failing to engage both early enough — is one of the most common reasons applications stall.

The Benefits and Eligibility Specialist (BES) is a county-level employee who handles the financial and administrative side of Medicaid eligibility. They verify income, assets, residency, and citizenship. They process the Medicaid application through WES (Wyoming Eligibility System). They issue eligibility letters and handle annual financial redeterminations. Every county in Wyoming has a BES office, and the family's assigned specialist is determined by the county where the applicant resides.

The case manager is a separately enrolled Medicaid provider who handles the clinical and service-coordination side. They conduct or coordinate the level of care assessment (LT-104 for developmental disabilities, LT-101 for acquired brain injury), help schedule the required psychological evaluation, assemble the eligibility packet, and submit it to the Medicaid Long-Term Care Unit. Once the applicant is on a waiver, the case manager coordinates the Individual Plan of Care (IPC), helps the family select service providers, and monitors ongoing compliance with waiver rules.

Selecting a Case Manager

The process starts with the BES. When a family contacts their county BES to begin the waiver application, the BES provides a list of enrolled, certified case managers in the area. The family interviews candidates and submits a signed Case Management Selection Form to the Developmental Disabilities Section.

What to look for in a case manager:

• Caseload size. A case manager juggling 40 clients across three counties will be less responsive than one carrying 20 in a single county. Ask how many active clients they manage.
• Familiarity with Chapter 46. The case manager should be able to explain the difference between the Supports and Comprehensive Waivers, how the ECC process works, and what happens during an annual level of care reassessment.
• Self-directed care experience. If the family anticipates using the self-directed service delivery model (common in rural areas where agency providers are scarce), the case manager should have experience coordinating with ACES$ (the Financial Management Service) and supporting employer-of-record families.
• Communication style. The case manager is the family's primary point of contact with the state system for years. Regular, proactive communication — not just responses to emergencies — matters.

Targeted Case Management During the Waitlist

Once the state finds the applicant eligible for waiver services but funding is unavailable, the person is placed on the Supports Waiver chronological waitlist. During this waiting period — which can last years — the case manager transitions to Targeted Case Management (TCM).

TCM is funded entirely by state dollars and is capped at 120 fifteen-minute units per plan year. The case manager's role during TCM is limited but important:

• Hold regular team meetings to monitor the individual's needs and living situation
• Assist the family in accessing non-waiver community resources — DVR services, Pre-ETS programs, respite care through other funding streams
• Maintain documentation of unmet needs — this record becomes critical if the family later petitions the Extraordinary Care Committee for emergency Comprehensive Waiver placement
• Ensure ongoing Medicaid eligibility by coordinating with the BES for annual financial redeterminations

The structural limitation of TCM is that the case manager cannot authorize or deliver direct services. They are coordinators and record-keepers, not service providers. The family carries the operational burden during the waitlist period.

Common Problems and How to Avoid Them

Missed BES deadlines. Financial redetermination happens through WES every 12 months. If the BES does not receive updated financial documentation on time, the case can be closed, putting continued eligibility and waitlist status at risk. The case manager should track these deadlines and remind the family, but families should maintain their own calendar.

Evaluator delays. If the psychologist or neuropsychologist does not submit the clinical report in time, the BES may close the case for incomplete documentation. The case manager should intervene directly with the evaluator — calling, faxing reminders, escalating if necessary — before the deadline passes.

Case manager turnover. Rural Wyoming counties experience significant case manager turnover. If a case manager leaves, the family must select a new one and submit a new selection form. Continuity of service depends on the written records the previous case manager maintained.

The Wyoming SSI at 18 & Adult Disability Benefits Guide includes case manager interview questions and a deadline tracking system for coordinating BES redeterminations, level of care reassessments, and TCM check-ins during the waitlist period.

See more Wyoming guides →