Wyoming Developmental Disabilities Waiver and HCBS Services

Wyoming's DD Waiver System

Wyoming's home and community-based services for people with developmental disabilities operate through two Section 1915(c) waivers administered by the Department of Health's Developmental Disabilities Section. Both serve as alternatives to institutional placement, funding services that help individuals live in their communities rather than in nursing facilities or the Wyoming Life Resource Center.

The Supports Waiver covers individuals of all ages with intellectual or developmental disabilities and adults aged 21-64 with acquired brain injuries. It provides a capped, individualized budget for services like day habilitation, supported employment, respite care, community integration, and personal care. It does not fund 24/7 residential care.

The Comprehensive Waiver provides intensive, round-the-clock residential habilitation for individuals whose needs exceed the Supports Waiver's capacity. Access is restricted to emergency priority (approved by the Extraordinary Care Committee) or reserved capacity (transitions from institutions, military dependents).

Both waivers require Medicaid eligibility as the financial foundation. In Wyoming, SSI approval automatically triggers Medicaid enrollment through the Section 1634 agreement — making SSI the typical entry point for the entire waiver system.

What HCBS Services Look Like in Wyoming

The services available through the waiver system are practical and community-focused:

Day habilitation — structured daytime programming that builds skills for community living, socialization, and activities of daily living.

Supported employment — job coaching, workplace support, and skills training to help individuals maintain competitive, integrated employment.

Respite care — temporary relief for primary caregivers, provided in the home or in a community setting.

Personal care — assistance with daily living activities like bathing, dressing, meal preparation, and medication management.

Community integration — support for participating in community activities, building social connections, and accessing public resources.

Targeted case management — the case manager coordinates services, schedules team meetings, and serves as the liaison between the family and state agencies. TCM is available even during the waitlist period, funded at up to 120 fifteen-minute units per plan year.

For the Comprehensive Waiver, add residential habilitation — 24/7 staffed living support, either in a provider-operated group home or through intensive in-home staffing.

The Provider Landscape

Wyoming's provider network is still recovering from the ARPA funding cliff. When enhanced federal matching funds expired in September 2025, the reimbursement rate for behavioral technician code 97153 dropped from $19.23 to $7.00 per unit. Private providers pulled out of rural counties across the state.

The 2026 legislature restored the rate to $19.23 effective July 2026, but the recovery is uneven. Urban areas (Cheyenne, Casper, Laramie) have more provider options. Rural and frontier areas may have few or no agency providers, pushing families toward the self-directed service model under Chapter 46, Section 12 — where a parent or guardian acts as Employer of Record and hires staff directly through ACES$, the state's Financial Management Service.

The state maintains an online DD Provider Search tool where families can find certified providers in their area. Once a funding slot is activated, the individual and their legally authorized representative select providers from this directory.

The Eligibility and Waitlist Structure

Getting onto the waiver requires a multi-step determination that's separate from basic Medicaid:

1. Contact your county Benefits and Eligibility Specialist
2. Select and submit a Case Manager Selection Form
3. Complete the LT-104 clinical assessment (DD) or LT-101 (ABI) within 30 days of case-manager selection
4. Complete a psychological or neuropsychological evaluation with a licensed, conflict-free, Medicaid-enrolled Wyoming clinician
5. Submit the financial eligibility packet to the Medicaid LTC Unit within 45 days of level-of-care approval

If eligible but no funding slot is available, you're placed on the Supports Waiver waitlist — chronological, first-come-first-served. As of mid-2025, 335 people were waiting, with projections reaching 415 by July 2026. The state postpones the ICAP assessment and Level of Service scoring until a slot actually opens, so families won't know their exact budget allocation while on the list.

The Wyoming SSI at 18 & Adult Disability Benefits Guide maps the complete waiver pathway from SSI approval through funded services, with the timeline and agency contacts at each step.

See more Wyoming guides →