Wyoming Supports Waiver: Application, Eligibility, and Waitlist

What the Supports Waiver Covers

Wyoming's Supports Waiver funds community-based services for individuals with intellectual or developmental disabilities (all ages) and adults aged 21-64 with acquired brain injuries. It provides an individualized budget for services like day habilitation, supported employment, respite care, community integration, and personal care — but it does not fund 24/7 residential care. That's the Comprehensive Waiver's territory.

The waiver is administered by the Wyoming Department of Health's Developmental Disabilities Section under Chapter 46 of the state's Medicaid rules. Unlike basic Medicaid (which covers doctor visits, prescriptions, and hospital care), waiver services are the hands-on daily supports that help adults with disabilities live in their communities.

How to Apply: The Step-by-Step Process

You don't apply for the Supports Waiver directly. The pathway runs through your county Benefits and Eligibility Specialist, and it requires active Medicaid eligibility — which in Wyoming means you typically need SSI approval first.

Step 1: Contact your county BES. The Benefits and Eligibility Specialist is your entry point. They'll verify your Medicaid status and provide a list of certified case managers in your area.

Step 2: Choose a case manager. Interview candidates from the BES list. This person will manage your waiver application, coordinate services, and serve as your primary contact with the state system for years. Submit the signed Case Management Selection Form to the Division.

Step 3: Clinical evaluation (within 30 days of case-manager selection). Your case manager submits the LT-104 assessment for developmental disabilities (or coordinates the LT-101 with a Public Health Nurse for acquired brain injuries) to establish that the individual meets institutional level of care. A licensed, conflict-free, Medicaid-enrolled Wyoming clinician must complete the required psychological or neuropsychological evaluation.

Step 4: Financial eligibility packet (within 45 days of level-of-care approval). The case manager submits financial documentation to the Medicaid Long-Term Care Unit. The individual's income must be below $2,982 per month (300% of the FBR), and countable resources must be under $2,000.

Step 5: Receive the eligibility determination. The state issues a letter confirming clinical and financial eligibility. If funding is available, you proceed directly to service planning. If not, you're placed on the waitlist.

The Waitlist Reality

Wyoming's Supports Waiver waitlist is chronological and first-come, first-served. Your position is determined by the date you're found eligible — not the date you first contacted the BES or the date you submitted paperwork. If two applicants share an eligibility date, priority goes to whoever submitted their Case Manager Selection Form first.

As of mid-2025, 335 individuals were on the waitlist: 263 children with I/DD, 68 adults with I/DD, and 4 adults with acquired brain injuries. The state projects the list will grow to 415 by July 2026. The estimated per-person funding cost is $30,000 for the biennium, and the 2026 legislature appropriated $9 million for new slots.

There's no published timeline for how long you'll wait. It depends entirely on legislative funding cycles and how many current participants leave the waiver (through moves out of state, institutionalization, or death). Families report waits of one to several years.

What Happens While You Wait

Being on the waitlist doesn't mean you're left with nothing, but the available supports are limited.

Your case manager can bill for Targeted Case Management services — up to 120 fifteen-minute units per plan year, funded by state dollars. TCM covers team meetings, coordination with schools and other agencies, and help accessing non-waiver resources. It doesn't fund direct services like personal care or respite.

During the wait, families need to maintain continuous Medicaid eligibility and document unmet needs. When a funded slot opens, the state conducts the ICAP assessment and calculates the Level of Service score at that point — not before. Wyoming specifically postpones this assessment because clinical needs change during the wait period. This means you won't know your child's exact waiver budget until a slot is funded and assigned.

Three things that can terminate waiver eligibility after enrollment: not receiving any active waiver services for three consecutive months, being institutionalized for 30 or more consecutive days, or moving your permanent residence to another state (or residing out of state for six consecutive months).

Finding Providers

Once a funding slot opens, you'll select providers from the state's DD Provider Search tool. But Wyoming's provider network has gaps — especially in rural counties. The ARPA funding expiration in September 2025 caused the reimbursement rate for behavioral technician code 97153 to drop from $19.23 to $7.00 per unit, which gutted the private provider network. The 2026 legislature restored the rate to $19.23 effective July 2026, but the recovery is still uneven.

If direct-service providers aren't available in your area, the self-directed service delivery model under Chapter 46, Section 12 lets the family member act as Employer of Record and contract with the state's Financial Management Service (ACES$) to hire and manage their own support staff.

The Wyoming SSI at 18 & Adult Disability Benefits Guide walks through the complete waiver application process with timeline worksheets and the agency contacts you need at each step.

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