(a) As used in this article:
(i) "Advisory committee" means the Wyoming rural health transformation advisory committee created in W.S. 35-25-703;
(ii) "Annual required distribution" means:
(A) Beginning July 1, 2026 and ending June 30, 2036, the greater of:
(I) The total program income, as defined in 2 C.F.R. § 200.1, earned during the previous fiscal year that is required to be expended under federal statutes, federal regulations or the terms and conditions of the Wyoming rural health transformation plan; or
(II) Four percent (4%) of the cumulative total of funds deposited into the perpetuity fund since inception, as calculated on the first day of each fiscal year.
(B) Beginning July 1, 2036 and each fiscal year thereafter, four percent (4%) of the previous five (5) year average market value of the perpetuity fund, as calculated on the first day of each fiscal year.
(iii) "Department" means the department of health;
(iv) "Perpetuity fund" means the Wyoming rural health transformation perpetuity fund created in W.S. 35-25-704;
(v) "Purpose-dedicated share" means a discrete fractional interest of the annual required distribution allocated to a specific allowable perpetuity fund expenditure authorized in W.S. 35-25-706;
(vi) "Rural health transformation funds" means federal funds awarded to the state of Wyoming under the federal rural health transformation program established by section 71401 of the federal One Big Beautiful Bill Act, P.L. 119-21;
(vii) "Wyoming rural health transformation plan" means the rural health transformation program application submitted to and approved by the federal government pursuant to section 71401 of the federal One Big Beautiful Bill Act, P.L. 119-21, and shall include any terms and conditions specified in any associated notice of award, cooperative agreement or similar federal instrument governing the receipt or use of funds, and any amendments thereto;
(viii) "Wyoming rural health transformation program" means the program established in W.S. 35-25-705.
35-25-703. Wyoming rural health transformation advisory committee; legislative liaisons.
(a) There is created the Wyoming rural health transformation advisory committee. The advisory committee shall be composed of nine (9) voting members, each of whom shall serve for a term of four (4) years. The governor shall make appointments and fill any vacancies for unexpired terms. Members are eligible for reappointment. The governor may remove any member as provided in W.S. 9-1-202.
(b) The director of the department or the director's designee and the director of the state budget department or the director's designee shall serve as ex officio members of the advisory committee, having the right to speak but not to vote.
(c) One (1) senator appointed by the president of the senate and one (1) representative appointed by the speaker of the house shall serve as nonvoting legislative liaisons to the advisory committee.
(d) The advisory committee shall select one (1) of its voting members to serve as chairman.
(e) The advisory committee shall meet not less than two (2) times per year.
(f) Voting members shall serve without compensation but shall be reimbursed for expenses incurred in the performance of their duties in the manner and amounts provided by law for state employees. Legislative liaisons shall be paid salary, per diem and mileage as provided in W.S. 28-5-101 when attending meetings of the advisory council.
(g) The advisory committee shall review the operations of the perpetuity fund and provide formal written recommendations to the department regarding the annual required distribution and allowable perpetuity fund expenditures. The department shall review any recommendations from the advisory committee and provide a written response.
(h) The advisory committee shall review and approve each grant, award or expenditure of rural health transformation funds in excess of five hundred thousand dollars ($500,000.00), excluding deposits into the perpetuity fund.
35-25-704. Wyoming rural health transformation perpetuity fund; investment; distributions.
(a) There is created the Wyoming rural health transformation perpetuity fund. The perpetuity fund shall consist of monies designated to the fund by law and other contributions, grants, gifts, bequests and donations made to the fund.
(b) The state treasurer, or the treasurer's designee, who shall be registered under the Investment Advisor's Act of 1940, as amended, if required to be registered by the terms of that act, as amended, shall invest the unobligated, unencumbered balance of the Wyoming rural health transformation perpetuity fund as authorized by law. Investments of the perpetuity fund shall be in accordance with subsection (c) of this section, if effective, and W.S. 9-4-715(a) and (c) through (e) and 9-4-716. All investment earnings shall be deposited to the perpetuity fund. In adopting investment policy statements for the perpetuity fund, the state loan and investment board, in consultation with the investment funds committee, shall seek to preserve the balance of the fund in a manner that strives for the highest possible risk-adjusted total net return consistent with an appropriate level of safety and liquidity to maintain a consistent annual required distribution.
(c) If this article is enacted by the legislature pursuant to the voting requirements of article 16, section 6(a)(ii)(B) of the Wyoming constitution, the state treasurer may invest the unobligated, unencumbered balance of the perpetuity fund in equities, including stocks of corporations.
(d) All monies deposited to the perpetuity fund, including investment earnings, shall be expended only for the allowable perpetuity fund expenditures authorized under the Wyoming rural health transformation program and in accordance with the terms and conditions under which the monies are received. Rural health transformation funds, and investment earnings thereon, expended in violation of the terms and conditions under which the monies are received shall be returned by the state to the federal source from which the monies originated.
(e) Each one million dollars ($1,000,000.00) of principal deposited to the perpetuity fund shall be allocated to one (1) purpose-dedicated share by the department, or fractional value thereof if a deposit is less than one million dollars ($1,000,000.00).
(f) The annual required distribution is continuously appropriated to the Wyoming rural health transformation expenditure account, which is hereby created. The state treasurer shall annually credit the annual required distribution to the expenditure account not later than September 30 of each year. Monies in the expenditure account shall only be expended by the department for allowable perpetuity fund expenditures under W.S. 35-25-706, the Wyoming rural health transformation plan and all other requirements and limitations specified in this article. Any unexpended, unobligated funds remaining from an annual required distribution, after a reasonable period for expenditure for which the funds were continuously appropriated, as recommended by the advisory committee and determined by the department, shall revert to the Wyoming rural health transformation perpetuity fund.
(g) Subject to W.S. 35-25-706(a), the total amount of the annual required distribution expended on each allowable perpetuity fund expenditure shall reasonably reflect the total number of purpose-dedicated shares initially allocated to that expenditure, divided by the total number of all purpose-dedicated shares in the perpetuity fund.
35-25-705. Wyoming rural health transformation program.
There is established the Wyoming rural health transformation program within the department. The department shall administer the program. The program shall be implemented in accordance with the Wyoming rural health transformation plan and shall be limited to the allowable perpetuity fund expenditures authorized in W.S. 35-25-706 and the time-limited initiatives authorized in W.S. 35-25-707. The department shall promulgate rules necessary to implement this section and the program.
35-25-706. Wyoming rural health transformation program; allowable perpetuity fund expenditures.
(a) Subject to the availability of funds, the department shall expend the annual required distribution solely for the allowable perpetuity fund expenditures authorized under this section. The allocation of purpose-dedicated shares and annually required distribution expenditures shall seek to achieve the percentage targets for support, grants and awards specified in this section. Upon a written recommendation of the advisory committee, the department may materially deviate from the percentage targets specified in this section to the extent necessary to meet documented need and demonstrated demand for the support, grants and awards specified in this section.
(b) Forty and seven-tenths percent (40.7%) of the annual required distribution shall be allocated for the critical access hospital basic incentive (CAHB) program. Under this program, the department shall provide incentive payments to hospitals that elect to participate and that meet service delivery requirements, subject to all of the following:
(i) A participating hospital shall operate a staffed twenty-four (24) hour emergency department with stroke and trauma imaging capability, provide or operate ground ambulance services within its service area, provide basic labor and delivery services if annual births exceed a threshold established by the department and participate in the statewide health information exchange;
(ii) Incentive payments under this subsection may include tiered payments, one (1) time grants, medical debt relief for Wyoming residents and ongoing payments to offset fixed costs.
(c) Twenty-six and nine-tenths percent (26.9%) of the annual required distribution shall be allocated for emergency medical service regionalization. After the submission of a statewide emergency medical services response time model to the joint labor, health and social services interim committee as provided in paragraph (i) of this subsection, the department shall provide incentive payments to emergency medical service providers that elect to participate and that meet regionalization requirements established by rule of the department, subject to the following:
(i) The department shall not require or implement emergency medical service regionalization under this subsection unless it first submits to the joint labor, health and human services interim committee a statewide emergency medical service response time model demonstrating no increase in emergency response times, staffing projections including volunteer impacts, inter-county governance and authority agreements and full cost estimates of regionalization, including long-term maintenance costs;
(ii) Eligibility for incentive payments under this subsection shall be limited to joint applications submitted by two (2) or more ground ambulance providers serving a contiguous rural or frontier region;
(iii) Joint applicants shall submit a regionalization plan to the department demonstrating maximization of revenue sources, integration with public safety answering points, use of interoperable equipment and technology, reduction of administrative overhead and commitment to community emergency medical services and tele-crisis stabilization services;
(iv) Incentive payments under this subsection shall include ongoing payments to offset fixed readiness costs and grants for ambulances, interoperability equipment and implementation of regional medical dispatch.
(d) Twenty-one and six-tenths percent (21.6%) of the annual required distribution shall be allocated for workforce education individual support. The department shall administer awards to individual persons for health care workforce education and training costs, including tuition, fees and stipends, subject to the following:
(i) Awards under this subsection shall be used to pay allowable education and training costs for eligible applicants pursuing credentials in one (1) or more of the following fields:
(A) Nursing, including certified nursing assistant, licensed practical nurse, registered nurse and advanced practice registered nurse programs;
(B) Emergency medical services, including emergency department technician, emergency medical responder, emergency medical technician and paramedic programs;
(C) Clinical behavioral health professions;
(D) Physician education, including undergraduate medical education.
(ii) As a condition of receiving an award under this subsection, an applicant shall agree to provide health care services in Wyoming for a minimum of five (5) years following completion of the approved program, under terms and conditions established by the department;
(iii) An applicant who fails to satisfy the service obligation required under paragraph (ii) of this subsection shall be required to repay to the department all or a prorated portion of the award, together with any applicable interest, as determined by rule of the department.
(e) Ten and eight-tenths percent (10.8%) of the annual required distribution shall be allocated for physician post-graduate medical education (GME) individual support. The department shall administer awards to individuals for physician medical education, including residency and fellowship training costs, subject to the following:
(i) In awarding funds under this subsection, the department shall prioritize awards to applicants in programs that will increase the supply of family medicine physicians and that provide training in obstetrics or other high-demand specialties, as determined by the department;
(ii) As a condition of receiving an award under this subsection, an applicant shall agree to provide health care services for a minimum of five (5) years in one (1) or more underserved counties within the state, under terms and conditions established by rule of the department.
35-25-707. Wyoming rural health transformation program; time-limited initiatives; sunset.
(a) Subject to the availability of rural health transformation funds and subsection (b) of this section, the department is authorized to expend funds for time-limited initiatives in amounts that seek to achieve the following percentage targets:
(i) Thirty-six and four-tenths percent (36.4%) of amounts available for time-limited initiatives for integrated primary care. Expenditures under this paragraph shall be for competitive grants to expand the number and geographical reach of federally qualified health centers in the state through conversion of existing facilities and practices for the integration of primary care delivery models that coordinate primary medical care with behavioral health services, obstetric and gynecological care, dental services and preventive health services;
(ii) Fifteen and one-tenths percent (15.1%) of amounts available for time-limited initiatives for a technology adoption challenge program. Expenditures under this paragraph shall be for competitive grants for health care technology procurement. Grants under this paragraph shall be awarded only to joint applications submitted by two (2) or more health care providers and shall be limited to projects that improve care delivery closer to patients' homes, enhance interoperability and coordination among providers and reduce administrative activity;
(iii) Nine and eight-tenths percent (9.8%) of amounts available for time-limited initiatives for exercise and diet programs. Expenditures under this paragraph shall be for competitive grants to Wyoming-based entities to promote physical activity and healthy nutrition. Projects that demonstrate measurable increases in participation in exercise, outdoor recreation or evidence-based nutrition practices shall be prioritized for the grants under this paragraph;
(iv) Eight and two-tenths percent (8.2%) of amounts available for time-limited initiatives for a statewide tele-specialist platform. Expenditures under this paragraph shall be for the procurement and operation of a centralized tele-specialty platform to deliver physician-level specialty consultations to health care providers statewide;
(v) Eight and two-tenths percent (8.2%) of amounts available for time-limited initiatives for workforce education startup costs. Expenditures under this paragraph shall be for competitive grants to support health care workforce training programs operated by educational institutions within the state. Grants under this paragraph shall be awarded to recipients that commit to establishing and maintaining a specified number of training positions for nurses, emergency medical service personnel, physicians, clinical behavioral health providers and other health care professionals;
(vi) Eight and two-tenths percent (8.2%) of amounts available for time-limited initiatives for care coordination. Expenditures under this paragraph shall be for competitive grants to hospitals, health care providers and rural health facilities to propose clinically integrated care coordination models for one (1) or more counties to improve the management of chronic disease among persons who are dually eligible for Medicare and Medicaid and who are identified as high risk. Funding awarded under this paragraph may include capped start-up costs, a per-member, per-month care coordination payment for assigned persons and performance-based payments tied to demonstrated cost savings;
(vii) Four and nine-tenths percent (4.9%) of amounts available for time-limited initiatives for centralized billing capacity. Expenditures under this paragraph shall be for centralized billing and revenue collection services for voluntarily participating emergency medical services agencies. This centralized billing capacity initiative may be expanded to other health care providers if the initiative demonstrates effectiveness and financial sustainability;
(viii) Two percent (2.0%) of amounts available for time-limited initiatives for a nonemergency transportation coordination platform. Expenditures under this paragraph shall be for the procurement and operation of a centralized nonemergency medical transportation coordination platform to improve access to health care appointments for seniors, persons with disabilities and other eligible populations. The platform shall facilitate the scheduling, coordination and billing of nonemergency transportation;
(ix) Two and six-tenths percent (2.6%) of amounts available for time-limited initiatives for administration. Expenditures under this paragraph include any administrative costs necessary to implement the rural health transformation program, including expenses of the advisory committee;
(x) Four and six-tenths percent (4.6%) of amounts available for time-limited initiatives included in the Wyoming rural health transformation plan that are not specifically authorized in this subsection shall be redistributed for expenditure on the initiatives authorized under this subsection.
(b) Upon a written recommendation of the advisory committee, the department may materially deviate from the percentage targets specified in subsection (a) of this section to the extent necessary to meet documented need and demonstrated demand for the time-limited initiatives specified in subsection
(a) of this section.
(c) The authority to administer the time-limited initiatives and any funds for the initiatives under subsection
(a) of this section shall terminate upon exhaustion of all rural health transformation funds appropriated or otherwise made available for the initiatives specified in subsection (a) of this section.
(a) In addition to any other limitations imposed by state or federal law, no expenditure of rural health transformation funds shall be made for abortions or for specified sex-trait modification procedures, as defined in 45 C.F.R. § 156.400.
(b) Each grant, award or expenditure of rural health transformation funds in excess of five hundred thousand dollars ($500,000.00) shall require written approval of the advisory committee and notice to the legislature not less than ten (10) days prior to authorization of the grant, award or expenditure. For authorized perpetuity fund expenditures, the notice shall identify the proposed recipient, amount, purpose and material terms of the grant, award or expenditure. For time-limited initiatives, legislative notice shall be satisfied by the department providing written notice to the joint appropriations committee in a manner similar to the process specified in W.S. 9-2-1005(b)(ii) and 9-2-1013(b).
(c) The state budget department, in consultation with the department, shall develop and maintain an electronic reporting portal to provide current information on expenditures and program activity of rural health transformation funds.
35-25-709. Recipient reporting; performance and accountability agreements; repayment.
(a) The department shall require each recipient of funds under the Wyoming rural health transformation program to submit reports sufficient to demonstrate compliance with applicable state and federal requirements. At a minimum, required reporting shall include detailed expenditure information, performance measures and documentation demonstrating the authorized use of funds.
(b) The department shall require each recipient hospital, clinic, emergency medical service provider or other health care-related organization receiving funds under the programs authorized in W.S. 35-25-706 to enter into a written performance and accountability agreement with the department. At a minimum, the agreement shall include requirements relating to:
(i) Operating margin targets;
(ii) Days cash on hand;
(iii) Liquidity ratio benchmarks;
(iv) The adoption of modernization and efficiency practices, including improved revenue cycle management systems;
(v) The development and implementation of a plan to reduce unprofitable, duplicative or nonessential service lines;
(vi) Participation in shared services, regional collaboration or other cost-containment arrangements where feasible; and
(vii) Submission of independent financial audits to the department for annual collection and transmittal to the joint appropriations committee.
(c) A recipient of funds under the Wyoming rural health transformation program that fails to comply with a requirement, condition or obligation imposed by statute, rule or performance and accountability agreement, or that fails to meet required performance targets, misuses funds, expends funds for purposes not authorized under state or federal law or fails or refuses to implement required operational reforms, shall repay to the department all or a prorated portion of the funds received, as determined by the department. The department may recover amounts owed under this subsection by any means authorized by law.
(a) As used in this article:
(i) "Automated external defibrillator (AED)" means a medical device heart monitor and defibrillator that:
(A) Has received approval of its premarket notification filed pursuant to U.S. Code, title 21, section 360(k) from the U.S. Food and Drug Administration;
(B) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and is capable of determining, without intervention by an operator, whether defibrillation should be performed; and
(C) Upon determining that defibrillation should be performed, automatically charges and delivers, or requests delivery of, an electrical impulse to an individual's heart.
35-26-102. Possession of automated external defibrillator.
(a) In order to ensure public health and safety, all persons who possess an AED shall:
(i) Obtain appropriate training in cardiopulmonary resuscitation (CPR) and in the use of an AED by the American Heart Association, American Red Cross or by another nationally recognized, or Wyoming department of health recognized, course in CPR and AED use and maintains currency through refresher training every two (2) years; and
(ii) Ensure that the AED is maintained and tested according to the manufacturer's guidelines.
(iii) Repealed by Laws 2005, ch. 89, § 2.
(b) Any person or entity in possession of an AED shall notify an agent of the emergency communications center and the local ambulance service of the existence, location and type of AED.
35-26-103. Limited liability for use of automated external defibrillator.
(a) Any person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical emergency, any prescribing physician who authorizes the purchase of the AED and any individual who provides training in cardiopulmonary resuscitation (CPR) in the use of an AED shall be immune from civil liability for any harm resulting from the use or attempted use of such device, unless the harm involved was caused by willful or criminal misconduct, gross negligence, reckless misconduct or a conscious, flagrant indifference to the safety of the victim who was harmed.
(b) Any person responsible for the site where the AED is located shall be immune from civil liability for any personal injury that results from any act or omission of acts that do not amount to willful or wanton misconduct or gross negligence if that person complies with the requirements of W.S. 35-26-102.
(c) Any clinical use of the AED shall be reported to the licensed physician.
(a) As used in this act:
(i) "Department" means the Wyoming department of health;
(ii) "TANF" means the federal temporary assistance to needy families program authorized by Pub. L. 104-193;
(iii) "Program" means the public health nursing infant home visitation subprogram created by this act;
(iv) "This act" means W.S. 35-27-101 through 35-27-104.
35-27-102. Public health nursing infant home visitation subprogram created; eligibility.
(a) There is created the public health nursing infant home visitation subprogram.
(b) Pregnant women, or families with infants, are eligible for services of the program if:
(i) The delivery of the newborn or the prenatal care is paid for, or is eligible to be paid for, under the Wyoming Medical Assistance and Services Act or the woman is eligible for services under the women's, infants' and children's supplemental food program;
(ii) The mother is confined to a county jail, the Wyoming women's center or any other correctional facility in the state, or is on probation or parole as a result of a conviction of a criminal offense;
(iii) The mother has a mental illness or substance abuse problem and is an inpatient at the Wyoming state hospital, a psychiatric hospital or an inpatient treatment facility, or is referred for services by a community mental health center; or
(iv) The mother is a victim of domestic abuse.
(c) The services provided under the program shall ordinarily be available only until the infant has attained twenty-four (24) months of age, but may be extended by the public health nurse to an older age in cases of special need.
(d) The program shall:
(i) To the extent practical and needed, provide prenatal contacts and follow-up contacts with each eligible pregnant woman. If another agency or program is actually performing adequate prenatal contacts, the program created under this act shall defer to that agency or program, or develop an agreement on a county by county or region by region basis as to which program will provide the contacts to avoid duplication;
(ii) To the extent needed where there were prenatal contacts, and to the extent practical where adequate contact was not made with the eligible mother prior to delivery, as soon as practical after the mother and infant return to their home, conduct a welcome home visit for the infant in the family home. During the welcome home visit, the public health nurse may, as appropriate:
(A) Provide information in written, audio or video format on the care and nurturing of infants;
(B) Provide information on recommended immunizations;
(C) Provide available supplies and equipment useful in the caring for infants. The public health nurses may accept donations of such supplies and equipment; and
(D) Assess the infant and the infant's circumstances in accordance with departmental instructions and protocols and, as needed, plan follow-up visits and services and refer the mother to other community or governmental resources, programs and providers.
(e) The department shall:
(i) Establish home visitation subprograms within available resources and shall initially use the following implementation priorities in case of shortage of resources:
(A) First time pregnant women under the age of twenty (20) years who are eligible for assistance under the Wyoming Medical Assistance and Services Act or the women's, infants' and children's supplemental food program;
(B) Any pregnant woman or family in need of the services of the program who is referred by an attending physician;
(C) First time births to women who, regardless of age, are eligible for assistance under the Wyoming Medical Assistance and Services Act or the women's, infants' and children's supplemental food program;
(D) Premature births;
(E) Victims of domestic abuse;
(F) Pregnant women or mothers with a mental illness or substance abuse problem;
(G) Pregnant women or mothers confined to a county jail, the Wyoming women's center or any other correctional facility in the state, or on probation or parole as a result of a conviction for a criminal offense; and
(H) Subsequent pregnancies and births where the woman or family is eligible for assistance under the Wyoming Medical Assistance and Services Act or the women's, infants' and children's supplemental food program.
(ii) Modify the priority list required under paragraph (i) of this subsection as needed;
(iii) Develop or specify protocols for public health nurses to use in the program;
(iv) Provide training for the nurses conducting the visits; and
(v) Where a county or municipal health department or health district exists, contract with the governing body of that department or district:
(A) For the provision of the program's services; or
(B) To provide the public health nurses to conduct the program.
(f) The department may subcontract with providers of research based, nonnurse models for home visiting services, as appropriate and indicated by client assessment, to secure the most effective services available for the eligible populations.
(g) The public health nurses responsible for each county shall jointly for that county develop a list of programs, resources and providers to whom referrals may be made and the types of referrals that may be made to each entity. The lists shall be reviewed at least annually with the county health officer, the manager of the department of family services field office serving the county, the preschool developmental disability program serving the county and the county or municipal human services agency or coordinator, if any.
(h) Any physician providing prenatal care or delivering a baby where the care or delivery is eligible for reimbursement under the Wyoming Medical Assistance and Services Act may, unless contraindicated, refer the expectant mother or the infant to the public health nurse serving the county for placement in the program. Physicians may refer other pregnant women, infants or families to the program as medically needed. The referrals shall begin once the program is operational within the county.
35-27-103. Program evaluation and statistical information.
(a) It shall be the goal of the program in each county to provide appropriate nursing contact to all eligible women. The department shall statistically track, in order to provide trending reports as needed, the number of known eligible births, the number receiving appropriate contacts, the number of women needing follow-up services and the number who did not receive follow-up services broken down by cause as follows:
(i) The number who refused service;
(ii) The number who did not receive follow-up services due to lack of resources;
(iii) The number who did not receive services for other reasons, which reasons may be specified to the extent useful.
(b) If the report required under subsection (a) of this section shows that appropriate contacts were not made for ninety-five percent (95%) of the eligible births, or less than seventy-five percent (75%) of the women needing follow-up services received them, the department shall provide a written explanation of the reasons why the goals and objectives of the program under this section were not met.
(c) The department shall collect statistics to the extent practical to permit evaluation of the success of the program in achieving the reduction:
(i) In abuse of the infants;
(ii) Of subsequent out of wedlock pregnancies by the visited mothers;
(iii) In problems resulting from substance abuse;
(iv) In number of arrests among mothers under the program;
(v) In the use of tobacco products by mothers under the program;
(vi) In violent and anti-social behavior by infants under the program once they reach adolescence and young adulthood, as measured by arrests and convictions.
The department shall report to the legislature any reduction in federal temporary assistance to needy families (TANF) program funds which results in the need for additional state funds to administer W.S. 35-27-101 through 35-27-104. The provisions of W.S. 35-27-101 through 35-27-104 shall not be effective one hundred eighty (180) days after the adjournment of the legislative session next following the submission of the report, unless the legislature appropriates the additional funds required.
(a) As used in this act:
(i) "Bathhouse" means a structure that contains dressing rooms, showers and toilet facilities for use with an adjacent public pool;
(ii) "Department" means the Wyoming department of agriculture;
(iii) "Director" means the director of the Wyoming department of agriculture or his duly authorized representative;
(iv) "Imminent health hazard" means a significant threat or danger to health when there is evidence sufficient to show that a product, practice, circumstance or event creates a situation that requires immediate correction or cessation of operation to prevent injury based on:
(A) The number of potential injuries; and
(B) The nature, severity and duration of the anticipated injury.
(v) "Local health department" means a health department established by a county, municipality or district pursuant to W.S. 35-1-301 et seq.;
(vi) "Person" means municipalities, recreation boards of trustees, counties, state agencies, individuals, corporations, partnerships, enterprises or associations;
(vii) "Pool" means an artificial structure containing water used for swimming, bathing, diving, surfing, wading or a similar use and operated by an owner, lessee, operator, licensee or concessionaire regardless of whether a fee is charged for use;
(viii) "Public pool" means a pool that is open to the public or a segment of the public;
(ix) "Regulatory authority" means the authority which issued the license or adopted the rule or regulation being enforced including the department of agriculture or local health department;
(x) "Spa" means a bathing facility including, but not limited to, a hot tub or whirlpool designed for recreational or therapeutic use and not designed to be drained, cleaned and refilled for each use. Spas are designed to provide a means of agitation, which may include, but is not limited to, hydro jet circulation, hot water, cold water, mineral baths, air induction systems or any combination thereof;
(xi) "Swimming pool" means a body of water, other than a natural swimming area, maintained exclusively for swimming, recreative bathing or wading, and includes appurtenances used in connection with the swimming pool;
(xii) "Waterborne disease outbreak" means the occurrence of two (2) or more cases of a similar illness resulting from the ingestion of water from a common water source;
(xiii) "Waterborne illnesses" means illnesses caused by microorganisms, including, but not limited to, cryptosporidium, giardia, pseudomonas, E. coli 0157:H7 and shigella and spread by accidentally swallowing water that has been contaminated with fecal matter;
(xiv) "This act" means W.S. 35-28-101 through 35-28-110;
(xv) "Flow-through pool" means an artificial or partially artificial pool that depends on the natural flow of water to maintain adequate water quality.
(a) The director shall establish and maintain a public pool and spa health and safety program. The director shall carry out provisions of the public pool and spa health and safety program and shall be assisted by the department of health. A local department of health, if established according to law, may establish and maintain its own local public pool and spa health and safety program so long as the program meets the requirements of this act and regulations adopted pursuant to this act. The director or his designee shall:
(i) Gather health and safety information related to public pools and spas and disseminate the information to the public, public pool or spa industry and local departments of health which have implemented a health and safety program;
(ii) On a voluntary basis, provide health and safety training for the pool and spa industry in this state, and work with other state, local and federal agencies to coordinate public health and safety educational efforts;
(iii) Regulate the health and safety of public pools and spas. In any area which does not have a local public health and safety program established pursuant to law, the department shall issue licenses, conduct inspections and hold hearings to enforce any legal provision or rule adopted under this act;
(iv) Maintain a statewide database of public pool and spa license and inspection results;
(v) Work with federal, state and local agencies to coordinate public health and safety efforts and activities related to public pools and spas and coordinate with all other agencies to maintain consistency in inspection and enforcement activities;
(vi) Establish health and safety priorities related to public pools and spas for this state;
(vii) Provide laboratory support if needed for the analysis of water samples used to support inspection activities and to monitor health and safety;
(viii) Provide support for local health and safety programs related to public pool and spa programs as authorized by the legislature;
(ix) Take appropriate action against any person holding a public pool and spa license for the purpose of protecting the public health and preventing the transmission of infectious disease.
(b) The director of the department of health or his designee shall:
(i) Investigate all possible waterborne illnesses and outbreaks and request assistance from the department of agriculture and local health departments as necessary;
(ii) Provide support for local health and safety programs related to public pool and spa programs as authorized by the legislature;
(iii) Provide laboratory support for water inspection and accompanying monitoring activities for the health and safety of a public swimming pool or spa.
(c) Duties of a local health department shall include:
(i) Issuing licenses, conducting inspections, holding hearings and taking enforcement actions as necessary to carry out the provisions of the health and safety program related to public pools and spas;
(ii) Coordinating activities with the department of agriculture in order to provide for statewide consistency; and
(iii) Reporting to the department of health any waterborne outbreak of illness and assisting the department of health in any outbreak investigations if requested.
(d) A local jurisdiction may provide laboratory support for water inspection and accompanying monitoring activities for the health and safety of a public swimming pool or spa.
(a) If the director of the department of agriculture or the director of the department of health has probable cause to believe that an imminent hazard to the public exists from a violation of this act, he may order any person to immediately cease the practice believed to be a violation of this act and shall provide the person an opportunity for hearing pursuant to the Wyoming Administrative Procedure Act within ten (10) days after issuing the order.
(b) In addition to any other remedies, the director may apply to the district court for injunctive relief from any person who violates this act.
Any person who knowingly and intentionally violates any provision of this act or regulation adopted pursuant to this act is guilty of a misdemeanor punishable by imprisonment for not more than six (6) months, a fine of not more than seven hundred fifty dollars ($750.00), or both.
The director may adopt regulations necessary for the efficient enforcement of this act and to ensure that appropriate sanitary conditions, public safety and water quality standards are met by any person engaged in operating a public pool or spa.
(a) For purposes of enforcement of this act, the director may, upon presenting appropriate credentials to the owner, operator or agent in charge:
(i) Enter at a reasonable time any public pool or spa; and
(ii) Inspect at any reasonable time and within reasonable limits and in a reasonable manner any public pool or spa and all pertinent equipment, finished and unfinished materials and obtain samples necessary for the enforcement of this act. The frequency of inspections shall be based on the relative risk to public health and safety, with no such facility receiving less than one (1) inspection per year.
(b) Upon completion of any inspection under this section but before leaving the premises, the director shall give to the owner, operator or agent in charge a report in writing setting forth any conditions or practices observed by him which in his judgment indicate that any public pool or spa:
(i) Is not being maintained in whole or in part in a clean and sanitary condition, in good repair and free of safety hazards;
(ii) Through testing, contains water which does not comply with the requirements set forth in the regulations;
(iii) Is failing to meet generally accepted health practices for pool and spa operation in compliance with the laws and rules pertaining to public pools and spas;
(iv) Is failing to keep and maintain records pertaining to the operation and maintenance of the public pool or spa as required by the regulations.
(a) Any person operating a public pool or spa shall obtain a license from the department of agriculture or a local health department and shall be thoroughly knowledgeable on good practices of swimming pool and spa operation and with the laws and rules pertaining to public swimming pools, spas and similar installations. The license is not transferable, shall be renewed on an annual basis and shall be prominently displayed in the facility. No public pool or spa shall operate without a valid license.
(b) Written application for a new license shall be made on a form approved by the department of agriculture and provided by the department of agriculture or the local health department and shall be signed by the applicant. An initial license fee of one hundred dollars ($100.00) shall accompany each application. All licenses shall expire June 30 of each year unless suspended, revoked or renewed. Licenses shall be renewed each year upon application to the department accompanied by a fee of fifty dollars ($50.00). Any public pool or spa which has a license on the effective date of this section shall pay a fee of fifty dollars ($50.00) for the following year and shall not be liable to pay the initial license fee of one hundred dollars ($100.00).
(c) Fees collected under this section shall be deposited in a special account within the department of agriculture's consumer health services food and license account and distributed monthly as follows:
(i) In any county, city or district without a local health department established pursuant to W.S. 35-1-301 et seq., the department of agriculture shall receive ninety percent (90%) of the fee collected and the department of health shall receive ten percent (10%). The revenues received by the department of agriculture under this paragraph shall be used to defray the cost associated with the public health and safety program related to public pools and spas;
(ii) In any county, city or district with a local health department established pursuant to W.S. 35-1-301 et seq., the local health department shall receive eighty-five percent (85%) of the amount of the fee collected, the department of agriculture shall receive ten percent (10%) and the department of health shall receive five percent (5%). The revenues received by the department of agriculture under this paragraph shall be used to defray the cost associated with the public health and safety program related to public pools and spas.
(d) Before approving an application, the department of agriculture or the local health department shall determine that the facility is in compliance with this act and any regulations adopted pursuant to this act.
(e) The director may allow the licensing, testing, inspection and reporting requirements of this chapter to be conducted electronically as provided by the Uniform Electronic Transaction Act, W.S. 40-21-101 through 40-21-119 and any applicable federal electronic requirements.
(a) A regulatory authority may summarily suspend a license to operate a public pool or spa if it determines through inspection, water quality testing, records or other authorized means, or after consultation with the state health officer, that an imminent health hazard exists including, but not limited to, fire, flood, extended interruption of electrical or water service, sewage backup or waterborne illness or disease.
(b) The regulatory authority may summarily suspend a license by providing written notice of the summary suspension to the license holder or the person in charge without prior warning, notice of a hearing or a hearing.
(c) The regulatory authority shall conduct an inspection of the facility for which the license was summarily suspended within forty-eight (48) hours after receiving notice from the license holder stating that the conditions cited in the summary suspension order no longer exist.
(d) A summary suspension shall remain in effect until the conditions cited in the notice of suspension no longer exist and their elimination has been confirmed by the regulatory authority through reinspection and other means as appropriate. A suspended license shall be reinstated immediately if the regulatory authority determines that the imminent health hazard no longer exists. A notice of reinstatement shall be provided to the license holder or person in charge of the facility.
(a) A regulatory authority may initiate revocation proceedings for a license by serving a complaint signed by the director or the director of a local department of health. The application shall be accompanied by an affidavit of the director or director of the local department of health stating:
(i) The condition for the summary suspension has not been corrected;
(ii) There is a history of noncompliance with this act or the regulations adopted under this act; or
(iii) There was a refusal to grant access to the regulatory authority.
(b) If requested, the regulatory authority shall provide notice and hold a hearing on any revocation proceeding in accordance with the provisions of the Wyoming Administrative Procedure Act, W.S. 16-3-101 et seq.
(c) If, upon completion of the hearing and consideration of the record, the department of agriculture or local department of health finds that the conditions present at the facility pose an imminent health hazard, there is a history of noncompliance with this act or the regulations adopted under this act or there was a refusal to grant access to the regulatory authority, the regulatory authority shall issue an order of license revocation which shall include findings of fact and conclusions of law, and findings of actions necessary to cure the causes leading to the revocation.
(d) The decision of the regulatory authority may be appealed to the district court pursuant to the Wyoming Administrative Procedure Act, W.S. 16-3-101 et seq.
(a) As used in this act:
(i) "Aftercare" means any assistance provided by a designated caregiver to a patient pursuant to this act after the patient's discharge from a hospital. Assistance under this act may include the performance of tasks necessary for the treatment of the patient's condition at the time of discharge and which do not require a licensed professional;
(ii) "Caregiver" means any person eighteen (18) years of age or older, including next of kin, duly designated as a caregiver pursuant to the provisions of this act who provides aftercare to a patient in the patient's residence;
(iii) "Discharge" means a patient's exit or release from a hospital to the patient's residence following any inpatient stay;
(iv) "Hospital" means as defined by W.S. 35-2-901(a)(xiii);
(v) "Representative of the patient" means any person who:
(A) Is a legal guardian;
(B) Holds a medical or legal power of attorney; or
(C) Is a representative named in an advance care directive in Wyoming or other similar law in another state.
(vi) "Residence" means a dwelling considered by a patient to be his home, but does not include:
(A) A hospital;
(B) A nursing care facility as defined by W.S. 35-2-901(a)(xvi); or
(C) An assisted living facility as defined by W.S. 35-2-901(a)(xxii).
(vii) "This act" means W.S. 35-30-101 through 35-30-106.
35-30-102. Designation of caregivers by hospital patients.
(a) Hospitals shall provide each patient or the representative of the patient with an opportunity to designate one (1) caregiver following the inpatient admission at the hospital and prior to the patient's discharge to the patient's residence or to another place:
(i) In the event the patient is unconscious or otherwise incapacitated upon admission to the hospital, the hospital shall provide the representative of the patient with an opportunity to designate a caregiver to care for the patient so long as the designation or lack of a designation does not interfere with, delay or otherwise affect the medical care provided to the patient;
(ii) In the event the patient or the representative of the patient declines to designate a caregiver under this act, the hospital shall document that determination in the patient's medical record and the hospital shall be deemed to be in compliance with the provisions of this act;
(iii) In the event that the patient or the representative of the patient designates an individual as a caregiver under this act, the hospital shall promptly request the written consent of the patient or the representative of the patient to release personal health information pertinent to the patient's designated caregiver pursuant to the hospital's established procedures for releasing personal health information and in compliance with applicable state and federal law;
(iv) If the patient or the representative of the patient declines to consent to the release of personal health information to the patient's designated caregiver, the hospital is not required to provide notice to the caregiver as provided in W.S. 35-30-103 and shall not release personal health information;
(v) The hospital shall record the patient's designation of a caregiver, the relationship of the caregiver to the patient and the name, telephone number and physical address of the patient's designated caregiver, if available, in the patient's medical record.
(b) A patient or representative of the patient may elect to change the designated caregiver.
(c) Designation of a caregiver by a patient or a representative of the patient pursuant to the provisions of this act shall not obligate any individual to perform any aftercare tasks for the patient.
(d) This section shall not be deemed to require a patient or a representative of the patient to designate any individual as a caregiver under this act.