(a) As used in this title:
(i) "Applicant" means any person applying for benefits under programs provided pursuant to this title;
(ii) "Department" means the department of family services unless otherwise specified;
(iii) Repealed by Laws 1991, ch. 161, § 4.
(iv) "Field office" means each field office of the department located within each county or region of the state;
(v) "Recipient" means any person receiving benefits under programs provided pursuant to this title.
(a) If any provision of this title or W.S. 14-2-1001 through 14-2-1008 is found to be in conflict with federal law or to come in conflict with federal law due to new federal enactments, the department shall:
(i) Follow the state rather than the federal law to the extent possible without incurring federal sanctions;
(ii) Seek any waivers from the federal government which appear to be appropriate and feasible to permit continued use of the provisions of state law;
(iii) Notify the joint labor, health and social services interim committee and the legislature of the conflict and the steps necessary to resolve the conflict; and
(iv) If necessary to avoid federal sanctions with significant adverse effects on the state or the people of Wyoming, implement the federal law until sixty (60) days after the end of the general or budget legislative session following the discovery of the conflict. This period may be extended by the governor until sixty (60) days after the end of the next legislative session if a waiver request is pending before the appropriate federal agency at the start of a legislative session.
(a) Except as otherwise specifically provided, as used in this article:
(i) "Commodities" means foods donated or available for donation by the department;
(ii) "Coupon" means any coupon, stamp or other type of certificate provided for the purchase of eligible food as defined by the supplemental nutrition assistance program;
(iii) "Electronic benefit transfer" means a system for the supplemental nutrition assistance program as an alternative to issuing a supplemental nutrition assistance program card. An electronic benefit transfer system is a computer-based system in which the benefit authorization is received through a point of sale terminal. Eligible households utilize plastic cards in lieu of supplemental nutrition assistance program coupons to purchase food items at authorized food retailers. This type of benefit may also be used to issue other types of public welfare benefits;
(iv) "Supplemental nutrition assistance program benefit" means assistance provided by the supplemental nutrition assistance program to eligible households in the form of coupons, electronic benefit transfers or cash that are redeemable at federally approved food retailers;
(v) "Performance payment" means an amount payable to or on behalf of an eligible recipient;
(vi) "Public assistance" means financial assistance in the form of a performance payment, vendor payment, supplemental nutrition assistance program benefits or a payment under the minimum medical program;
(vii) "Public welfare benefit" means financial assistance provided to eligible persons in the form of a performance payment, vendor payment, supplemental nutrition assistance program benefit, electronic benefit transfer or cash. These benefits may be received from several state or federal welfare programs including:
(A) Medicaid;
(B) Repealed by Laws 2017, ch. 108, § 2.
(C) Repealed by Laws 2017, ch. 108, § 2.
(D) Low income energy assistance program;
(E) Minimum medical program;
(F) Child care program;
(G) Personal opportunities with employment responsibilities (POWER);
(H) Supplemental nutrition assistance program.
(viii) "Social services" mean services specifically authorized by the legislature, defined by the comprehensive social services plan of the department and provided or purchased in accordance with this act;
(ix) "Approved educational program" means any program at the University of Wyoming or a Wyoming community college leading to a baccalaureate, associate degree, or certificate at the school or a vocational program approved by the department, or other accredited educational program within Wyoming leading to a baccalaureate, associate degree or nationally recognized certification or license. The department, may, by rule and regulation specify particular courses of study or majors that do not generally lead to employment and are not approved educational programs.
42-2-103. Provision of assistance and services; duties of
department; burial assistance; department of health state supplemental security income program.
(a) The department shall provide and administer programs for public assistance and social services in Wyoming to those individuals lacking sufficient income or resources to provide themselves or their families with a reasonable subsistence compatible with decency and health or with services necessary for their well-being.
(b) In carrying out subsection (a) of this section and except as provided under the Wyoming Medical Assistance and Services Act, the department shall:
(i) Repealed by Laws 2017, ch. 179, § 2.
(ii) Establish policies and standards for the provision of public assistance and social services in accordance with this article and federal law and regulation;
(iii) Except as otherwise provided by law, establish by rule and regulation payment amounts and service levels for public assistance and social services programs provided under this article based upon the financial condition of the individual applicant or recipient;
(iv) Supervise the expenditure of state funds and federal funds allocated to the state for purposes of providing public assistance and social services in such a manner as to ensure that, to the extent funds are available and authorized by the legislature, funds may be used in separate state-funded programs to:
(A) Use, to the extent practicable, state maintenance of effort funds in a separate state funded program to provide public assistance to eligible individuals who have exhausted their benefits under the federal temporary assistance to needy families block grant and are exempt from the five (5) year limitation under paragraph (e)(i) of this section;
(B) Repealed by Laws 2017, ch. 108, § 2.
(C) Allow an individual receiving assistance to attend school as provided by W.S. 42-2-109(a) provided the individual:
(I) Has completed an employment assessment conducted under department rule or regulation;
(II) Meets the income and resource eligibility requirements of the personal opportunities with employment responsibilities (POWER) program;
(III) Qualifies as a full-time student under W.S. 42-2-109(a)(ii)(A) and (C).
(v) Cooperate with and report to the United States department of health and human services and other federal agencies as necessary to qualify the state for federal funding for public assistance and social services and comply with federal law and regulations governing the administration and expenditure of federal funds allocated to the state;
(vi) Serve as an agent of the federal government in matters of mutual concern and in the administration of federal funds allocated to the state for public assistance and social services;
(vii) Cooperate with other agencies as necessary to administer this article;
(viii) Limit approved educational programs under paragraph (iv) of this subsection to educational courses not to exceed the baccalaureate level, or to one (1) vocational training program;
(ix) Amend the state plan submitted to the United States department of health and human services to provide that the state elects as authorized by section 402(1)(A)(ii) of P.L. 104-193 to define work as including all activities permitted under section 407 of P.L. 104-193 plus satisfactory full-time school attendance as defined by W.S. 42-2-109;
(x) To the extent funds are available and authorized by the legislature and if full-time students as defined by W.S. 42-2-109 are required by federal law or regulation to work in addition to attending school full-time, create a state funds only program using funds required for maintenance of effort to provide assistance to such students. Such a program shall take priority over other uses of the maintenance of effort funds available;
(xi) Not discriminate against married couples with one (1) or more dependent children applying for assistance, provided the department may maintain work requirements for married couples consistent with the federal requirements for work participation for two (2) parent families;
(xii) Provide benefits under the personal opportunities with employment responsibilities (POWER) program to permanent resident aliens lawfully admitted to the United States under the Immigration and Nationality Act, as allowed under section 402 of P.L. 104-193;
(xiii) Exempt individuals domiciled in Wyoming from the application of section 115, subsection (a) of P.L. 104-193 allowing payment of benefits under the personal opportunities with employment responsibilities program (POWER) and the supplemental nutrition assistance program;
(xiv) Promulgate and adopt rules and regulations necessary to carry out this article;
(xv) Subject to the availability of funds, provide to recipients in an approved education program under W.S. 42-2-109(a) at least two (2) hours of dependent day care, if needed, for each hour the applicant is required to be in class, laboratory or other required instructional activity;
(xvi) Conduct the eligibility and identity verification process as provided in W.S. 42-10-101 through 42-10-107. Note: Effective 1/1/2027 this paragraph will read as:
(xvi) Conduct the applicable eligibility and identity verification process as provided in W.S. 42-10-101 through 42-10-110.
(c) Notwithstanding any other provision of this article and subject to the availability of funds, the department shall pay the burial or cremation expenses of any recipient of aid under the personal opportunities with employment responsibilities (POWER) program, supplemental security income or Medicaid at the time of his death and without sufficient means in his own estate or other resources to provide burial or cremation. The amount paid under this subsection shall not exceed one thousand five hundred dollars ($1,500.00) after consideration of funds available to the recipient from all other sources. In addition to the amount paid for burial or cremation under this subsection, an amount shall be paid for transportation expenses to the veteran's cemetery for a deceased veteran who qualifies for burial there and who qualifies for burial expenses under this subsection in an amount not to exceed five hundred dollars ($500.00). In determining eligibility under this subsection, the department shall not consider as available funds, an amount up to or equal to one thousand five hundred dollars ($1,500.00) of the corpus of a Medicaid qualifying trust meeting the requirements of W.S. 42-4-113. No board of county commissioners shall be responsible for any burial or cremation expenses in excess of the amount paid under this subsection. Burial or cremation expenses under this subsection shall not include those expenses relating to cemetery costs.
(d) The department of health shall, by rule, administer a state supplemental security income program entitling any individual receiving payments under the federal supplemental security income program with no other income during any one (1) calendar month, to a payment for each month the condition exists. The monthly payment under this subsection shall be established by the legislature within the department of health's biennial budget appropriation, which shall not be less than the required payment under applicable federal law. Rules promulgated in accordance with this subsection shall include procedures for applying, approving, reviewing and terminating assistance under this subsection. Decisions of the department of health under this subsection regarding entitlement to payments shall be subject to the contested case procedures of the Wyoming Administrative Procedure Act.
(e) In administering this section and in addition to other requirements imposed under this chapter and the Wyoming Medical Assistance and Services Act and federal rule and regulation, the department shall by rule and regulation:
(i) Limit assistance payable under W.S. 42-2-104 to five (5) years for any assistance unit within a lifetime, regardless of location. Time spent on assistance funded with federal funds and time spent on assistance funded with state funds, shall be added together in determining the time spent on assistance for the purposes of this section. Adults who previously received assistance as a dependent child, excluding minor parents, shall be allowed up to the five (5) year lifetime limit under their own assistance unit. For minor parents only, one (1) year in the personal opportunities with employment responsibilities (POWER) program prior to reaching the age of majority shall be counted against the five (5) year lifetime limit. Months of assistance received for an eligible dependent child by a nonparent caretaker relative who is not included in the calculation of the performance payment to the dependent child shall not count toward the nonparent caretaker relative's lifetime limit. Individuals who have received assistance under W.S. 42-2-104 for three (3) or more years as of January 1, 1997, shall be eligible for two (2) additional years of assistance used after January 1, 1997. Any individual who is totally physically or mentally disabled as specified by department rules, or who is a caretaker and stays at home to provide full-time care for a totally disabled or incapacitated immediate family member who resides with the caretaker because no other reasonable alternative, as determined by the department, is available to provide care and who otherwise qualifies for assistance under W.S. 42-2-104 shall not be subject to the limitation imposed under this paragraph. For an individual who is such a caretaker, the department shall waive any work requirements that unduly interfere with the provision of care and may waive other program requirements as appropriate. For purposes of this section an individual is totally disabled or incapacitated if he has a physical or mental impairment to the extent that it prevents the individual from achieving independent living, full-time employment, or participation in job training programs that will reasonably lead to independent living and monetary self sufficiency. The department may consult a licensed physician or other appropriate professional to make its determination of disability or incapacitation. Nothing in this paragraph shall prohibit the department from requiring recipients to maintain, improve or enhance employment and self-sufficiency efforts and activities. The department shall waive time limits, and may waive other program requirements as provided in paragraph (viii) of this subsection, as allowed under sections 402(a)(7)(A)(iii) and 408(a)(7)(A)(iii) of the federal Social Security Act, as amended by P.L. 104-193, for a period not to exceed two (2) years for individuals who are fleeing for personal safety or for the safety of their children or who have been victimized by domestic violence or who are at risk of further domestic violence. The department may extend assistance up to one (1) year under either the federal or state program in addition to the five (5) year limitation imposed under this paragraph for the following reasons:
(A) Repealed by Laws 1997, ch. 196, § 2.
(B) Continuation of education leading toward an associate or a baccalaureate degree under the state funded program only;
(C) Abandonment.
(ii) Require an unmarried parent under the age of eighteen (18) and the dependent child of the minor parent to reside in the household of a parent or in a supervised setting with an adult relative or court appointed guardian or custodian in order to qualify for assistance under W.S. 42-2-104, unless the minor parent is emancipated under law. Assistance under this paragraph shall be payable to the parent, relative or court appointed guardian or custodian on behalf of the minor parent and the dependent child. The income and resources of the parents shall be considered in determining eligibility for assistance under W.S. 42-2-104. If the minor custodial parent is living with a qualified person other than a parent and except for exemptions specified by department rule and regulation, the department shall through local child support enforcement agencies, enforce child support obligations of the parents of each minor parent, including the parents of the noncustodial minor parent. The department shall waive the requirements of this subsection if the only available households contain an individual who has been convicted of violating W.S. 6-4-402 or who has been charged with violating W.S. 6-4-402 and the charges have not received final disposition. The department shall assist law enforcement officials and the family of a minor mother to pursue the filing of criminal charges against the father of the minor mother's child if the minor mother conceived her child while under sixteen (16) years of age and the father was at least four (4) years older than the minor mother at the time of conception;
(iii) Limit assistance payable under W.S. 42-2-104 for the year 2008 as follows: Family Size Cumulative Inflation Maximum POWER Factor Payment 1 1.489 $290 2 1.489 476 3 1.489 506 4 1.489 506 5 1.489 536 6 1.489 536 7 and above 1.489 566 Beginning July 1, 2009 and annually thereafter, the maximum payment level shall be adjusted for the percentage change in the Wyoming cost-of-living index for the previous fiscal year as determined by the division of economic analysis of the department of administration and information.
(iv) Establish only one (1) earned income disregard for determining assistance payable under W.S. 42-2-104 at six hundred dollars ($600.00) per month for any one (1) recipient. For married couples the earned income disregard shall be one thousand two hundred dollars ($1,200.00) per month. The department may in addition establish an additional individual earned income disregard tailored to the individual person as part of that person's self-sufficiency plan developed pursuant to paragraph (v) of this subsection, provided:
(A) Such an individual earned income disregard shall be available only during time periods when the person is working at paid employment enough average number of hours per week to qualify as working for the purposes of section 407 of P.L. 104-193;
(B) The amount disregarded shall not exceed six dollars and fifty cents ($6.50) per hour except that in high cost of living areas as defined by the department it shall not exceed seven dollars and fifty cents ($7.50) per hour;
(C) The disregard shall be structured to allow one-half (1/2) of the person's preemployment personal opportunities with employment responsibilities (POWER) grant for a period not to exceed six (6) months and one-quarter (1/4) of the personal opportunities with employment responsibilities (POWER) grant for an additional period not to exceed six (6) months;
(D) The one-half (1/2) grant in the first period may be paid from either state funds or federal funds and shall count toward the five (5) year limit established by W.S. 42-2-103(e). The one-quarter (1/4) grant in the second period shall be paid from state maintenance of effort funds and shall not be subject to the time limits established by W.S. 42-2-103(e);
(E) The use of the individual earned income disregard may be conditioned upon successful completion of other portions of the person's self-sufficiency plan;
(F) The decision to allow an individual earned income disregard in a particular case is discretionary with the department and the department's decision is not subject to judicial review;
(G) The individual earned income disregard shall be used only to the extent the department determines funds are available and are not needed for other purposes with higher priority.
(v) In accordance with guidelines and criteria prescribed by rule and regulation of the department and unless otherwise qualifying for a good cause exemption pursuant to rule and regulation of the department, require the development of and adherence to a self-sufficiency plan with guidelines and assistance provided by the department, as a condition for benefit eligibility under the personal opportunities with employment responsibilities (POWER) program. A self-sufficiency plan including timely completion of an approved educational program complying with W.S. 42-2-109(a) shall be deemed to meet the requirements of this subsection if adhered to. Any person not qualifying for a good cause exemption and failing to comply with this paragraph shall be sanctioned under the personal opportunities with employment responsibilities (POWER) program. Subject to procedure prescribed by department regulation, any recipient may at any time request a good cause exemption from the requirements of this section;
(vi) Impose time limitations on educational goals of recipients of assistance under W.S. 42-2-104 who are under twenty (20) years of age and have not obtained a high school diploma or general equivalency degree;
(vii) Require that applicants and current recipients cooperate within a period specified by department rules to establish paternity and child support obligations, subject to good cause exceptions established by department rules and regulations. The applicant shall not be eligible for personal opportunities with employment responsibilities benefits and a recipient shall not receive benefits until the applicant or recipient has cooperated as required under this paragraph;
(viii) Provide that the department may waive program requirements, other than time limits which shall be waived under paragraph (i) of this subsection, for individuals who are fleeing for personal safety or for the safety of their children or who have been victimized by domestic violence, or who are at risk of further domestic violence, as follows:
(A) Work participation requirements or state postsecondary education program restrictions may be waived for one (1) year, without re-evaluation, for individuals who have not exhausted their benefits under the federal temporary assistance to needy families block grant. Program requirements under this paragraph may not be waived for longer than:
(I) One (1) year, unless the recipient's circumstances are re-evaluated at six (6) month intervals after the first year;
(II) Two (2) years, unless the recipient meets the requirements of subdivision (I) of this subparagraph and is cooperating in the development and implementation of a plan with the department and the local domestic violence agency to correct circumstances which have contributed to the domestic violence or the threat of domestic violence.
(B) For individuals who have exhausted their benefits under the federal temporary assistance to needy families block grant, program requirements under this paragraph may be waived by the department only if the individual's circumstances are re-evaluated at six (6) month intervals and, after one (1) year, the individual is cooperating in the development and implementation of a plan with the department and the local domestic violence agency to correct circumstances which have contributed to the domestic violence or threat of domestic violence.
(f) In administering the child care and development fund provided for in the federal Child Care and Development Block Grant Act, and subject to approval of a state plan amendment by the administration of children and families of the United States department of health and human services, the department shall:
(i) Annually by April 1 establish the hourly copayment required to be paid by parents for each eligible child, subject to the following:
(A) Households with income at or below one hundred percent (100%) of the federal poverty level shall not be required to make a copayment;
(B) For households with income above one hundred percent (100%) up to two hundred twenty-five percent (225%) of the federal poverty level, the copayment shall be calculated based on the following table. For each category of income in the first column, the parents' hourly copayment per child shall be determined by multiplying the annual income dollar amount for a family of two (2) that corresponds with the percentage of federal poverty level in the second column by the multiplier in the third column, then dividing by two thousand three hundred forty (2,340), the annual number of hours of child care required by a full-time working parent, and rounding the result to the nearest five cents ($.05): Household Category Federal Poverty Multiplier of Income Level Income Factor 101% - 125% 113% 1.25% 126% - 150% 138% 2.00% 151% - 175% 163% 7% 176% - 200% 188% 9% 201% - 225% 213% 12%
(C) In determining eligibility, the department shall use the most recent federal poverty guidelines for the applicant's household size and income. In determining the hourly copayment for each eligible child, the department shall use the appropriate category of income in which the household qualifies;
(D) If the department determines that funding will be inadequate to implement the child care and development fund for the balance of the appropriation period, the department may increase copayments as calculated by subparagraph (B) of this paragraph by ten percent (10%) for households whose income is less than two hundred percent (200%) of the federal poverty level and by twenty percent (20%) for households whose income is equal to or above two hundred percent (200%) of the federal poverty level.
(ii) From funds available under the American Recovery and Reinvestment Act of 2009, any funds not needed for completion of the electronic benefit transfer system shall be used to make grants for materials and supplies to child care facilities, provided however that a facility receiving a grant shall agree in writing to provide not less than twenty-five percent (25%) of the facility's available care to persons determined eligible under paragraph (i) of this subsection, for a period commensurate with the amount of the grant as determined by rule and regulation of the department, or to repay any monies granted under this paragraph to the state of Wyoming plus interest at the rate of ten percent (10%) per annum;
(iii) If the department determines that eligibility for other social services programs changes in ways that require a change in the formula provided by paragraph (i) of this subsection, the department shall report the change together with recommended legislation to the joint labor health and social services interim committee.
responsibilities; provision; eligibility; unemployed parent program.
(a) The department may through the personal opportunities with employment responsibilities (POWER) program provide financial assistance for a dependent child and an eligible caretaker. Financial assistance under this program shall be in the form of a performance payment or protective payment payable to or on behalf of an eligible recipient. Any individual not a relative of the dependent child but interested in or concerned with the welfare of the child and his eligible caretaker may subject to qualifications prescribed by rule and regulation of the department, receive a protective payment on behalf of the dependent child which shall not count toward the caretaker's five (5) year limit for benefits under W.S. 42-2-103(e)(i) unless the nonrelative caretaker is included in the calculation of the performance payment of the dependent child.
(b) In addition to any other state or federal regulation and subject to W.S. 42-2-103(e), an assistance unit qualifying under W.S. 42-2-103(a) with a dependent child is eligible for financial assistance under the personal opportunities with employment responsibilities (POWER) program. For purposes of this subsection, a dependent child includes any child who is under eighteen (18) years of age and living with a relative in a residence maintained by the relative as determined by rule and regulation of the department, regularly attending school or its equivalent as determined by the department, or is expected to graduate from high school before the age of nineteen (19) years. For purposes of this subsection, a dependent child does not include a minor parent.
(i) Repealed By Laws 1997, ch. 196, § 2.
(ii) Repealed By Laws 1997, ch. 196, § 2.
(c) Repealed By Laws 1997, ch. 196, § 2.
(d) Subject to the availability of funds, the department may by rule and regulation create a program to provide financial assistance to assistance units in which there is a dependent child and both of the parents are unemployed.
42-2-105. Application for assistance and services; investigation of applicant.
(a) An individual or other person on his behalf may apply in writing for public assistance and social services under this article to the field office of the department located within the county or region in which the individual resides. A relative or other person interested in the welfare of a dependent child and his family may apply for the child. Application shall be upon a form and in a manner prescribed by rule and regulation of the department.
(b) Upon receipt of an application under subsection (a) of this section, the department shall investigate the facts stated in the application and obtain necessary information to determine eligibility for public assistance and social services.
notification of applicant; amount and form of assistance and services.
(a) Based upon the eligibility of an applicant, the department shall approve or disapprove each application for public assistance or social services filed with its field offices pursuant to W.S. 42-2-105 and shall notify the applicant of its decision. Eligibility determinations for public assistance under this chapter shall be made separately from eligibility determinations for medical assistance under Title XIX of the federal Social Security Act.
(b) Upon approval and in accordance with this article and its rules and regulations, the department shall determine the form, amount and commencement date of public assistance and social services for each approved application. In determining the amount of public assistance and social services for applicants who receive a housing subsidy, for households with a supplemental security income recipient or for unmarried minor parent applicants, the department shall take into consideration the supplied shelter tables as established in its rules and regulations.
(c) In any assistance program under this chapter for which income is the criterion or one (1) of the criteria for assistance payments, compensation received for a veteran's service connected disability shall not be counted in determining income if that compensation on an annual basis is not more than the poverty level for the applicant as determined by the federal office of management and budget.
(d) When the department approves an application for public assistance under the personal opportunities with employment responsibilities (POWER) program, it shall inform the approved applicant of the opportunity to continue to receive benefits under the program while participating in an approved educational program, provided the person is accepted into the approved educational program and otherwise continues to meet eligibility requirements of both programs.
42-2-107. Payment of assistance; custodian for incompetent recipients.
(a) Public assistance and social services approved under this article:
(i) May be provided in the form of a performance payment or other financial assistance, in the home of the applicant, in an institution or in any other manner or form determined appropriate by rule and regulation of the department;
(ii) Shall be provided to the recipient until terminated or modified pursuant to this article;
(iii) Shall be provided to qualified recipients who move to Wyoming from other states, except the amount of the performance payment or other financial assistance for the first twelve (12) months of eligibility in Wyoming may, at the option of the department, be the lesser of:
(A) The amount of assistance for which the recipient would be entitled in Wyoming; or
(B) The amount of the assistance the recipient would be receiving in the state of prior residence.
(b) A performance payment or any other form of public assistance shall be payable to the recipient or to a custodian or a vendor on behalf of the recipient. If the recipient is determined incompetent for purposes of using the public assistance provided under this article in the most beneficial manner, the amount may be payable to a custodian of the recipient. Subject to approval of the department, the custodian may receive and dispose of the public assistance on behalf of the recipient and shall report quarterly to the department providing a detailed accounting of his management of the amounts received under this subsection. The department shall review the report, determine if the conduct of the custodian is in the best interests of the recipient and file a copy of the report in the recipient's case record.
42-2-108. Continuous assistance to recipient changing
residence to another county; assistance provided to nonresidents; termination upon leaving state.
(a) The department shall provide for the continuous and uninterrupted receipt of approved public assistance and social services by any eligible recipient changing his residence from one (1) county to another county in the state until otherwise terminated or modified in accordance with this article.
(b) Any transient or nonresident of the state may receive public assistance or social services provided under this article if approved in accordance with this article. The department may require the transient or nonresident to pay his transportation and expenses if he possesses property, income or other resources other than personal effects necessary for decency and health.
(c) Public assistance or social services shall be terminated in the manner prescribed by rule and regulation of the department for any recipient moving to another state.
42-2-109. Review of assistance and services; termination or modification; notice to department of change in assets.
(a) Public assistance and social services provided under this article shall be reviewed at least once each year, except for recipients enrolled in an approved educational program which shall be reviewed once every six (6) months. An approved educational program under this section shall be limited to educational courses not to exceed the baccalaureate degree level. After review, the department may continue, modify or terminate public assistance and social services in accordance with the circumstances of the recipient and the provisions of this article. Review of recipients in an approved educational program pursuant to this subsection shall require that recipients:
(i) To maintain a "C" or equivalent cumulative grade point average in the approved educational program;
(ii) Be enrolled as a full-time student, provided:
(A) To qualify as a full-time student under this paragraph, the student shall be enrolled for a minimum of twelve (12) credit hours per semester or activities that equal twelve (12) credit hours as defined by the institution and complete twenty-four (24) or more credit hours per year or activities that equal twenty-four (24) credit hours per year as defined by the institution in an approved educational program;
(B) A full-time student qualifying under this paragraph is exempt from any work or community service requirement under this article, except as provided in paragraph
(iii) of this subsection;
(C) To qualify under this paragraph, the full-time student shall be a Wyoming resident in accordance with guidelines and criteria prescribed by rule and regulation of the department.
(iii) From the end of the spring semester to the beginning of the fall semester, work at least thirty-two (32) hours per week for at least ten (10) weeks or successfully complete six (6) credit hours. The department may waive this requirement for good cause.
(iv) Repealed by Laws 2005, ch. 238, § 2.
(b) Upon gaining possession of any property, income or other assets after receiving any public assistance and social services under this article, a recipient shall notify the department not later than ten (10) calendar days after becoming aware of the change in circumstances. The amount of public assistance and social services provided to the recipient shall be accordingly terminated or modified pursuant to rule and regulation of the department. The department shall exempt not more than two (2) licensed motor vehicles from personal assets in determining eligibility for any household under the personal opportunities with employment responsibilities (POWER) program.
(c) Repealed By Laws 1997, ch. 196, § 2.
(a) An applicant or recipient whose application is not acted upon within a reasonable time following the date of application or who is aggrieved by any determination for the provision, amount, modification or termination of public assistance and social services under this article may appeal to the department in a manner and form prescribed by the department. The department shall provide the applicant or recipient reasonable notice in accordance with its rules and regulations and shall provide opportunity for hearing pursuant to the Wyoming Administrative Procedure Act. Following conclusion of the hearing, the department shall render a final decision.
(b) A decision of the department may be appealed to the district court as provided by the Wyoming Administrative Procedure Act.
42-2-111. Prohibited disclosure and use of records; penalty; judicial discovery.
(a) Except as provided in this section, no person shall disclose, receive, use or knowingly permit or participate in the use of any information derived from records maintained pursuant to law or acquired in the performance of duties under this article for purposes not directly related to the administration of this article.
(b) A violation of subsection (a) of this section is a misdemeanor.
(c) In accordance with the Wyoming Rules of Civil Procedure, any county or district court may subpoena the records maintained under this article and require the testimony of personnel involved in the administration of this article which is pertinent to any proceeding involving the:
(i) Custody, welfare or interest of any minor receiving public assistance and social services under this article;
(ii) Termination of parental rights as provided by law;
(iii) Prosecution of any person for a crime connected with obtaining public assistance and social services;
(iv) Foreclosure of liens held by the department.
(d) Upon request of a federal, state or local law enforcement officer as defined by federal statute and W.S. 9-1-701(a)(vi), the department may furnish the requesting officer the current address of any recipient under the personal opportunities with employment responsibilities (POWER) program if the requesting officer:
(i) Furnishes the department with the name of the recipient; and
(ii) Notifies the department that the recipient:
(A) Is a fleeing felon as described in paragraph
(iii) of this subsection or has information necessary for the requesting officer to conduct the officer's official duties; and
(B) The location or apprehension of the recipient is within the requesting officer's duties.
(iii) For purposes of this section, a fleeing felon is defined as an individual who:
(A) Is fleeing to avoid prosecution, custody or confinement after conviction, under the laws of the jurisdiction from which the individual flees, for a crime or attempt to commit a crime, which is a felony under the laws of the jurisdiction from which the individual flees, or which, in the case of the state of New Jersey, is a high misdemeanor, or is violating a condition of probation or parole imposed under federal or state law; and
(B) Whose conduct as described in this subsection has not been pardoned by the president of the United States or the governor of the jurisdiction from which the felon flees.
(e) If the department learns of the location of a fleeing felon or of an individual who has an outstanding warrant for his arrest, the department shall notify the appropriate law enforcement agency. The department shall limit disclosure under this section by providing only the current address of the recipient under the personal opportunities with employment responsibilities (POWER) program.
42-2-112. Misrepresentation; penalties; recovery, termination or modification of assistance and services.
(a) No person shall knowingly make a false statement or misrepresentation, fail to disclose a material fact, aid, abet or conspire with any other person in obtaining any form of supplemental nutrition assistance benefit under the supplemental nutrition assistance program.
(b) No person shall knowingly make a false statement or misrepresentation, fail to disclose a material fact, aid, abet or conspire with any other person in obtaining any commodity under the supplemental nutrition assistance program.
(c) No person shall knowingly trade or otherwise dispose of any supplemental nutrition assistance benefit received under the supplemental nutrition assistance program, except to a federally authorized food retailer.
(d) No person shall knowingly sell any form of supplemental nutrition assistance benefit to any other person.
(e) No person shall knowingly give, sell, trade or otherwise dispose of any commodity obtained under the supplemental nutrition assistance program to any other person.
(f) No person shall knowingly buy, trade or otherwise obtain any form of supplemental nutrition assistance benefit from any other person, except as authorized by law.
(g) No person shall knowingly buy, trade or otherwise obtain any commodity under the supplemental nutrition assistance program from any other person, except as authorized by law.
(h) No person shall knowingly make a false statement or misrepresentation, knowingly fail to disclose a material fact, aid, abet or conspire with any other person in obtaining public welfare benefits.
(j) No person shall knowingly directly or indirectly deprive himself of any property, income or other resources in order to qualify for public welfare benefits.
(k) Any person violating this section is guilty of:
(i) A felony punishable by imprisonment for not more than ten (10) years, a fine of not more than ten thousand dollars ($10,000.00), or both, if the value of the commodity, supplemental nutrition assistance benefit or other public welfare benefit under this article is five hundred dollars ($500.00) or more; or
(ii) 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, if the value of the commodity, supplemental nutrition assistance benefit or other public welfare benefit under this article is less than five hundred dollars ($500.00).
(m) In addition to the penalty imposed under subsection
(k) of this section, the amount of public welfare benefits improperly provided due to any violation of this section may be recovered by appropriate action which shall be instituted by the department or by the attorney general on behalf of the department.
(n) The department shall disapprove, terminate or modify the public welfare benefits to any applicant or recipient who has been found guilty of violating this section until any court sentence under this section is completed and full restitution is made to the department. Public welfare benefits shall not be denied to any minor because of violation of this section by a parent or guardian.
42-2-113. Assignment or transfer of assistance and services; exemption from legal process.
(a) Any assignment or transfer of public assistance and social services provided under this article is void.
(b) Except as authorized under W.S. 42-2-112(m), public assistance and social services provided by this article are exempt from levy, execution, attachment, garnishment or other legal process or debt collection remedy. A waiver of exemptions provided by this subsection is void.
42-2-115. Supplemental nutrition assistance program
eligibility recertification frequency. Note: this section is effective as of 1/1/2027.
(a) The department shall assign certification periods of not greater than four (4) months to households that include an able bodied adult without dependents and other households whose circumstances are determined by the department to be unstable, unless otherwise prohibited under federal law for the supplemental nutrition assistance program.
(b) The department shall assign certification periods of one (1) or two (2) months to households that the department determines will become ineligible for the supplemental nutrition assistance program in the near future, unless otherwise prohibited under federal law.
(c) Except as provided by subsections (a) and (b) of this section, the department shall assign certification periods of not more than six (6) months to households whose members are not elderly or disabled, unless otherwise prohibited under federal law.
(a) As used in this article:
(i) "Program" means the employment and training program created under this article;
(ii) "Support services" includes transportation, child care and other services necessary to enable participants in the program to participate without hardship to themselves or their families.
42-2-202. Participation required; exemptions; disqualification of benefits.
(a) If available within the county of his residence, any person receiving benefits from the department under the supplemental nutrition assistance or personal opportunities with employment responsibilities (POWER) programs shall as a condition of receiving any benefits, participate in the employment and training program unless he:
(i) Is not physically able to work;
(ii) Is determined to be unemployable by an employment assessment conducted pursuant to department rule or regulation; or
(iii) Qualifies for a good cause exemption under rule and regulation of the department.
(b) Any person not exempt under this section and failing to participate in the program as required under this article may be disqualified from receiving benefits under the supplemental nutrition assistance or personal opportunities with employment responsibilities (POWER) programs. A good cause exemption may be requested at any time by a benefit recipient.
(c) Notwithstanding any other provisions of this title all nonexempt recipients under the personal opportunities with employment responsibilities (POWER) program in the state shall be required to work or perform community service as defined by rules and regulations of the department subject to coordination with the United States department of health and human services if required. Recipients may be exempted from the requirement under this subsection if one (1) of the nonexempt recipients within the assistance unit:
(i) Repealed By Laws 1997, ch. 196, § 2.
(ii) Repealed By Laws 1997, ch. 196, § 2.
(iii) Except as provided in paragraph (c)(iv) of this section, has a child who has not attained the age of three (3) months;
(iv) Gives birth to a child after ten (10) months as a recipient under the personal opportunities with employment responsibilities (POWER) program. The recipient under this paragraph shall be exempted from the requirements under this section for a period of three (3) months after the child is born, unless the parent is a minor child in which case the recipient shall be required to attend school in accordance with paragraph (v) of this subsection;
(v) Is a minor child who is required to attend school pursuant to W.S. 21-4-102; or
(vi) For other good cause as determined by the department.
(d) Benefits and eligibility requirements under the personal opportunities with employment responsibilities (POWER) program shall be modified for assistance units under subsection
(c) of this section as follows:
(i) Assistance units complying with subsection (c) of this section shall receive full benefits to which they are otherwise entitled under this title;
(ii) In an assistance unit having a minor who has completed the eighth grade or has attained sixteen (16) years of age, but has not yet graduated from high school and refuses to attend school or accept suitable employment if the parent will not cooperate with the appropriate authorities as specified in a plan approved by the department to resolve the problem, the assistance unit shall not receive a performance payment for any month the minor refuses to attend school or accept suitable employment;
(iii) Monthly earned income of a dependent full-time student up to the age of eighteen (18), excluding minor parents, shall not be included as income and resources in determining the eligibility of the assistance unit for assistance and the amount of assistance while the student is living in the residence of his caretaker relative;
(iv) In assistance units in which recipients not otherwise exempted from the requirements of subsection (c) of this section, the assistance unit shall not receive a performance payment for any month the recipient fails to comply with subsection (c) of this section and the recipient shall not be eligible for medical assistance under chapter 4 of this title until the recipient complies with the provisions of this section;
(v) Excluding allowance for personal motor vehicles as specified under W.S. 42-2-109(b), the amount of assets an assistance unit may own shall be not greater than five thousand dollars ($5,000.00).
42-2-203. Establishment of program; powers and duties of division.
(a) The department shall:
(i) Establish an employment and training program which shall include job registration and may include job search employment training, work experience and support services;
(ii) Establish the program in as many counties as is feasible given funding limitations, cost effectiveness, geography and unemployment in the county;
(iii) Enter into cooperative agreements with other agencies providing employment training and experience programs to prevent duplication;
(iv) Repealed by Laws 2017, ch. 179, § 2.
(v) Provide participants a copy of the rules and regulations promulgated by the department for the program on participation and for fair hearings.
(b) The department may contract with public agencies and private entities to implement this article. The department may promulgate rules and regulations to implement this article.
(a) For purposes of this article:
(i) "Asset", with respect to an individual, means:
(A) All income and resources of the individual and of the individual's spouse, including any income or resources to which the individual or his spouse is entitled but does not receive because of action:
(I) By the individual or his spouse;
(II) By a person, including a court or administrative body, with legal authority to act in place of or on behalf of the individual or his spouse; or
(III) By any person, including a court or administrative body, acting at the direction or upon the request of the individual or his spouse.
(B) An annuity purchased by or on behalf of an annuitant who has applied for medical assistance with respect to long-term care services unless the annuity is an annuity as described in 42 U.S.C. 1396p(c)(1)(G)(i) or (ii).
(ii) "Income" means "income" as defined under 42 U.S.C. 1396p(h)(2);
(iii) "Institutionalized individual" means an individual who is an inpatient in a nursing facility, who is an inpatient in a medical institution and with respect to whom payment is made based on a level of care provided in a nursing facility, or who is receiving home and community-based services;
(iv) "Long-term care services" means nursing facility services, a level of care in any institution equivalent to that of nursing facility services, and home and community-based services;
(v) "Resources" means "resources" as defined under 42 U.S.C. 1396p(e)(5);
(vi) "Department" means the department of health unless otherwise specified.
42-2-402. Transfers of assets affecting eligibility; exceptions; disclosures by applicants.
(a) If an institutionalized individual or the individual's spouse has disposed of, for less than fair market value, any asset or interest therein within sixty (60) months before or any time after the first date the individual has both applied for medical assistance and been institutionalized, the individual is ineligible for medical assistance for long-term care services for the period of time determined under subsection (b) of this section.
(b) For a transfer within the provisions of subsection (a) of this section, the number of months of ineligibility for long-term care services shall be the total, cumulative uncompensated value of all assets transferred within the sixty (60) month period, divided by the average monthly cost to a private patient for nursing facility services on the date of application. The period of ineligibility begins with the later of:
(i) The first day of the first month in which the assets were transferred and which does not occur in any other period of ineligibility;
(ii) The date on which the individual is eligible for medical assistance under the state plan and would otherwise be receiving institutional level care, but for the application of the penalty period, and which does not occur during any other period of ineligibility under this section.
(c) In the case of a transfer by the spouse of an individual which results in a period of ineligibility for medical assistance under this section for the individual, the department shall, using a reasonable methodology as specified by the secretary of health and human services, apportion the period of ineligibility for any portion of the period, among the individual and the individual's spouse if the spouse otherwise becomes eligible for medical assistance under chapter 4 of this title.
(d) An institutionalized individual is not rendered ineligible for long-term care services due to a transfer within the provisions of subsection (a) of this section if the asset transferred was a home and:
(i) Title to the home was transferred to the individual's:
(A) Spouse;
(B) Child who is under age twenty-one (21);
(C) Blind or disabled child as defined in 42 U.S.C. 1382c;
(D) Sibling who has equity interest in the home and who was residing in the home for a period of at least one (1) year immediately before the date the individual became an institutionalized individual; or
(E) Child who was residing in the home for a period of at least two (2) years immediately before the date the individual became an institutionalized individual, and who provided care to the individual which permitted the individual to reside at home rather than in an institution or facility.
(e) An institutionalized individual is not rendered ineligible for long-term care services due to a transfer within the provisions of subsection (a) of this section if the department determines:
(i) The individual intended to dispose of the asset at fair market value or for other valuable consideration;
(ii) The asset was transferred exclusively for a purpose other than to qualify for medical assistance;
(iii) That to the extent assets were transferred for less than fair market value, that the assets or their fair market equivalent have been returned to the individual; or
(iv) To grant a waiver of the excess resources created by the uncompensated transfer because denial of eligibility would cause undue hardship for the individual, based on criteria established by the secretary of health and human services.
(f) An institutionalized person who has made or whose spouse has made a transfer within the provisions of subsection
(a) of this section is not ineligible for long-term care services if the asset was transferred:
(i) To the individual's spouse or to another individual for the sole benefit of the individual's spouse;
(ii) From the individual's spouse to another individual for the sole benefit of the individual's spouse;
(iii) To the individual's child who is blind or disabled, as defined by 42 U.S.C. 1382c, or to a trust established solely for the benefit of the child;
(iv) To a trust established solely for the benefit of an individual under sixty-five (65) years of age who is disabled as defined by 42 U.S.C. 1382c(a)(3).
(g) An applicant for long-term care services shall disclose any interest the applicant, or the applicant's spouse who is not residing in long-term care, has in an annuity or similar financial instrument, regardless of whether the annuity or instrument is irrevocable or is treated as an asset. For purposes of subsection (a) of this section, the purchase of an annuity shall be treated as the disposal of an asset for less than fair market value unless:
(i) The state is named as the remainder beneficiary in the first position for at least the total amount of medical assistance paid on behalf of the annuitant under this article; or
(ii) The state is named as the remainder beneficiary in the second position after the spouse or minor or disabled child and is named in the first position if the spouse or a representative of the child disposes of any of the remainder for less than fair market value.
42-2-403. Trust transfers affecting eligibility for medical assistance.
(a) For purposes of determining an individual's eligibility for or the amount of benefits under chapter 4 of this title, the rules specified in subsections (d) and (e) of this section shall apply to a trust established by the individual.
(b) For purposes of this section, a trust shall be considered to have been established if an asset of an individual, other than an asset transferred by will, was used to form all or part of the corpus of the trust by any of the following:
(i) The individual;
(ii) The individual's spouse;
(iii) A person including a court or administrative body, with legal authority to act in place of or on behalf of the individual or the individual's spouse;
(iv) A person including a court or administrative body, acting at the direction or upon the request of the individual or the individual's spouse.
(c) In the case of a trust the corpus of which includes assets of any other person, the provisions of this section shall apply to the portion of the trust attributable to the assets of the individual. This section shall apply without regard to:
(i) The purposes for which a trust is established;
(ii) Whether the trustees may exercise any discretion under the trust;
(iii) Any restrictions on when or whether distributions may be made from the trust; or
(iv) Any restrictions on the use of distributions from the trust.
(d) In the case of a revocable trust:
(i) The corpus of the trust shall be considered resources available to the individual;
(ii) Payments from the trust to or for the benefit of the individual shall be considered income of the individual; and
(iii) Any other payments from the trust shall be considered assets disposed of by the individual for purposes of W.S. 42-2-402.
(e) In the case of an irrevocable trust:
(i) If there are any circumstances under which payment from the trust could be made to or for the benefit of the individual, the portion of the corpus or corpus income from which payments to the individual could be made shall be considered resources available to the individual, and payments from that portion of the corpus or income to or for the benefit of the individual shall be considered income of the individual. Payments from that portion of the corpus or income for any other purpose shall be considered a transfer of assets by the individual subject to W.S. 42-2-402; and
(ii) Any portion of the trust or corpus income from which no payment could under any circumstances be made to the individual shall be considered, as of the date of establishment of the trust or, if later, the date on which payment to the individual was foreclosed, to be assets disposed by the individual for purposes of W.S. 42-2-402. The value of the trust shall be determined for purposes of W.S. 42-2-402 by including the amount of any payments made from such portion of the trust after the date specified in this paragraph.
(f) Notwithstanding any other provision of this section, this section shall not apply to any of the following trusts:
(i) A trust containing the assets of an individual under age sixty-five (65) who is disabled as defined by 42 U.S.C. 1382c(a)(3) and which is established for the benefit of that individual by a parent, grandparent, legal guardian of the individual or a court if the state will receive all amounts remaining in the trust upon the death of the individual up to an amount equal to the total medical assistance paid on behalf of the individual under chapter 4 of this title;
(ii) A trust established for the benefit of an individual if:
(A) The trust is composed only of pension, social security and other income to the individual and accumulated income in the trust; and
(B) The state will receive all amounts remaining in the trust upon the death of the individual up to an amount equal to the total medical assistance paid on behalf of the individual under chapter 4 of this title.
(iii) A trust containing the assets of an individual who is disabled as defined in 42 U.S.C. 1382c(a)(3), that meets the following conditions:
(A) The trust is established and managed by a nonprofit association;
(B) A separate account is maintained for each beneficiary of the trust but, for the purposes of investment and management of funds, the trust pools the accounts;
(C) Accounts in the trust are established solely for the benefit of individuals who are disabled as defined by 42 U.S.C. 1382c(a)(3), by the parent, grandparent, legal guardian of the disabled individual, by the disabled individual or by a court; and
(D) To the extent that amounts remaining in the beneficiary's account upon the death of the beneficiary are not retained by the trust, the trust pays to the state from the remaining amounts in the account an amount equal to the total amount of medical assistance paid on behalf of the beneficiary under chapter 4 of this title.
(g) The department shall establish procedures in accordance with standards specified by the secretary of health and human services under which the department waives the application of this section for an individual if the individual establishes that application would work an undue hardship on the individual as determined on the basis of criteria established by the secretary.
(h) For purposes of this section, "trust" includes any legal instrument or device that is similar to a trust but includes an annuity only to the extent and in the manner as the secretary of health and human resources specifies.
In the case of an asset held by an individual in common with another person in a joint tenancy, tenancy in common or similar arrangement, the asset, or the affected portion of the asset, shall be considered to be transferred by the individual when any action is taken, either by the individual or by any other person, that reduces or eliminates the individual's ownership or control of the asset.
42-2-405. Individuals with substantial home equity; disqualification.
(a) An applicant shall not be eligible for long-term care services under this article if the applicant's equity interest in the applicant's home exceeds five hundred thousand dollars ($500,000.00).
(b) Beginning on July 1, 2011 and annually thereafter, the dollar amount in subsection (a) of this section shall be adjusted based on the consumer price index for urban consumers published by the United States department of labor, bureau of labor statistics, for the preceding calendar year.
(c) Subsection (a) of this section shall not apply to an individual whose spouse, or child under age twenty-one (21), is lawfully residing in the individual's home and is blind or disabled as defined in 42 U.S.C. 1382c.
(d) Nothing in this section shall be construed as preventing an applicant from using a reverse mortgage or home equity loan to reduce the applicant's total equity interest in the applicant's home.
42-2-501. Low income home energy assistance and weatherization program; funding.
(a) The department shall administer a low income home energy assistance program in accordance with federal P.L. 97-35, as amended. The department shall submit and keep current a state plan and shall administer the program in accordance with the state plan and this section.
(b) The program shall provide energy assistance to eligible households as provided in this section. Energy assistance shall include those uses of federal funds authorized under P.L. 97-35, as amended. To the extent permitted by federal law the state plan shall provide that of the authorized uses not less than twenty-five percent (25%) of the available funding for the program shall be used for weatherization assistance. Weatherization assistance shall include the following for residential dwellings only:
(i) Weatherization needs assessments and audits;
(ii) Caulking, insulation, storm window and similar improvements to reduce energy use;
(iii) Furnace and heating system modifications and repairs;
(iv) Furnace replacement;
(v) Repealed By Laws 2013, Ch. 183, § 1.
(vi) Repair or replacement of water heaters and heating systems for portions of a dwelling;
(vii) Other measures as determined by the department to be necessary to ensure a safe, well-weatherized dwelling.
(c) In addition to categorically eligible individuals authorized under P.L. 97-35, as amended, the state plan shall provide eligibility for those households with incomes which do not exceed the lesser of:
(i) An amount equal to two hundred fifteen percent (215%) of the federal poverty level for Wyoming; or
(ii) An amount equal to sixty percent (60%) of the state median household income.
(d) The department may modify the state plan as necessary:
(i) To meet federal requirements not to exclude households with lesser incomes than the amounts specified in subsection (c) of this section; and
(ii) To exclude households from receiving federal funds if the household income limitation provided in this section would violate federal restrictions.
(e) The maximum assistance provided to any household under the program in any state fiscal year shall not exceed the federal department of energy maximum annual unit average as calculated and authorized under P.L. 106-469, as amended.
(f) The department may adopt rules and regulations as necessary to implement this section.
(a) The child support and revenue enhancement account is created.
(b) The following payments, collections and revenues shall be transmitted to the state treasurer for deposit to the credit of the child support and revenue enhancement account:
(i) Child support payments collected under the Child Support Enforcement Act;
(ii) Fees collected pursuant to W.S. 20-6-105(b); and
(iii) All funds collected under the overpayment and fraud recovery program of the department.
(c) For purposes of this chapter, "department" means the department of family services created by W.S. 9-2-2006.
The department shall administer the funds in the child support and revenue enhancement account and report annually to the joint appropriations interim committee and joint judiciary interim committee. The account may be divided into subaccounts for purposes of administrative management.
(a) Funds in the child support and revenue enhancement account shall be expended only as authorized by this section.
(b) The department may at any time disburse funds in the account for:
(i) Payments to support obligees and disbursements required under the guidelines of the federal child support enforcement program;
(ii) Authorized transfers of the federal share of funds collected under the child support enforcement program and the division's overpayment and fraud recovery program;
(iii) Incentive payments as provided by W.S. 20-6-106(j);
(iv) Reimbursement to the department of health for costs under Title XIX of the Social Security Act or may retain funds to pay for the costs of foster care or minimum medical program benefits; and
(v) Reimbursement to service providers for the costs of collection under the child support enforcement and overpayment recovery programs.
(c) Subject to legislative appropriation, the state's share of funds in the account shall be expended for:
(i) Administrative costs of the child support enforcement program;
(ii) Funding of benefits under the personal opportunities with employment responsibilities (POWER) program; and
(iii) Other administrative costs of the department.
(d) Notwithstanding any other provision of this section, if funds are recovered by the department under the overpayment and fraud recovery program within the same biennial period during which the funds were originally appropriated, the department may expend those funds for the purposes for which they were appropriated without further legislative appropriation.
This chapter may be cited as the "Wyoming Medical Assistance and Services Act". The program and services provided pursuant to this chapter and Title XIX of the federal Social Security Act may be cited as "Medicaid" or the "Medicaid program".
(a) As used in this chapter:
(i) "Categorically eligible" means any individual in need of medical assistance authorized by the legislature and by Title XIX of the federal Social Security Act to be covered by a state plan for medical assistance and services;
(ii) "Medical assistance" means partial or full payment of the reasonable charges assessed by any authorized provider of the services and supplies enumerated under W.S. 42-4-103 and consistent with limitations and reimbursement methodologies established by the department, which are provided on behalf of a qualified recipient, excluding those services and supplies provided by any relative of the recipient, unless the relative is a family caregiver providing services through a corporation or a limited liability company, which corporation or limited liability company the relative may own, under a home and community based waiver program, or for cosmetic purposes only;
(iii) "Qualified" means any categorically eligible individual satisfying eligibility criteria imposed by this chapter, the state plan for medical assistance and services and by rule and regulation of the department;
(iv) "Relative" means any person as defined by department rule and regulation;
(v) "Resident" means any individual residing in this state, including any individual temporarily absent from this state;
(vi) "Institutionalized spouse" means as defined by the Medicare Catastrophic Coverage Act of 1988, P.L. 100-360;
(vii) "Department" means the state department of health;
(viii) "Direct patient care personnel" means only:
(A) Certified nursing assistants;
(B) Licensed practical nurses;
(C) Registered nurses.
(ix) "Skilled nursing home extraordinary care" means skilled nursing home services clearly exceeding standard skilled nursing home services and meeting the criteria established by the department pursuant to W.S. 42-4-104(d);
(x) "Intermediate care facility for people with intellectual disability" means "intermediate care facility for the mentally retarded" or "ICFMR" or "ICFs/MR" as those terms are used in federal law and in other laws, rules and regulations;
(xi) "Family caregiver" means a relative of a waiver recipient with a developmental disability or acquired brain injury, who provides waiver services through a corporation or a limited liability company, which corporation or limited liability company the relative may own, to the person with a developmental disability or acquired brain injury and who meets the requirements for a qualified family caregiver as established by rules promulgated by the department. Family caregivers shall be certified by the department in the same manner as nonfamily caregivers. For purposes of providing for reimbursement of services to a family caregiver, the department shall amend the state plan and apply for a waiver from the centers for Medicaid and Medicare services, as necessary;
(xii) "Intentional" means that a person, with respect to information, intended to act in violation of the law;
(xiii) "Knowing" or "knowingly" includes intentional or intentionally and means that a person, with respect to information, acts:
(A) With actual knowledge of the information;
(B) In deliberate ignorance of the truth or falsity of the information; or
(C) In reckless disregard of the truth or falsity of the information.
(a) Services and supplies authorized for medical assistance under this chapter include:
(i) Inpatient hospital services;
(ii) Outpatient hospital services;
(iii) Laboratory and x-ray services;
(iv) Skilled nursing home services;
(v) The professional services of a licensed and certified physician, osteopathic physician or chiropractic doctor;
(vi) Home health services;
(vii) Family planning services;
(viii) Services provided by an authorized rural health care clinic;
(ix) Midwife services provided by a:
(A) Certified nurse midwife licensed by the board of nursing;
(B) Midwife licensed by the board of midwifery.
(x) Early and periodic screening, diagnosis and treatment for individuals who have not attained the age of twenty-one (21) years in accordance with Title XIX of the federal Social Security Act;
(xi) Premiums, deductibles and coinsurance under federal Medicare Part A, hospital insurance, and Part B, supplemental medical insurance;
(xii) The professional services of a licensed optometrist;
(xiii) Prescription drugs and oxygen;
(xiv) Prosthetic devices which are necessary to replace a missing portion of the body or assist in correcting a dysfunctional portion of the body including training required to implement the use of the device but excluding dental prostheses;
(xv) Licensed rehabilitation center services and if specifically prescribed by a licensed physician, outpatient services of a privately operated licensed occupational, speech, audiology or physical therapy center and the professional services of a licensed occupational therapist, licensed speech pathologist, licensed audiologist or a licensed physical therapist;
(xvi) Services provided by an institution for mental illnesses;
(xvii) Services provided under a federal home and community based waiver;
(xviii) The professional services of a licensed dentist which may be legally and alternatively performed by a licensed physician or osteopathic physician and except as provided under paragraph (a)(x) of this section, which are not primarily provided for the care, treatment or replacement of teeth or structures directly supporting teeth;
(xix) Services provided by a freestanding ambulatory surgical center;
(xx) Services provided by a certified mental health center or community substance abuse treatment center; mental health services provided to qualified recipients by a licensed physician or under the direction of a physician if an individual treatment plan is established in writing, approved and periodically reviewed by a licensed physician; services provided by a licensed mental health professional. Authorized services shall include services provided by a person holding a provisional license as a mental health professional if the services were provided under the supervision of a licensed mental health professional. The department of health shall by rule and regulation or within the state plan for medical assistance and services, define those services qualifying as mental health services under this paragraph and, pursuant to W.S. 9-2-102, establish standards for certification under this paragraph. As used in this paragraph "licensed mental health professional" means a licensed professional counselor, a licensed marriage and family therapist, a licensed addictions therapist or a licensed clinical social worker;
(xxi) Services provided by intermediate care facilities;
(xxii) Services provided by an intermediate care facility as defined under 42 U.S.C. § 1396d(d);
(xxiii) Services provided by freestanding end stage renal dialysis clinics or centers;
(xxiv) Services provided by advanced practitioners of nursing;
(xxv) Hospice care as defined in W.S. 35-2-901(a)(xii) and authorized under 42 U.S.C. § 1396a(a)(10)(A)(ii)(VII) including hospice care in a hospice facility for an eligible individual and room and board for individuals receiving the care in a hospice facility. Reimbursement rates for hospice care shall be set annually to match Medicare hospice reimbursement rates. The room and board reimbursement rate for hospice facilities shall not exceed one hundred percent (100%) of the statewide average of the Medicaid nursing home room and board rate when an eligible individual is receiving hospice. For the purposes of this paragraph, "eligible individual" means a person who is eligible for hospice care as defined in the state Medicaid plan in effect on July 1, 2012;
(xxvi) Tuberculosis ambulatory care authorized under 42 U.S.C. § 1396a(a)(10)(A)(ii)(XII);
(xxvii) Targeted case management services, which shall be services which will assist targeted individuals eligible under the state plan in gaining access to needed medical, social, educational and other services;
(xxviii) Skilled nursing home extraordinary care in accordance with W.S. 42-4-104(d);
(xxix) Bone marrow, kidney and liver transplant services;
(xxx) Programs and services provided under the school health program;
(xxxi) Services of a licensed dietitian;
(xxxii) Air ambulance transport services, consistent with W.S. 42-4-123;
(xxxiii) Clubhouse rehabilitation services in accordance with W.S. 42-4-124;
(xxxiv) The professional services of a school psychologist;
(xxxv) The professional services of a school social worker;
(xxxvi) School based services delivered pursuant to an individualized education program, including services:
(A) Provided by an otherwise enrolled Medicaid provider type;
(B) Provided by a licensed professional in a school setting; or
(C) Otherwise covered under this chapter to support delivery of special education programs and services.
(xxxvii) The professional services of a licensed pharmacist;
(xxxviii) Podiatry services provided by a podiatrist licensed by the board of registration in podiatry, if referred to a podiatrist by a physician, physician assistant or an advanced practice registered nurse;
(xxxix) Services provided by birthing centers as defined by W.S. 35-2-901(a)(iii).
(b) In addition to other payments authorized under this chapter, the department may provide payments to skilled nursing homes which are providing services covered under this chapter if:
(i) The nursing home demonstrates that one hundred percent (100%) of the additional amount received will be expended upon direct patient care personnel salaries and benefits; and
(ii) The nursing home agrees to provide sufficient data to the department substantiating compliance with paragraph
(i) of this subsection.
(c) For purposes of implementing Medicaid reform pursuant to 2013 Wyoming Session Laws, Chapter 117, the department may apply for any applicable waivers or permissions to allow exceptions to federal conflict free case management definitions for frontier and rural areas, which to the extent consistent with federal law, shall implement a system using a neutral third party to ensure no conflicts exist. Consistent with federal law, the department may phase in the independent case management system. In negotiating a waiver pursuant to this subsection, the department shall, to the extent practicable and approved by the center for Medicare and Medicaid services:
(i) Allow an individual or agency to provide case management and direct services to discrete clients if the services are provided under conflict free circumstances;
(ii) When implementing updated case manager educational standards, provide for a three (3) year transition period and allow credit for prior case manager experience.
42-4-104. Powers and duties of department of health; state Medicaid agent appointed by governor.
(a) The department of health shall:
(i) Administer this chapter;
(ii) Develop a state plan for medical assistance and services provided to qualified recipients under this chapter and otherwise providing for the effective administration of this chapter;
(iii) Maintain records on the administration of this chapter, report to the federal government as required by federal law and regulation and within limitations imposed under W.S. 42-4-112, may provide for the availability of information on the administration of this chapter to interested persons;
(iv) Adopt, amend and rescind rules and regulations on the administration of this chapter following notice and public hearing in accordance with the Wyoming Administrative Procedure Act.
(b) In carrying out subsection (a) of this section, the department may:
(i) Advise, consult and cooperate with any state agency or political subdivision, any other state, the federal government, private industry and other interested persons;
(ii) Negotiate and enter into contract with other public and private agencies and persons as necessary to administer this chapter;
(iii) Directly or by contract and through one (1) or more fiscal intermediaries, provide payments to providers of services and supplies for medical assistance authorized by this chapter in the manner and amount provided by this chapter;
(iv) Receive funds from any source for purposes of carrying out this chapter;
(v) Establish reasonable limits on services and supplies authorized under W.S. 42-4-103;
(vi) Conduct pilot projects pursuant to W.S. 42-4-107(c);
(vii) Provide for part or all of the services and supplies authorized under W.S. 42-4-103 for some or all categorically eligible individuals through health care insurance or through contracts with networks of health care providers;
(viii) Purchase stop gap insurance;
(ix) Enter into intergovernmental transfer arrangements with qualifying facilities and providers, including but not limited to hospitals, nursing homes, hospital owned and operated professional service providers and ground ambulance service providers, in which all federal funding received as a result of the intergovernmental transfer arrangements shall be distributed to participating facilities and providers in accordance with the terms of an approved state plan amendment or other agreement with the centers for Medicare and Medicaid services. Notwithstanding, if consistent with the state plan amendment or agreement, the department may use funds derived from such intergovernmental transfers to pay administrative expenses incurred by the department or its agent in performing the activities authorized under this subsection, provided that these expenses shall not exceed a total of three percent (3%) of the aggregate intergovernmental transfer funds collected in the fiscal year;
(x) Provide for the withholding of medical assistance payments from nursing care facilities in accordance with W.S. 42-8-107(b)(i).
(c) Subject to limitations imposed under this subsection, the department shall, at least once every five (5) years but not more than once in any three (3) year period, establish a new base period to be used in calculating all skilled nursing homes' medical assistance per diem base rate reimbursable under this chapter, using the most recent cost report information provided to the department. For purposes of medical assistance reimbursable under this chapter, the department shall reimburse each eligible provider of skilled nursing home services the greater of the following amounts:
(i) Medical assistance computed on the per diem base rate under the new base period established pursuant to this subsection; or
(ii) For the state fiscal year beginning July 1, 2003 and ending June 30, 2004, medical assistance computed on the per diem base rate existing prior to the establishment of the new base period under this subsection.
(d) The department shall establish by rule the conditions and requirements for skilled nursing home extraordinary care. The requirements shall include, but are not limited to the following:
(i) The care shall be previously authorized by the department for each individual and subject to continual audit by the department;
(ii) The cost for the care shall clearly exceed the standard skilled nursing home per diem rate;
(iii) The cost shall be excluded from the nursing home's cost report to the department; and
(iv) No extraordinary care payment shall be made for equipment owned by the nursing home in providing the care.
(e) The chief administrator of the Medicaid program created pursuant to this chapter shall be the state Medicaid agent within the department of health, who shall be appointed by the governor, shall serve at the pleasure of the governor and may be removed by the governor as provided by W.S. 9-1-202. The state Medicaid agent shall oversee and coordinate all programs which provide Medicaid services or determine Medicaid eligibility pursuant to W.S. 42-4-106 and chapter 2 of this title.
42-4-106. Application for assistance; determination of
eligibility; assignment of benefits; resources and income allowances defined for institutionalized spouse.
(a) Any Wyoming resident may apply for medical assistance under this chapter by filing an application by telephone, by mail, in person at the eligibility customer service center in Cheyenne, on the eligibility internet site or at a department of family services field office located in the county in which the individual resides. A determination of eligibility for medical assistance shall be based upon the application. Medical assistance shall be provided on behalf of a qualified applicant with reasonable promptness.
(b) Upon signing an application for medical assistance under this chapter, an applicant assigns to the department any right to medical support or payment for medical expenses from any other person on his behalf or on behalf of any relative for whom application is made. The assignment is effective upon a determination of eligibility. Application for medical assistance shall contain an explanation of the assignment provided under this subsection.
(c) In determining the eligibility of an institutionalized spouse for medical assistance under this chapter, the resources of the noninstitutionalized spouse shall not be considered available to the institutionalized spouse to the extent the amount of his resources does not exceed the maximum authorized by the Medicare Catastrophic Coverage Act of 1988, P.L. 100-360. For purposes of determining the amount of an institutionalized spouse's monthly income to be applied towards payment of institutional care costs, the maximum amount of allowance authorized by the Medicare Catastrophic Coverage Act of 1988, P.L. 100-360 shall be deducted from his monthly income.
(d) In any assistance program under this chapter for which income is the criterion or one (1) of the criteria for assistance payments, compensation received for a veteran's service connected disability shall not be counted in determining income if that compensation on an annual basis is not more than the poverty level for the applicant as determined by the federal office of management and budget.
(e) The following requirements shall be met before an applicant is eligible for medical assistance under this chapter: [NOTE: This subsection will be effective 7/1/2027.]
(i) An applicant shall be a citizen or national of the United States and shall provide a valid social security number and proof of identity. An applicant considered to be lawfully present in the United States shall be eligible for medical assistance under this chapter. The requirement in this paragraph shall not apply when determining if the department of health will cover children in the custody of the department of family services;
(ii) An applicant shall be a Wyoming resident or meet the criteria specified in the Wyoming Medicaid state plan. An applicant who intends to return to the applicant's home in another state or country shall not be considered a Wyoming resident;
(iii) An applicant shall fulfill not less than one (1) of the following criteria:
(A) Be determined disabled according to social security guidelines by the social security administration or the department;
(B) Be entitled to receive supplemental security income or be eligible for supplemental security income-related programs;
(C) Be entitled to receive hospice services in accordance with a voluntary election and a health care provider statement of a terminal condition where:
(I) The applicant has received hospice services or resided in a medical institution for not less than thirty (30) consecutive days; or
(II) The applicant is not a supplemental security income recipient and dies before completion of the time requirement specified in subdivision (I) of this subparagraph.
(D) Be qualified for services, pursuant to rules of the department, under a Medicaid waiver or other expansion that the legislature has authorized;
(E) Be infected with tuberculosis and, if the person is not a Wyoming resident or United States citizen, is present in Wyoming and, if not treated, is a threat to infect Wyoming residents with tuberculosis;
(F) Be otherwise qualified for medical assistance pursuant to federal Medicaid regulations or be eligible under a mandatory requirement of the federal government for participation in Medicaid, provided that no expansion eligibility for Medicaid beyond the eligibility as of January 1, 2026 shall occur without prior authorization by the legislature, except that the governor may authorize a temporary expansion in eligibility needed to combat a public health emergency, provided that the temporary expansion shall end not more than thirty (30) days after the adjournment of the next legislative session;
(G) Be a child in the custody of the department of family services in foster care, basic foster care, noncitizen foster care, subsidized adoption or in residence at the Wyoming boys' school or the Wyoming girls' school;
(H) Be enrolled in the 1115 family planning waiver. The department of health is authorized to continue operating the 1115 waiver until its planned expiration in December 31, 2027 and is not authorized to renew the waiver beyond this expiration date;
(J) Be enrolled in the employed individuals with disabilities program under section 1902(a)(10)(A)(ii)(XV) of the federal Social Security Act;
(K) Be enrolled in the breast and cervical cancer treatment program under section 1902(a)(10)(A)(ii)(XVIII) of the federal Social Security Act.
(iv) An applicant shall fulfill any other criteria required pursuant to rules of the department or federal Medicaid regulations.
42-4-107. Uniform application throughout state; discrimination prohibited; pilot projects authorized.
(a) This chapter and the state plan for medical assistance and services developed under W.S. 42-4-104(a)(ii) shall be uniformly applied within all political subdivisions of the state.
(b) The provision of medical assistance to any applicant or qualified recipient shall not be denied or delayed and the administration of this chapter shall not otherwise discriminate against any applicant or recipient on the basis of race, creed, color, national origin, sex or mental or physical handicap.
(c) Notwithstanding any other provision of this act, the department, in providing services and supplies authorized by this act, may conduct pilot projects pertaining to some or all categorically eligible individuals.
In accordance with the Wyoming Administrative Procedure Act, the department shall provide opportunity for a hearing to any individual denied medical assistance under this chapter or otherwise aggrieved by the administration of this chapter.