048-46 Wyo. Code R. § 46-10
(a) The services that may be self-directed are outlined in the Comprehensive and Supports Waiver Service Index, which is incorporated by reference.
(b) At least once a year, each participant's case manager shall provide the participant or legally authorized representative information regarding the option to self-direct waiver services. Information shall include requirements of the employer of record, not limited to:
(c) Self-Directed services are available to a participant who:
(d) To self-direct waiver services, the participant or legally authorized representative or other designee shall act as the Employer of Record and use a Financial Management Service on contract with the Division.
(e) A participant shall only self-direct services if the Financial Management Service contractor has open slots for new people to enroll, based upon the contracted capacity.
(f) The Financial Management Service shall assist the participant in being the Employer of Record.
(g) The Division shall provide the recommended wage ranges for all self-directed services.
(h) The Employer of Record shall be responsible to recruit, hire, schedule, evaluate, and supervise self-directed employees. The Employer of Record shall have the budgetary authority to negotiate and set wages and payment terms for all services received.
(i) The Employer of Record shall hire employees to provide waiver services and work with the Financial Management Service to determine that the potential employee meets the general and specific provider standards for the service being provided.
(j) Consistent with the service definitions as outlined in the Comprehensive and Supports Waiver Service Index, which is incorporated by reference, the Employer of Record shall work with the employee hired through self-direction to determine the specific tasks to be completed during the provision of services, the employee's schedule, and how to document services and report documentation and timesheets to the Employer and Financial Management Service. The Employer of Record shall ensure documentation is available to the case manager by the tenth (10th) business day of the month following the month in which services were provided.
(k) When the Employer of Record and the employee have reached agreement on the services, schedule, and rate, the Financial Management Service shall track the rate and services authorized and ensure the employee wages are paid in accordance with state and federal laws.
(l) Employees hired through self-direction shall document services provided in accordance with Chapter 45 and the agreed upon manner between the Financial Management Service and the Employer of Record. The Employer of Record shall maintain documentation in accordance with the Wyoming Medicaid Rules.
(m) The Employer of Record, with assistance from the case manager as needed, shall review employee documentation of the services provided and the employee timesheets to ensure accuracy with the type, scope, amount, frequency, and duration of services agreed upon in the individualized plan of care.
(n) A participant may choose to voluntarily terminate self-direction at any time during the plan year and shall work with the case manager to transition to other services or providers. The case manager shall disenroll the participant from the Financial Management Service within thirty (30) calendar days of notification that the participant chooses to terminate self-direction services.
(o) A participant shall be involuntarily terminated from the use of self-direction if:
(p) A participant who is involuntarily terminated from this service under subsection (o) shall receive written notice from the Division and may request an administrative hearing as provided in Chapter 4 of the Department of Health's Medicaid Rules.
048-46 Wyo. Code R. § 46-10
Adopted, Eff. 6/21/2017.
Amended, Eff. 7/26/2018.