(a) The allocation of Medicaid waiver funds that may be available to a participant to purchase services shall be based on his or her assessed needs.
(b) Eligible individuals shall be assigned a Level of Service score.
(c) The Supports Waiver. - (i) The purpose of the Supports Waiver is to assist individuals and their families in obtaining person-centered services and utilizing both natural supports and paid providers to support individuals in the home they own, lease, or share with family. This waiver allows for more flexibility for waiver participants to develop and change their service plans, provides resources and training to assist participants in learning the services system, offers new service options, gives participants an opportunity to self-direct services and hire and fire staff, and provides ongoing resources and training.
- (ii) Participants enrolled in the Supports Waiver shall be assigned an individual budget amount based on:
- (A) The participant's age group, whether or not the participant has reached the age of 21;
- (B) An average cost for the assessed service needs for individuals in the participant's age group;
- (C) The participant's access to services available through programs funded under Section 110 or 504 of the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act ( 20 U.S.C. 1401 et seq.);
- (D) An amount for annual case management services;
- (iii) The Level of Service score shall be used in order to determine eligibility and priority order for Comprehensive Waiver funding.
- (iv) Transition to the Comprehensive Waiver shall only occur as funding and a slot on the Comprehensive Waiver becomes available.
(d) The Comprehensive Waiver. - (i) Participants shall meet criteria outlined in Section 5(d) to be considered for Comprehensive Waiver Services.
- (ii) Participants enrolled on the Comprehensive Waiver shall be assigned an individual budget amount based on the following factors:
- (A) Functional and medical assessments, including the ICAP assessment, and past approved individualized plans of care;
- (B) The participant's age group, whether or not the participant has reached the age of 21;
- (C) The participant's living situation;
- (D) The participant's need for a higher level of services;
- (E) An amount for annual case management services; and
- (F) Any temporary or permanent increase or decrease as determined by the ECC.
- (iii) The factors in subsection (d)(ii) determine the participant's Level of Service score in order to plan for appropriate services and supports.
- (iv) Supports to the participant through waiver services shall align with the Level of Service scoring rubric associated with the person's Level of Service score. The scoring rubric is outlined in the Comprehensive and Supports Waiver Service Index, which is incorporated by reference.
- (v) A participant's individual budget amount on the Comprehensive Waiver shall not exceed the current annual average cost of a resident at the Wyoming Life Resource Center. A participant who needs services in excess of this amount shall have the individualized plan of care and budget approved by the ECC, who shall work with the participant's providers and plan of care team to evaluate the provision of services, monitor service delivery and participant outcomes, improve services and supports, and make plans to improve outcomes for the participant.
048-46 Wyo. Code R. § 46-8