ADULT HEALTH SERVICES PROVIDER IN WYOMING

SUPPORTING HEALTH, FUNCTIONAL ABILITY, AND DAILY WELLNESS FOR ADULTS WITH DISABILITIES OR AGE-RELATED CONDITIONS THROUGH PREVENTIVE AND RESTORATIVE CARE

Adult Health Services in Wyoming help adults with disabilities, chronic health conditions, or aging-related needs maintain or improve their overall health, functional abilities, and quality of life. These services are typically non-clinical but health-related and are delivered in the home, adult day settings, or community-based programs to support continued independence and community living. Adult health services are covered under Wyoming Medicaid’s Community Choices Waiver (CCW) and may also be included as supportive components within Developmental Disabilities (DD) Waivers, such as the Comprehensive and Supports Waivers, depending on the participant’s Individualized Plan of Care (IPC) or service plan.

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1. GOVERNING AGENCIES

Agency: Wyoming Department of Health – Division of Healthcare Financing

Role: Oversees policy, funding, and quality monitoring for Medicaid and waiver-based health support services.

Agency: Public Health Nursing (PHN) / Case Management Agencies

Role: Coordinate assessments and care plans that include adult health supports.

Agency: Medicaid Provider Services

Role: Handles provider enrollment, reimbursement, and prior authorization for services under CCW and other Medicaid-funded programs.

2. ADULT HEALTH SERVICES OVERVIEW

Adult Health Services focus on maintaining wellness, supporting functional ability, and preventing health deterioration through structured, non-invasive, supportive care.

Common service components include:

• Health education (nutrition, medication routines, chronic disease self-care)

• Supervision and support with ADLs and basic health routines

• Monitoring weight, blood pressure, or blood glucose (non-diagnostic)

• Cognitive engagement and memory support activities

• Safety checks and fall prevention routines

• Assistance with health-related tasks under RN delegation (when appropriate)

• Coordination with physicians and health providers (non-clinical support)

Services may be provided in-home, in adult day health programs, or via community-based wellness visits.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Wyoming Secretary of State

• Obtain a Federal EIN and Type 2 NPI (if billing Medicaid directly)

• Enroll as a Medicaid waiver provider (CCW or DD Waiver, as applicable)

• Develop an Adult Health Services Policy & Procedure Manual

• Hire staff with experience in health support, aging services, or disability care

• Ensure background checks, abuse registry clearance, and basic health training

• If offering delegated health-related supports, partner with or employ an RN

Licensure is generally not required unless providing clinical or skilled nursing services. However, RN oversight is required for delegated care tasks.

4. WYOMING PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN/NPI

Step 2: Apply for enrollment under the Community Choices Waiver or applicable DD Waiver

Step 3: Submit staff credentials, service descriptions, and Policy & Procedure Manual

Step 4: Complete program-specific training or orientation (if required)

Step 5: Begin services once the participant’s service plan includes authorized adult health supports

5. REQUIRED DOCUMENTATION

• Medicaid provider enrollment documentation

• Adult Health Services Policy & Procedure Manual, including:

  • Participant intake and service assessment process

  • Daily wellness support plans and task documentation

  • Health observation logs (e.g., vital sign trends, changes in condition)

  • HIPAA and client rights protections

  • RN delegation policies (if applicable)

  • Grievance and incident reporting procedures

  • Staff supervision and training records

  • Transportation and community access safety procedures (if applicable)

• Sample care logs, wellness activity checklists, and emergency protocols

6. STAFFING REQUIREMENTS

Role: Adult Health Support Worker / Wellness Aide

Requirements:

• High school diploma or GED

• Experience with aging populations or adults with disabilities preferred

• CPR/First Aid certification

• Background check and abuse registry clearance

• Onboarding and annual training in HIPAA, safety, and client interaction

Role: Registered Nurse (optional/required for delegated tasks)

Requirements:

• Active Wyoming RN license

• Provides care oversight and training to support staff

• May conduct assessments or assist with documentation of health changes

All staff must complete:

• Confidentiality and rights training

• Abuse and neglect prevention

• Health support and emergency procedures training

• Annual performance and competency reviews

7. MEDICAID PROGRAMS THAT COVER ADULT HEALTH SERVICES

• Community Choices Waiver (CCW): Covers wellness support and adult day health services for adults age 65+ or with physical disabilities

• Comprehensive Waiver (I/DD): May include individualized adult health supports in residential or community habilitation contexts

• Supports Waiver (I/DD): Limited availability of adult health-related supports based on functional need

• EPSDT (for individuals under 21): Health support services may be available under Early and Periodic Screening, Diagnostic, and Treatment when medically justified

Note: Adult health services must be included in the participant’s IPC and be linked to documented functional limitations or health maintenance goals. Delegated care must follow state nurse delegation rules.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Development

Timeline: 2–3 weeks

Phase: Staff Hiring & Training Setup

Timeline: 30–45 days

Phase: Medicaid Waiver Enrollment & Approval

Timeline: 1–3 months

Phase: Begin Service Delivery

Timeline: Upon IPC approval and provider credentialing

9. CONTACT INFORMATION

Wyoming Medicaid Provider Services

Website: https://health.wyo.gov/healthcarefin/medicaid/providers/

Community Choices Waiver Info

Website: https://health.wyo.gov/healthcarefin/ltc/home-and-community-based-waiver/

Developmental Disabilities Division (DDD)

Website: https://health.wyo.gov/behavioralhealth/dd/

Wyoming Secretary of State – Business Portal

Website: https://sos.wyo.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WYOMING ADULT HEALTH SERVICES PROVIDER

WCG helps agencies design and launch wellness-focused adult health services that bridge the gap between clinical care and daily living support, improving health outcomes and preserving independence.

Scope of Work:

• Medicaid waiver enrollment support

• Adult Health Services P&P Manual development

• Daily wellness tracking templates and documentation tools

• Staff onboarding checklists and training resources

• RN delegation policy assistance (if applicable)

• Billing and audit documentation support

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.