Wyoming Community Choices Home & Community Based Services Medicaid Waiver

Program Description

The Community Choices Home and Community Based Services Waiver, abbreviated as CCW, provides long-term care services for individuals who require a nursing home level of care, but choose to remain living in the community (their home, the home of a family member, or an assisted living residence) rather than in a nursing home. Services include personal care assistance, meal delivery, adult day care, respite care, and more.

One particularly attractive benefit of the CWW is the In-Home Participant Directed Option (more commonly called self-directed or consumer directed care). This benefit allows eligible participants to serve as the employer of their care provider, also referred to as a direct service worker. This means they can choose who will be their paid caregiver. Individuals using the In-Home Participant Directed Option must have the ability to, and must want to, direct their own care. The role includes all aspects of being an employer, including hiring, training, and firing of their direct service worker. For those unable to manage these activities, a family member with power of attorney may be able to do so on their behalf.

Another attractive component of the In-Home Participant Directed Option is that family members, such as an adult child, can be hired as the direct service worker. Make note, spouses, legal guardians, power of attorneys for health care, power of attorneys, and health care directive designees cannot be hired to provide care. Direct service workers earn approximately $10 - $12 / hour and cannot work in excess of 40 hours / week.

The Community Choices Waiver is not an entitlement program, which means there are limited slots available for enrollment. Said another way, just because one is eligible for the program does not guarantee that they will be accepted into the program. CCW is administered by the Wyoming Department of Health’s Division of Healthcare Financing.

Make note, the Wyoming Medicaid Long Term Care Waiver (also known as the Home and Community Based Waiver and the Elderly and Physically Disabled Long Term Care Waiver) and the Assisted Living Facility Waiver are now operating under the Community Choices Waiver. 

Eligibility Guidelines

Community Choices Home and Community Based Services Waiver is a Medicaid program and as such, the participant must be eligible for Wyoming Medicaid (also known as Equality Care). The following eligibility criteria are specifically for seniors for this waiver.

Residency – Applicants must be residents of the state of Wyoming.

Age - Applicants must be 65 years of age or older or between 19 and 64 years old and be declared blind or disabled.

Functional Ability - Applicants must require a level of care that is equivalent to that of nursing home care.

Income - As of 2017, a single applicant cannot have income in excess of $2,205 / month, or said another way, no more than $26,460 / year. However, having income greater than this amount does not automatically disqualify an applicant. One possible way to still qualify is by establishing an income trust. Learn more about income trusts here.

Assets - In 2017, a single applicant can have resources (assets) up to $2,000. That being said, certain resources are considered exempt items, such as one vehicle and an individual’s primary home, given the home is not valued at more than $560,000 and the applicant lives in the home.

Wyoming residents who exceed these limits but still cannot afford their care costs might also qualify for this program by working with a Medicaid planning professional. Learn more.

 

Benefits and Services

A variety of services are available via this waiver, including both in-home services and services provided in assisted living. (This waiver does not cover room and board for assisted living, strictly services to help delay nursing home placement.) Make note, not all services may be available in all areas.

  • Adult Day Care
  • Assisted Living Services – homemaker, personal care, medication management, and supervision
  • Case Management
  • Home Delivered Meals – up to two meals / day
  • In-Home Participate Directed Option / Direct Service Worker
  • Non-Medical Transportation
  • Personal Care Attendant – assistance with bathing, grooming, oral hygiene, toiletry, grocery shopping, meal preparation, etc. 
  • Personal Emergency Response System
  • Respite Care – 30 day limit per year
  • Skilled Nursing – must be prescribed by a physician

 

How to Apply / Learn More

For additional information about the Community Choices Waiver, click here. To apply, contact the Division of Healthcare Financing Long Term Care Unit at 855-203-2936. Applicants should expect to have a medical assessment done to determine the level of care needed. In most cases, one’s application is either approved or denied within 45 days.