Getting paid to care for a family member in Wyoming
Depends.
In Wyoming, whether a family member can be paid depends on the program's rules, which are below with their sources. Whether a spouse can be paid depends on conditions set out below with their sources.
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Medicaid waiver
Community Choices Waiver
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Who qualifies
Wyoming adults 65 or older, and adults 19 to 64 with a disability that meets Social Security Administration criteria, who are eligible for Wyoming Medicaid (or meet the income and resource rules of the Special HCBS Waiver Group) and who are found, after an assessment by a trained public health nurse, to need the level of care a nursing facility provides.
People on an HCBS waiver, including the Community Choices Waiver, who choose to hire someone to help with daily activities such as bathing, dressing and meal preparation instead of having a traditional agency come to their home. You, or a person you choose who is 18 or older, act as the employer: you hire, train, manage and dismiss your own employees, set their wages within program and service plan limits, and stay within your budget. A Financial Management Service (currently ACES$) handles enrollment and payroll.
Participant-direction is a way of receiving waiver services, not a separate program. Talk to your case manager to find out whether it fits your situation.
Depends.
Yes, unless the family member holds financial authority for you. Any person can be your employee who is 18 or older, passes the required background screenings, can provide the services in your plan of care, and is not legally responsible for making financial decisions for you. Your legally authorized representative or decision maker, anyone with legal permission to make financial decisions or sign financial documents for you, your case manager and your case manager's spouse cannot be your employee.
Companion and homemaker services cannot be provided by the participant's biological, adoptive or step parents. If someone else acts as your employer, that person and their spouse cannot also be your paid employee.
Depends.
Yes, under conditions, through participant-direction. Wyoming's approved Community Choices Waiver says a spouse may be paid for Personal Support Services, Adult Day Services, Respite, Homemaker Services, Companion Services and Non-Medical Transportation under participant direction if the spouse meets the service qualifications, is not the participant's legal guardian or designated employer of record, and is not authorized to make financial decisions for the participant.
In the same approved waiver, item C-2-d on paying legally responsible individuals for personal care is marked No. The Wyoming Department of Health's 2026 renewal training adds that the care needed must exceed what is naturally expected in a spousal relationship, the service plan must document that it prevents service gaps and nursing home placement, and the case manager must document these conditions before the spouse is hired.
Complete an application for Medicaid and the Community Choices Waiver application. The Division's Client Services Unit can make the waiver referral when you apply for Medicaid, and family members, friends, hospitals, senior centers or case management agencies can also refer you by calling the Home and Community-Based Services Unit or emailing ccw.waivers@wyo.gov. During the application you choose a case management agency serving your county.
Work with your case manager to decide whether participant-direction fits you. The case manager gives you the Participant Direction Employer Manual and helps you complete the Employer Delegation Form (PD06) and Employer Agreement (PD09), which go with the referral to the Financial Management Service. Your employee can start once the FMS has an agency-approved budget and complete enrollment paperwork.
