Waiver service providers are persons or agencies (public or private) who not only meet the qualifications and certification requirements of the Waiver program, but who also posess certain qualities. Waiver service providers should be strong communicators who are respectful, trustworty and capable of managing many tasks in an organized manner. After being approved, waiver service providers are then chosen by the child/family and are authorized to provide specific non-clinical services as outlined in the Individual Service Plan (ISP).
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Click here to view complete and specific provider qualifications.
To view complete and specific roles and expectations for the different types of waiver providers, click your choice:
FCC (Family Care Coordinator)
Youth and Family Training and Support
Respite
Click here to view the process of how a provider gets paid
To become a waiver services provider, applicants must do the following:
· Successfully pass criminal history and background investigations
· Successfully pass an abuse registry screening
· Complete the required Division training
· Complete and mail/email the service provider application the CMHW program
After becoming a certified provider you will be required to do the following:
· Must enroll (or already be enrolled) as a Medicaid provider
· Must obtain continuing education hours as outlined for your service provider type
· Must have secure access to a computer with a current and working email address
Please contact Sarah Compton via email at sarah.compton@wyo.gov to have a Provider Application sent to you.
Documents & packet are currently under construction and cannot be accessedd from this site.
These forms are currently being updated.
Provider Forms
FCC 1 Monthly Report Word
FCC 1 Monthly Report PDF
FCC 2 Individual Service Plan Modifications
FCC 3 Pre-approval for Modification PDF
FCC 3 Pre-approval for Modification Word
FCC 6 Psychotropic Medication Consent Form PDF
FCC 10 Waiver Closure Form Word
FCC 11 Out of Home Care Status Report
FCC 12 You Are So Important – Children PDF
FCC 13 You Are So Important – Pre-teen PDF
FCC 14 You Are So Important – Young Adult PDF
FCC 15 You Are So Important -- Document of Training PDF
FCC 16 ISP Review Criteria for Plan Approval (initial plan) PDF
FCC 16 ISP Review Criteria for Plan Approval (subsequent) PDF
FCC 20 SNCD (Strengths, Needs and Cultural Discovery) Word (updated 04/2012)
Letter to prescribing clinician
Provider transition checklist
Questions for parents to ask about psychiatric medications
Waiver service plan team meeting agenda
WP 3 Level of Care Criteria for re-evaluation
WP 4 Exceptional Service Plan Request
WP 9 Freedom of Choice Statement
WP 10 Choice of Provider