Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 47 - CHILDREN'S MENTAL HEALTH WAIVER (CMHW) AND CARE MANAGEMENT ENTITY (CME) RULES
Section 47-20 - Transition Process

Universal Citation: WY Code of Rules 47-20

Current through September 21, 2024

(a) Transition of youth who exceed the maximum age limitation shall occur before the end of the month of their twenty-first (21st) birthday:

(i) Any and all pertinent POC shall initiate development of a plan to address transition goals before transition is expected to occur.
(A) Transition plans shall include, but not be limited to, detailed, measurable objectives to be followed by the team in support of the youth and family during the transition.

(b) If a youth loses Medicaid eligibility, the youth is no longer eligible for state plan services. The Department will reserve five (5) waiver funding opportunities per year for Medicaid state plan youth enrolled in the HFWA program who lose Medicaid eligibility to assist with the transition off or completion of their HFWA POC. This transition shall occur concurrently to the youth's loss of Medicaid to prevent a lapse in care.

(c) The Department shall reserve five (5) CMHW program funding opportunities to triage financially and clinically qualified youth with a CASII composite score of 25 or higher or an ESCII composite score of 23 or higher. Immediate service initiation shall occur to prevent or divert the youth from being admitted to an inpatient psychiatric facility for individuals under age 21 as provided in 42 CFR § 440.160.

(d) CME and CMHW participants who are placed out of their community in an out-of-home placement that results from hospitalization, detention, other types of institutionalization, or who have relocated out of their home community for any other reason, shall be disenrolled no later than one hundred twenty (120) days from the initial date of their absence from the community.

(i) Upon written request from the provider, exceptions to the one hundred twenty (120) day absence rule may be allowed when it is anticipated the youth will return to their community within one hundred eighty (180) days of the initial date of their absence, and the CME network provider has gained prior approval from the CME via the youth's current POC to extend wraparound services during this time frame to assist in transition back to the community.

Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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