The Joint Appropriations Committee in Dubois heard detailed testimony Tuesday that funding everyone currently on the developmental disabilities (DD) waiver wait list would require about $24.9 million on the 2027–28 biennium, and that addressing provider reimbursement and emergency-care funding will be necessary to convert that budget into real services.

Why it matters: The committee must weigh a biennial funding request alongside broader Department of Health priorities and federal matches. Lawmakers and providers told the committee that money alone will not solve a workforce shortage and that the state’s rate study and rebasing work must inform any appropriation.

Stefan Johansson, director of the Wyoming Department of Health, told the committee the department’s follow-up memo projects 389 people on the DD waiver wait list as of the hearing, with a modeled projection in the 400–450 range if current enrollment trends continue. "If you, legislature, wanted to provide support waiver budget right now for everybody on the wait list, that would provide them an individual level budget," Johansson said, summarizing the department’s estimate that the supports waiver costs about $30,000 per year per person and that funding roughly 415 people would total about $24,900,000 for the biennium. Johansson said approximately half of that amount would be state general fund, matched by federal Medicaid dollars.

Department officials emphasized three connected policy issues for lawmakers: (1) funding people off the wait list; (2) provider reimbursement rates; and (3) emergency or extraordinary-care funding for cases whose needs change during the wait. Elizabeth Forslund, the department’s home and community-based services section administrator, described what the published rate studies include: direct-care wages and benefits, non–face-to-face time such as supervision, and indirect costs like fleet vehicles and property-related expenses. She also noted the state’s statutory requirement to perform those rate studies.

Provider capacity and wages were a prominent focus. Committee members and providers said recruitment and retention of direct service professionals (DSPs) is a major constraint. Testimony at the committee and in a tour the day before noted entry wages around $15–$16 per hour; the department’s most recent rate-rebasing analysis modeled a DSP wage assumption of roughly $20 per hour (including benefits), which was a primary driver of a far larger rebasing cost estimate. The 2024 rate-rebasing study estimated a roughly $24,000,000 annual price to rebase rates; biennialized at that level it would be roughly $48,000,000 with the federal match structure described by the department.

Providers urged the committee to accept and use the cost study as the factual basis for decisions. Bob Sell, chief executive and president of the Wyoming Community Service Providers Association, read the steering committee language: "the steering committee voted to issue this report with the rate analysis and model as presented, but it also recommended against funding the rate model." Sell argued the publication met the statutory study requirements and said the department’s later comments about a low response rate should not be read as evidence that providers do not need higher rates.

Provider and family testimony underscored workforce pressure and family strain. Jeff Gardner, executive director of the Wyoming Community Service Providers, told committee members that direct-support wages are the foundational component of provider cost models and praised the committee’s attention. Tina Conley, executive director of IReach 2 in Casper, described accreditation and regulatory safeguards and defended system integrity against claims of widespread fraud. Parent Dylan Cummings said support workers often cannot make a living wage and worried that funding the wait list without raising pay would leave too few workers to serve newly funded participants.

Other figures and program details offered during testimony: the department said about 500–600 providers operate statewide and that roughly half of those serve fewer than three people each; waste/fraud review activity included 39 cases opened, 29 found compliant, 8 ongoing and 2 concluded with settlements (recoveries reported in one example totaling $132,550.63, half of which is typically returned to the federal government). The department also described the extraordinary care committee (ECC) process used to authorize emergency funding when an enrolled person’s needs change.

Committee action: Representative Pendergraft moved that the Joint Appropriations Committee form a three-member subcommittee (two Republicans, one Democrat) to conduct a deeper interim review of the Department of Health budget and to hold up to five meetings (two in person and three virtual) before the committee’s December meeting. Representative Sherwood seconded the motion. The committee approved the motion; Senator Gru registered the only recorded dissent. The motion directs the co-chairs to select membership and seek funding for the subcommittee’s travel/meetings.

What’s next: Johansson said the department will submit its formal biennial budget request to the governor in the coming weeks and that the department’s request will attempt to blend funds for wait-list drawdown, targeted provider-rate increases and extraordinary-care funding. Department staff offered to provide updated wait-list projections and additional tables showing how different funding tiers would affect both wait-list drawdown and provider reimbursement.

The committee members said they will continue follow-up work between now and the session, and the newly formed subcommittee will undertake a deeper analysis of the Department of Health budget to inform decisions on which combinations of wait-list funding, rate rebasing and emergency funding the legislature may adopt.