The Wyoming Department of Health told the Joint Labor, Health & Social Services Committee it plans to submit an application by the Nov. 5 federal deadline for the Rural Health Transformation Program created under HR1. The department said that if Wyoming’s application is approved under the program’s formulaic first tranche, the state would receive a floor allocation of $100 million per year — roughly $500 million over five years — and could compete for additional discretionary funds.

Deputy director Franz Fuchs and Medicaid officials briefed the committee on program structure and the state’s public engagement. The department ran a set of in‑person town halls (Wheatland, Newcastle, Powell, Buffalo, Lander/Riverton tribal meeting, Evanston, Saratoga, Laramie) and three virtual sessions, then put an online survey in the field for about eight days; officials said they received roughly 1,500 responses. The feedback, department officials told the committee, coalesced around a short list of priorities that the state will use to frame its application: improving the financial viability of small rural hospitals (emergency care and basic inpatient services), expanding affordable health insurance options, recruiting and retaining primary care physicians, expanding nursing and direct‑care training capacity, strengthening obstetric/labor‑and‑delivery services, and improving ambulance/EMS availability.

Department officials emphasized program constraints in federal guidance. The funds cannot generally be used for broad, indefinite increases in reimbursement rates; capital construction of new facilities is broadly disallowed though limited "rightsizing" or conversion work tied to sustainability is allowed within caps. CMS guidance also requires sustainability plans for investments and authorizes federal review and potential clawbacks if agreed milestones or accountability measures are not met. The department said it intends to limit administrative overhead well under the CMS cap (the guidance caps program administrative expenses, and the state aims to be below 10 percent) and to prioritize program elements that can be sustained after the federal five‑year window.

Officials sketched a few concrete examples: supporting alternative payment approaches to help hospitals cover fixed costs (emergency departments, OB, high‑acuity behavioral health), targeted investments to shore up EMS readiness, and scaling existing workforce programs such as loan repayment and scholarships to increase the supply of nurses and primary care providers. Fuchs said the state already operates some programs that could be scaled quickly (loan repayment for providers, community college nursing expansion) and that a careful prioritization process is necessary because federal funds cannot reasonably solve every need.

Committee members asked about allowable uses of funds, program accountability, and tribal participation; the department said it had met with tribal leaders and is incorporating tribal feedback. The department told the committee it will pursue a two‑part application strategy: the formulaic guaranteed allotment (floor) and the competitive "workload" tranche for additional funds, and reiterated the Nov. 5 submission target.

What to watch: The state application and any draft sustainability commitments submitted to CMS; whether Wyoming’s priorities (hospital financial viability, EMS, OB, workforce and insurance access) are reflected in the final application; and whether the state wins additional competitive awards beyond the floor allocation.