Article 1 in general 351101. Local contributions; disposition


1621.  All state funds for human services contracted to department; federal and private funding not affected



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351621.  All state funds for human services contracted to department; federal and private funding not affected.
A state agency which provides state or federal funds to a community based mental health, substance abuse, developmental disabilities or other human services program shall contract the funds to the department. The department shall expend the funds in accordance with W.S. 92102 and this act. This section does not impair the ability of community based programs to apply for or receive funds directly from federal or private sources, subject to W.S. 351620(b)(i).
351622.  Department; budget requests; purchase of service contracts; local match.
(a)  The department's budget request shall recommend:
(i)  The types of services that the division shall purchase, which shall not include shelter and crisis services for victims of domestic abuse or sexual assault;
(ii)  The levels of services that the division shall purchase based on population, needs assessment, regional cost differences necessary to provide reasonably similar access to services and other criteria; and
(iii)  The quality of services that the division shall purchase.
(b)  The department shall contract with community boards, public agencies and private agencies to purchase only those services funded by the legislature on a statewide basis. Funds contracted for under this act, other than funds for developmental preschool services, shall not exceed ninety percent (90%) of the total nonfederal expenditures for human services programs by any community board or public agency. For developmental preschool services the local match requirement shall be three percent (3%).
351623.  Contracts; reports; regular payments; termination.
(a)  Every contract awarded pursuant to this act shall require:
(i)  The program provider to submit annual financial and expenditure reports to the department;
(ii)  The division to make regular payments to the program provider based on the services provided;
(iii)  Compliance with W.S. 183516(e).
(b)  The division shall terminate a contract with a program provider made under this act when the division finds, after a hearing in accordance with W.S. 163107 through 163112 if requested by the provider, that the program provider is not using contract funds for contract purposes, or that a contract program is not being administered in accordance with this act.
351624.  Contracts with private agencies; eligibility.
(a)  To be eligible to contract with the department, a private agency shall:
(i)  Have as its primary purpose the provision of human services programs;
(ii)  Be chartered under the laws of the state of Wyoming;
(iii)  Provide at least one (1) human services program which serves the residents of at least one (1) county;
(iv)  Appoint a director whose qualifications meet the standards fixed by the division and prescribe his duties; and
(v)  Charge clients fees at a rate comparable to the uniform schedule of fees for services that have been promulgated by the division. Private agencies may charge a reasonable fee for those services not covered in the division's uniform fee schedule.
351625.  Protection of clients' rights.
(a)  Every contract awarded under this act shall require the program provider to guarantee the clients' rights to:
(i)  An individualized plan of appropriate services which provides for the least restrictive treatment that may reasonably be expected to benefit the client;
(ii)  Send and receive sealed mail;
(iii)  Wear his own clothing, to keep and use personal possessions, including toilet articles, unless the articles may be used to endanger their own or others' lives, and to keep and be allowed to spend his own money;
(iv)  Be free from physical restraints and isolation except for emergency situations or when isolation or restraint is a part of a treatment program;
(v)  Be free from unnecessary or excessive medication;
(vi)  Make and receive telephone calls within reasonable limits;
(vii)  Receive visitors daily; and
(viii)  Be informed orally and in writing of the rights under this section at the time of admission.
(b)  Every contract awarded under this act shall require the program provider to:
(i)  Post copies of this section conspicuously in each client area;
(ii)  Make copies of this section available to the client's guardian or immediate family.
351626.  Isolation; restraint; medication.
(a)  Isolation or restraint of a client may be used only when less restrictive measures are ineffective or not feasible for the welfare of the client and shall be used for the shortest time possible. Each center or facility shall have a written policy covering the use of restraint or isolation which ensures that the dignity and safety of the individual are protected and that there is regular, frequent monitoring by trained staff.
(b)  No medication may be administered to a client except on the written order of a physician. A record of the medication which is administered to each patient shall be kept in his treatment record. Medication may not be used as punishment, for the convenience of staff or in quantities that interfere with a client's treatment program.
351627.  Examination of accounts.
The governing body of any entity receiving state funds under this act shall not less than every two (2) years cause to be made an audit or other oversight of the financial affairs and transactions of all funds and activities of the entity in accordance with W.S. 164121(b) and (c) and 164122. Costs of the audit or other oversight shall be borne by the entity. Copies of audit reports or other reports shall be submitted to the division upon completion. The director of the state department of audit may examine the accounts of any entity receiving state funds under this act. The legislative service office may audit the accounts of any entity. These accounts shall be maintained in a manner to guarantee confidentiality of the patient's identity. The state auditor and treasurer shall not disburse any state money to any entity refusing access to its accounts and records for the purposes of this section.
351628.  Community based respite care services.
(a)  The department of health shall develop and administer a statewide program to provide community based respite care services to families with a member age birth to twenty-one (21) years who has developmental disabilities who is not eligible for home and community based waiver services under medicaid. This program shall be designed so as to permit persons with developmental disabilities who are under twenty-one (21) years of age to be cared for by the family to the greatest extent possible. The department in consultation with the Wyoming governor's council on developmental disabilities shall:
(i)  Establish criteria for eligibility for respite care services which shall include consideration of:
(A)  The family's need for services, including factors such as the demonstrated willingness and ability of family members to provide care and special requirements of the family member with a developmental disability;
(B)  Family income;
(C)  Family expenses, including those related to care of the individual with a developmental disability;
(D)  Reasonable payment by the family for respite care services provided.
(ii)  By rule and regulation limit the ability of individual eligible families to use the program so that all eligible families are able to use the program without exceeding the appropriation available;
(iii)  Promulgate rules and regulations necessary for the administration of the program.
(b)  As used in this section:
(i)  "Developmental disability" means a severe, chronic disability of a person which is attributable to a mental, emotional or physical impairment or combination of impairments, manifested before the person attains twentytwo (22) years of age, is likely to continue indefinitely and results in substantial functional limitations in three (3) or more of the following areas:
(A)  Selfcare;
(B)  Receptive and expressive language;
(C)  Learning;
(D)  Mobility;
(E)  Selfdirection;
(F)  Capacity for independent living; and
(G)  Economic selfsufficiency.
(ii)  "Respite care" means care of a developmentally disabled person by a competent person, trained to meet the individualized needs of a child who meets the eligibility criteria of this program, for short periods of time to allow other members of the family reprieve from continuous care.
ARTICLE 7

SCHOOL HEALTH


351701.  Joint committee created.
A joint committee on school health composed of the state department of education and the state department of health is hereby created and established.
351702.  Duties of joint committee; limitation upon application of policies.
It shall be the duty of the joint committee on school health to prescribe uniform policies regarding the medical services, sanitary environment and health instruction of the school children. Provided that any policies prescribed relating to medical treatment or physical examination shall not be applicable to any student whose parent or guardian in writing objects to such regulation on religious grounds. Such objection shall not exempt the student from the quarantine laws of the state, nor prohibit an examination for infectious or contagious diseases.
ARTICLE 8

EMERGENCY MEDICAL SERVICES AND TRAUMA SYSTEM


351801.  Department of health to develop comprehensive emergency medical services and trauma system.
The department of health shall develop a comprehensive emergency medical services and trauma system.
351802.  Designation of trauma areas; trauma system hospitals.
(a)  The department of health shall designate within the state trauma areas consistent with local resources, geography and current patient referral patterns.
(b)  Each trauma area shall have:
(i)  Medical control for all field care and transportation consistent with geographic and current communications capability;
(ii)  Specified triage protocols;
(iii)  Hospitals categorized according to existing standards of the department.
(c)  On and after July 1, 1993, the department may designate trauma system hospitals in areas that meet state objectives and standards.
(d)  On or after July 1, 1994, the department may implement area trauma system plans.
351803.  Trauma system hospitals designation.
Applications to be categorized or designated as trauma system hospitals shall be made upon forms provided by the department of health.
351804.  Department of health to promulgate rules; contents.
The department shall promulgate reasonable rules and regulations which specify state trauma system objectives and standards, hospital categorization criteria and criteria and procedures to be utilized in designating trauma system hospitals and for the prevention of trauma and injuries. The rules shall be in conformance with the most current standards of the American college of surgeons committee on trauma standards, but may be expanded into further categories.
351805.  Duties of the department of health.
The department of health shall identify the causes of trauma in Wyoming and propose programs of prevention thereof for consideration by the legislature, health care providers and other agencies concerned with accident prevention or aftercare.
ARTICLE 9

MEDICAL MALPRACTICE INSURANCE ASSISTANCE ACCOUNT


351901.  Definitions.
(a)  As used in this article:
(i)  "Account" means the medical malpractice insurance assistance account;
(ii)  "Claims made" when describing an insurance policy or coverage means insuring against liability on those claims brought against the insured only during the term of the policy or coverage;
(iii)  "Contracting entity" means an entity which contracts with a Wyoming licensed health care facility to provide physician services to the facility and which in fulfillment of such a contract procures medical malpractice insurance for physicians providing the contracted services;
(iv)  "Department" means the department of health;
(v)  "Director" means the director of the department of health;
(vi)  "Physician" means a person licensed under W.S. 3326303.
351902.  Repealed by Laws 2016, ch. 37, § 2.
351903.  Assistance for risk retention group participation; duties of the department; requirements for assistance; breach.
(a)  Any physician who is licensed and practicing in the state may apply to the department for a loan to be used to pay the cost of the physician's participation in a risk retention group, of which the majority of ownership interest is held by Wyoming physicians, providing medical malpractice insurance coverage. Upon approval of the application for a loan, the physician shall enter into a contract with the state, wherein the physician shall agree:
(i)  To practice in the area of medical specialty or subspecialty for the entire period of time for which the loan under this section remains unpaid;
(ii)  To provide medical care, for the entire period of time the loan under this section remains unpaid, to Wyoming residents qualified under the Wyoming Medical Assistance and Services Act or the Child Health Insurance Program established under W.S. 3525101 who are seeking medical care which the physician is qualified to provide;
(iii)  To submit documentation to establish that the physician has complied with the terms of the contract and to determine the amount of the loan that should be provided under this section;
(iv)  To provide the state with a security interest in the physician's membership or shareholder interest in the risk retention group;
(v)  To repay any loans made under this section within ten (10) years from the date of disbursement of loan proceeds, together with interest as determined by the state treasurer at an annual rate equal to the average prime interest rate during the preceding fiscal year plus one percent (1%). To determine the average prime interest rate, the state treasurer shall average the prime interest rate for at least seventy-five percent (75%) of the thirty (30) largest banks in the United States. The interest rate shall be adjusted on January 1 of each year; and
(vi)  To immediately repay all funds distributed to the physician pursuant to this section, together with attorney fees and costs incurred in collection, for any contract period in which the physician is in breach of the contract.
(b)  At the times specified in the contract but in no event less than once per year, the physician shall submit documentation to the department showing compliance with the terms of the contract. The amount of loan to be made shall be the amount applied for but not to exceed one hundred fifty percent (150%) of the physician's most recent annual malpractice insurance premium. The amount shall also be prorated for the percentage of the physician's actual practice in Wyoming. The department may approve the making of the loan upon its determination of compliance with this section. Loan proceeds shall not be disbursed until the physician has paid or immediately will pay for his participation in the risk retention group.
(c)  If funding available from the account is insufficient to pay assistance for all physicians who apply for assistance under this article, the department may at its discretion reduce the payments to pay each eligible physician a pro rata amount.
(d)  Any physician who fails or refuses to fulfill the terms of the contract required under subsection (a) of this section shall be in breach of the contract.
(e)  No loan shall be made under this section unless the physician has completed and submitted an application to the department on or before March 30, 2007.
ARTICLE 10

WYOMING CRITICAL ACCESS/RURAL HOSPITAL ENDOWMENT



CHALLENGE PROGRAM
3511001.  Wyoming critical access or rural hospital endowment challenge program.
The Wyoming critical access/rural hospital endowment challenge program is created.
3511002.  Definitions.
(a)  As used in this article:
(i)  "Challenge account" means the critical access or rural hospital endowment challenge account created under this article;
(ii)  "Critical access or rural hospital" means:
(A)  A county hospital established pursuant to W.S. 188101, et seq., or a special district hospital established pursuant to W.S. 352401, et seq., that is certified to receive cost-based reimbursement from Medicare or has forty (40) beds or less; or
(B)  A hospital that is certified to receive cost-based reimbursement from Medicare or has forty (40) beds or less which is owned by a private not for profit entity and is operated in a county in this state in which there is no hospital meeting the requirements of subparagraph (A) of this paragraph.
(iii)  "Endowment gift" means an irrevocable gift or transfer to a Wyoming critical access or rural hospital foundation of money or other property, whether real, personal, tangible or intangible, and whether or not the donor or transferor retains an interest in the property, where the gift or the foundation's interest in the property is required to be used by the foundation exclusively for endowment purposes, provided:
(A)  The gift was received or the transfer occurred during the period July 1, 2007, through June 30, 2014; or
(B)  A commitment to make the gift or transfer was made in writing to the respective critical access or rural hospital foundation, which commitment was received during the period July 1, 2007, through June 30, 2014, and the gift was received or the transfer occurred not later than June 30, 2015.
(iv)  "Foundation" means an organization established for each critical access or rural hospital that among other purposes, exists to generate additional revenues for critical access or rural hospital programs and activities;
(v)  "Permanent endowment funds managed by a Wyoming critical access or rural hospital foundation" means the endowment funds that are invested by the respective Wyoming critical access or rural hospital foundation on a permanent basis and the earnings on those investments are dedicated to be expended exclusively to benefit and promote the mission, operation or any program or activity of the respective critical access or rural hospital, including but not limited to capital and programmatic expenses, healthcare, increases to the corpus of the endowment and to defray reasonable costs of endowment administration;
(vi)  "Unobligated," for purposes of W.S. 3511003(b) and (d), means no commitment meeting the requirements of subparagraph (iii)(B) of this subsection was received prior to June 30, 2012.
3511003.  Wyoming critical access or rural hospital endowment challenge account.
(a)  The Wyoming critical access or rural hospital endowment challenge account is created and, until June 30, 2013, shall consist of separate accounts, one (1) account for each Wyoming critical access or rural hospital.
(b)  On June 30, 2012, from amounts which are within the challenge account, or as necessary within separate accounts which are unobligated, one million five hundred thousand dollars ($1,500,000.00) shall be segregated within the endowment challenge account for distribution as provided in W.S. 3511004(k).
(c)  The state treasurer shall invest funds within the account created under subsection (a) of this section and shall deposit the earnings from account investments to the general fund.
(d)  Any unexpended and unobligated funds in excess of one million five hundred thousand dollars ($1,500,000.00) from the amount appropriated to the separate accounts within the challenge account shall revert to the budget reserve account on June 30, 2012. Any unexpended funds remaining in the separate accounts within the challenge account shall revert to the budget reserve account on June 30, 2013. Of the one million five hundred thousand dollars ($1,500,000.00) segregated in the challenge account pursuant to subsection (b) of this section, any remaining funds in the account shall revert to the budget reserve account on June 30, 2015.
3511004.  Endowment challenge account matching program; matching payments; agreements with foundations; annual reports.
(a)  Until June 30, 2012, funds within the challenge account shall be expended as provided in this subsection. Funds within a separate account which are obligated for commitments made prior to July 1, 2012 shall remain in the separate account to fulfill the obligation in accordance with this subsection until June 30, 2013. From and after July 1, 2012 funds in the challenge account shall be expended as provided in subsection (k) of this section. To the extent funds are available in the separate account of any critical access or rural hospital within the endowment challenge account, the state treasurer shall match endowment gifts actually received by that critical access or rural hospital's foundation. A match shall be paid under this subsection by the state treasurer at the time any accumulated amounts actually received by a critical access or rural hospital foundation total ten thousand dollars ($10,000.00) or more. The match shall be made by transferring from the separate challenge account to the appropriate critical access or rural hospital board of trustees an amount equal to the amount accumulated by the foundation or, if the critical access or rural hospital was eligible to receive revenues from any tax imposed under W.S. 352414(b) and (c) and a tax was not levied or was levied pursuant to one (1) but not both of those subsections, an amount equal to fifty percent (50%) of the amount accumulated by the foundation. The board shall immediately transfer all matching funds received to its foundation. The critical access or rural hospital foundation shall match the funds received under this subsection with an equal amount of foundation funds to be managed in accordance with subsection (b) of this section.
(b)  Each critical access hospital shall enter into an agreement with its foundation under which the foundation shall manage the matching funds received under subsection (a) of this section in the same manner as other permanent endowment funds are managed by its foundation, including the permanent investment of funds, maintenance of the fund corpus as inviolate and the expenditure of fund earnings for endowment purposes only.
(c)  Earnings from endowment funds established with matching funds under this section shall be expended only for the purpose of the endowment, including increasing the balance in the fund corpus and reasonable costs of administration.
(d)  The state treasurer shall make transfers to the appropriate critical access hospital board under this section not later than the end of the calendar quarter following the quarter during which foundation gifts total at least ten thousand dollars ($10,000.00). If gifts are made through a series of payments or transfers, no matching funds shall be transferred under this section until the total value of all payments or transfers actually received totals at least ten thousand dollars ($10,000.00).
(e)  Matching funds paid under this section shall not be distributed to or encumbered by any critical access or rural hospital foundation in excess of the amount in the challenge account for that critical access or rural hospital. Matching funds shall not be transferred to any critical access or rural hospital board by the state treasurer or from any such board to a foundation except to match gifts actually received by the foundation.
(f)  If the foundation's board of any critical access or rural hospital determines that the purpose of an endowment gift to the critical access or rural hospital is not consistent with the mission or capability of that critical access or rural hospital, the gift shall not qualify for matching funds under this section.
(g)  For the purpose of computing the matching amount, the state treasurer shall use the value of an endowment gift based upon its fair market value at the time the gift is received by the critical access or rural hospital foundation. The critical access or rural hospital shall provide evidence of fair market value for any gift if requested by the state treasurer and shall fund the cost of providing any requested evidence.
(h)  Each critical access or rural hospital shall on or before October 1 of each year submit a report to the state treasurer from its foundation on the endowment matching program under this section for the preceding fiscal year. The report shall include a financial summary and a review of the accomplishments resulting from endowment program expenditures. The report required under this subsection shall be for each applicable fiscal year through June 30, 2015.
(j)  Notwithstanding any other provision of this article, for any critical access or rural hospital qualifying under the provisions of W.S. 3511002(a)(ii)(B), funds provided under this article shall be disbursed only to the board of county commissioners in which the hospital is located. The board of county commissioners shall provide those funds to the critical access or rural hospital under contract between the board of county commissioners and the critical access or rural hospital, which contract shall incorporate all provisions of this article and which shall control the distribution and use of those funds.
(k)  From and after July 1, 2012, to the extent a critical access or rural hospital has not received matching funds under this article totaling at least two hundred fifty thousand dollars ($250,000.00), and to the extent funds segregated under W.S. 3511003(b) are available in the challenge account, the state treasurer shall match endowment gifts actually received by that critical access or rural hospital’s foundation. A match shall be paid under this subsection by the state treasurer at the time any accumulated amounts actually received by a critical access or rural hospital foundation total ten thousand dollars ($10,000.00) or more. The match shall be made by transferring from the challenge account to the appropriate critical access or rural hospital board of trustees an amount equal to the amount accumulated by the foundation or, if the critical access or rural hospital was eligible to receive revenues from any tax imposed under W.S. 352414(b) and a tax was not levied pursuant to that subsection, an amount equal to fifty percent (50%) of the amount accumulated by the foundation. The board shall immediately transfer all matching funds received to its foundation. The critical access or rural hospital foundation shall match the funds received under this subsection with an equal amount of foundation funds to be managed in accordance with subsection (b) of this section.
ARTICLE 11

PROVIDER RECRUITMENT GRANT PROGRAM



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