Purpose: This section will assist in determining eligibility for the Children’s Mental Health Waiver.

Current Policy Effective Date: August 1, 2025

Previous Policy: October 1, 2017

POL M1002C: DETERMINING ELIGIBILITY FOP CHILDREN'S MENTAL HEALTH WAIVER

1. Applicants Must Meet Basic Eligibility

Refer to Section M600 for basic eligibility factors.

2. Applicants Must be Age Four Through Age 20

3. Applicants Must Meet Clinical Eligibility

The Wyoming Department of Health (WDH), Behavioral Health Division determines clinical eligibility.

4. Applicants Must Meet Disability Requirements

Applicants meeting the clinical eligibility fulfill the disability requirement.

5. Applicants Must Meet Income Requirements

Require countable income to be within the maximum income standard per month. Refer to Medicaid Table 1A for income standards. Refer to Section M901 to determine if income is countable. Provide an Income Trust Packet when the countable income is above the maximum income standard.

6. Applicants Must Meet Resource Requirements

Require the countable resources to be within the maximum resource standard. Refer to Medicaid Table 7 for resource standards. Refer to Section M801 to determine if resources are countable.

7. Services Withheld For Resource Transfers

Nonexempt resources cannot be transferred for less than fair market value during the look-back period prior to application or when clients are receiving benefits.

Refer to Section M803 to determine if a resource transfer is exempt and to Section M804 for information on related penalties.

8. Applicants May Have Eligibility For 12 Continuous Months

The eligibility continues for 12 months from the effective date of eligibility, or for 12 months from the last periodic review, for applicants under the age of 19.

9. Benefits Begin First Day Of Month Using Plan Of Care Date

10. Clients Must Be Reviewed

Clients must be periodically reviewed every 12 months to determine continued eligibility. Refer to Section M1403 for information on reviewing eligibility.

A review is not required for SSI clients.

Clients must be reviewed for other Medicaid program eligibility before closing cases.

11. Clients May Lose Benefits

The case will close on the first day of the next month when any of the following occur: Client does not complete review. Client dies. Client determined no longer eligible. Client enters public institution. Client moves out of state. Client’s 12-month period ends and he or she is no longer eligible.