What is the Community Choices Waiver?
The Community Choices Waiver (CCW) is a Wyoming Medicaid Home and Community-Based Services (HCBS) program authorized under Section 1915(c) of the Social Security Act. It gives people who would otherwise need a nursing facility an alternative: they can stay in their own home, a family member's home, an assisted living facility, or a similar community setting and receive Medicaid-funded support there instead. Covered services include personal support (personal care), homemaker services, respite, home health aide, home-delivered meals, adult day services, skilled nursing, case management, and personal emergency response systems.
What makes CCW valuable for families is its participant-direction option (sometimes called self-direction or consumer direction). Instead of an agency assigning a stranger to the home, the participant -- or a representative they choose -- becomes the employer. They decide who to hire, they train that person on the specific help they need, they set the schedule, and they can let the worker go if it is not working out. For families who have quietly been providing care for years, this is the path that finally lets that work be paid.
CCW is built around a set of program objectives the state spells out explicitly: giving participants authority over their own services, person-centered planning, promoting community relationships, and balancing independence with health and safety. Because the participant directs the care, no formal home health certification, CNA, or nursing license is required of the person they hire. The direct service worker simply has to complete the required onboarding and CCW training.
The employer side of self-direction -- payroll, tax withholding, background checks, and Electronic Visit Verification -- is handled by a Financial Management Services (FMS) agency. In Wyoming that agency is ACES$, which serves the Community Choices Waiver along with the state's Comprehensive and Supports waivers. The FMS agency does not choose the worker or supervise care; those decisions stay with the participant or their designated employer.
Community Choices Waiver eligibility requirements
To enroll in CCW, the person who needs care must meet Wyoming Medicaid rules, require nursing-facility level of care, and fall into one of the waiver's target groups. The caregiver does not have to meet any income or asset test -- only the participant does. CCW is not an entitlement, so meeting the criteria puts you in line for a limited number of slots, and a waiting list can form.
Who can -- and cannot -- be paid through the Community Choices Waiver
Under CCW participant direction, the Medicaid member (or the representative acting as their employer) chooses who to hire. Wyoming is more flexible than many states on spouses: a spouse can be a paid worker as long as they are not the person legally authorized to make financial decisions for the participant. The one firm rule is that whoever holds the employer role -- and that person's spouse -- cannot also be the paid worker. Always confirm your specific situation with Wyoming Medicaid before hiring.
- Adult children (18 or older) of the participant
- Siblings, grandchildren, nieces, nephews, aunts, uncles, and in-laws
- A spouse -- but only if that spouse is NOT the participant's financial decision-maker or Employer of Record, and the participant's circumstances make it necessary
- Close friends, neighbors, or other trusted individuals
- Multiple family members splitting the approved hours (subject to the 40-hour-per-week worker limit)
- The participant's Employer of Record (the person delegated to run the self-directed budget) -- and that employer's spouse
- Anyone legally authorized to make financial decisions on the participant's behalf (financial power of attorney or legal guardian)
- A representative who is directing the care while also trying to be the paid worker -- one person cannot hold both roles
- A worker who has not completed required background screening and CCW training through the FMS agency
Community Choices Waiver pay, hours, and overtime
CCW personal support and homemaker services are paid as a taxable hourly wage. Wyoming does not set a state minimum wage above the federal floor, and the state ranks near the bottom nationally for direct-care pay, so rates tend to be modest. The number of hours a participant is approved for depends on their assessed needs and the person-centered service plan built with their case manager.
Hourly pay
In 2025-2026, home-care and personal-care wages in Wyoming generally run from about $13 per hour at entry level to roughly $18 per hour for experienced workers, with a statewide average near $15 per hour. Under CCW self-direction the participant (as employer) sets the worker's pay within the Medicaid-authorized budget and rate limits, so the exact number varies by county and by the FMS agency's guidance. Workers are paid as W-2 employees through ACES$, so federal income tax, Social Security, and Medicare are withheld from each paycheck. Reported ceilings for family caregivers under Wyoming waiver programs land in the ballpark of $2,900 per month, depending on approved hours.
Hours and scheduling
Approved hours come from the LT-101 assessment and the service plan, not a fixed statewide number, so they vary widely based on how much help the participant needs with activities of daily living. A single self-directed worker generally cannot be paid for more than 40 hours in a week, which is why many families split the approved hours across two or more caregivers -- for example, two adult children covering different days.
Overtime rules
Because direct service workers under participant direction are capped at 40 hours per week for a single participant, CCW self-direction is structured to avoid routine overtime. If a participant needs more coverage than one worker can provide within that limit, the solution is to hire additional workers rather than pay one person overtime. The FMS agency (ACES$) processes payroll and tracks hours, and it can explain how any overtime or multi-worker situation is handled under current program rules.
How to apply for the Community Choices Waiver in Wyoming
- Contact the Wyoming Department of Health HCBS Section to start a CCW application, or ask a case manager to help you complete it.
- HCBS Section: 1-800-510-0280
- Email or mail the CCW application to the HCBS Section (ccw.waivers@wyo.gov)
- You can be assisted or represented by a person of your choice during the process
- Apply for Wyoming Medicaid if the person needing care is not already enrolled. Financial eligibility for the waiver is handled separately from the functional side.
- Long-Term Care Eligibility Unit: 1-855-203-2936
- Wyoming Medicaid Customer Service: 1-855-294-2127
- Apply online through the state benefits system (wesystem.wyo.gov)
- Complete the LT-101 level-of-care assessment. A trained public health nurse evaluates the applicant's need for help with activities of daily living to confirm nursing-facility level of care.
- Choose a Case Management Agency. Your case manager helps build the person-centered service plan, determines your approved services and hours, and coordinates enrollment.
- Elect participant direction and enroll with the Financial Management Services (FMS) agency, ACES$, which becomes the payroll and administrative hub for your self-directed worker.
- ACES$ Wyoming: 1-844-500-3815
- The FMS agency runs background screenings, tax withholding, and Electronic Visit Verification
- The participant (or a designated Employer of Record) is the employer -- not ACES$
- Hire and onboard your caregiver. Have them complete background screening, employment paperwork, and the required CCW training, then submit hours each pay period for the FMS agency to process.
- Reassess at least annually. Level of care and the service plan are reviewed every year to confirm continued eligibility and adjust approved hours if the participant's needs change.
Community Choices Waiver Wyoming frequently asked questions
Can my spouse be paid through the Community Choices Waiver?
In Wyoming, yes -- with an important condition. Under CCW participant direction, a spouse can be hired as the paid worker as long as that spouse is not the person legally authorized to make financial decisions for the participant, and the participant's circumstances make hiring the spouse necessary. The firm rule is that the Employer of Record (whoever runs the self-directed budget) and that employer's spouse cannot also be the paid worker, and anyone holding financial power of attorney or legal guardianship over the participant is excluded from being paid. So the workaround is usually to make sure someone other than the paid spouse holds the employer and financial-decision role. Wyoming is more permissive here than states like New York, where spouses are flatly barred from the equivalent program. Because interpretations can vary by situation, confirm your exact family setup with the HCBS Section at 1-800-510-0280 before you hire.
How much does the Community Choices Waiver pay a family caregiver in 2026?
CCW pays personal support and homemaker work as a taxable hourly wage. Wyoming has no state minimum wage above the federal level and ranks near the bottom nationally for direct-care pay, so rates are modest: home-care wages in the state generally run from roughly $13 per hour for entry-level work to about $18 per hour for experienced caregivers, with a statewide average near $15. Under self-direction, the participant acts as the employer and sets the worker's pay within the Medicaid-authorized budget and rate limits, so the exact figure depends on your county and the FMS agency's guidance. Workers are paid as W-2 employees through ACES$, meaning federal income tax, Social Security, and Medicare come out of each check. Reported monthly ceilings for family caregivers under Wyoming waiver programs are in the neighborhood of $2,900, depending on how many hours are approved.
How long does it take to get approved for the Community Choices Waiver?
Plan for roughly two to three months, and sometimes longer. Wyoming states that the Medicaid application process alone can take up to three months. On the waiver side, the Department reviews a completed CCW application and its supporting documents within about 30 calendar days, and a case manager assisting you has 30 days to submit required documentation. The LT-101 level-of-care assessment has to be scheduled and completed by a public health nurse, which adds time. On top of that, CCW is not an entitlement -- enrollment slots are limited, so if all slots are full you may be placed on a waiting list even after you are found eligible. You can speed things up by gathering proof of Wyoming residency, identification, Social Security information, and income and asset documentation before you apply.
What training or certification does the caregiver need?
No nursing license, CNA, or home health aide certification is required to be a self-directed worker under CCW. Because the participant directs their own care, they train the worker on the specific tasks they need help with -- bathing, dressing, meal preparation, transfers, and similar activities of daily living. There are, however, some required steps before someone can be paid: the worker must pass a background screening, complete employment paperwork, and finish CCW-specific training. Wyoming requires that CCW training for employees and employers be renewed every two years. All of this onboarding is coordinated through the Financial Management Services agency, ACES$, which handles the screenings and paperwork. This low training barrier is a big part of what makes the waiver accessible to family members who have been informally caregiving and simply want to be compensated for it.
What is participant direction and who is the employer?
Participant direction (also called self-direction or consumer direction) means the person receiving waiver services has decision-making authority over some of their care -- most importantly, who they hire to help them. Instead of an agency assigning a worker, the participant chooses, trains, schedules, and can dismiss their own caregiver. The participant is the employer, sometimes called the Employer of Record, Participant-Employer, or Designated-Employer. If the participant cannot manage that role themselves, they can name a representative to be the employer on their behalf -- but that representative cannot also be the paid worker. The employer makes the hiring and management decisions, while the Financial Management Services agency (ACES$ in Wyoming) handles the back-office employer duties: payroll, tax withholding, background checks, and Electronic Visit Verification. This split lets families stay in control of care without having to run a payroll system themselves.
Who is ACES$ and what do they do?
ACES$ is the Financial Management Services (FMS) agency that supports participant-directed care in Wyoming, serving the Community Choices Waiver along with the Comprehensive and Supports waivers. When you self-direct under CCW, you (or your designated employer) make the caregiving decisions, and ACES$ handles the employer paperwork that comes with having a paid worker. That includes enrolling the worker, running background screenings, processing payroll and issuing paychecks, withholding and filing taxes, managing Electronic Visit Verification and shift information, and tracking compliance with program rules. ACES$ does not choose your worker, set their schedule, or supervise the care -- those decisions stay with you. Think of them as the payroll and compliance partner that makes it legal and manageable to pay a family member. You can reach ACES$ Wyoming at 1-844-500-3815, and many enrollment forms and packets are available through their document center.
What services does the Community Choices Waiver cover?
CCW offers a broad menu of home-and-community-based services designed to keep people out of nursing facilities. Covered services include personal support (hands-on personal care), homemaker services, respite care, home health aide, skilled nursing, adult day services, home-delivered meals, non-medical transportation, personal emergency response systems, environmental modifications, assisted living facility services, and case management. There are also transition services -- like transition intensive case management and transition setup expenses -- to help someone move from an institution back into the community. Not every participant receives every service; your case manager builds a person-centered service plan based on your assessed needs and the hours you are approved for. Personal support and homemaker services are the ones most families use when a relative becomes the paid caregiver, because those cover the day-to-day help with activities of daily living.
Is there a waiting list for the Community Choices Waiver?
There can be. Unlike regular Medicaid, the Community Choices Waiver is not an entitlement -- meeting all the eligibility criteria does not guarantee immediate services. The program has a limited number of enrollment slots, and when those slots are full, a waiting list forms. That means an applicant can be found fully eligible on both the financial and level-of-care sides and still have to wait for a slot to open. Because of this, it is worth applying as early as possible rather than waiting until care is urgently needed. While you wait, a case manager can help you understand your position and point you toward other Wyoming resources or state-plan Medicaid services that may be available in the meantime. For current information on slot availability and wait times, contact the HCBS Section at 1-800-510-0280.
See also: Wyoming caregiver guide
For all the ways to get paid to care for a family member in Wyoming — including Community Choices Waiver, VA programs, long-term care insurance, and more — read the full Wyoming guide.