State Codes and Statutes

Statutes > Wyoming > Title35 > Chapter25

CHAPTER 25 - PUBLIC PROGRAMS

 

ARTICLE 1 - CHILD HEALTH INSURANCE PROGRAM

 

35-25-101. Uninsured child health insurance program.

 

Thereis created a child health insurance program for families with a gross monthlyincome at or below one hundred eighty-five percent (185%) of the federalpoverty level, until July 1, 2005, and thereafter, for families with a grossmonthly income at or below two hundred percent (200%) of the federal povertylevel.

 

35-25-102. Definitions.

 

(a) As used in this act:

 

(i) "Child" means a person who has not yet reachedthe nineteenth anniversary of his birth;

 

(ii) "Department" means the department of health;

 

(iii) "Federal poverty level" means the federal povertyguideline updated annually in the federal register by the United Statesdepartment of health and human services under the authority of section 673(2)of the Omnibus Budget Reconciliation Act of 1981;

 

(iv) "Private health insurance" means an individualinsurance policy or contract for the purpose of paying for or reimbursing thecost of hospital and medical care;

 

(v) "State plan" means the state plan required byPublic Law 105-33 to be submitted by the state to the United States secretaryof health and human services to receive federal funding for a child healthinsurance program;

 

(vi) "This act" means W.S. 35-25-101 through35-25-108.

 

35-25-103. Child health insurance program eligibility.

 

Subjectto approval of the state plan by the United States secretary of health andhuman services, and subject to available state and federal funding thedepartment shall provide a health insurance plan offered through a privateinsurance company licensed by the insurance commissioner to write insurance inWyoming for an eligible child whose monthly gross family income is not morethan one hundred eighty-five percent (185%) of the federal poverty level, untilJuly 1, 2005, and thereafter, whose monthly gross family income is not morethan two hundred percent (200%) of the federal poverty level. A child who isdetermined eligible to receive benefits under this section shall remaineligible for twelve (12) months as long as the child resides in the state ofWyoming and has not yet attained nineteen (19) years of age. A child'seligibility to receive benefits under this act shall be redetermined on anannual basis. A simplified application process, which includes minimumeligibility requirements, shall be provided throughout the state at variouspublic and private establishments approved by the department of health. To bedetermined eligible to receive benefits under this section, a child shall notbe eligible under the Wyoming Medical Assistance and Services Act, shall nothave been covered under another health insurance plan for a minimum of one (1)month prior to application for coverage under this act or, upon birth, thechild would not otherwise be covered by a public or private health insuranceplan. Eligibility under this section shall be determined by the department ofhealth or its designee.

 

35-25-104. Private insurance program benefits.

 

Achild eligible for services under this act shall receive benefits developed bythe health benefits committee established under W.S. 35-25-105 that includecost sharing factors, not to exceed the maximum allowable under Public Law105-33, exclusions and limitations. The benefit package shall include, at aminimum, inpatient and outpatient hospital services, physician services,laboratory and x-ray services, well-baby and well-child care including ageappropriate immunizations and the additional services of prescription drugcoverage, vision coverage and dental coverage which will include preventive andbasic services developed by the health benefits committee.

 

35-25-105. Health benefits plan committee.

 

(a) A health benefits plan committee is hereby established andshall be composed of ten (10) members, which include:

 

(i) The director of the Wyoming department of health or hisdesignee;

 

(ii) The director of the Wyoming department of family servicesor his designee;

 

(iii) The Wyoming insurance commissioner or his designee;

 

(iv) One (1) representative each, appointed by the governor,consisting of:

 

(A) An authorized insurer writing individual and group healthinsurance business in Wyoming;

 

(B) An employer;

 

(C) A parent;

 

(D) A licensed insurance agent experienced in selling healthinsurance;

 

(E) A licensed physician who specializes in pediatric care orfamily medicine;

 

(F) A licensed health care provider experienced in providingpediatric care; and

 

(G) A member of the general public.

 

(b) The terms of the committee members appointed by thegovernor shall be four (4) years. Members of the committee appointed prior toJuly 1, 2003 may continue to serve the remainder of their terms. The committeeshall review on at least a biennial basis the form and level of benefits to bemade available pursuant W.S. 35-25-104.

 

(c) The committee shall develop a package of benefits asallowed by section 2103(a)(4) of Public Law 105-33, including cost sharingfactors, exclusions and limitations.

 

(d) The committee shall submit its recommendations to thedirector of the department for approval no later than October 1, 2003, and atleast biennially thereafter.

 

(e) Members of the committee shall be reimbursed for travel andper diem in the same manner as state employees. Members may also be reimbursedfor any committee-related expenses which receive prior approval by thedepartment. Members shall not be otherwise compensated for their services.

 

(f) Committee meetings shall be open to the public.

 

35-25-106. Private health insurance plan request for proposals.

 

(a) The department shall publish notice of a request forproposals from qualified insurers to provide a health insurance plan forchildren insured under W.S. 35-25-103 of this act. The department shall awardthe contract for this service to an insurer based on price, the provision ofbenchmark services determined pursuant to W.S. 35-25-105(c), and other factorslisted in the department's request. The contract for health insurance awardedunder this section shall contain provisions with respect to exclusions fromcoverage for preexisting conditions that are no more restrictive than thosedescribed in section 2102 (b)(1)(B)(ii) of Public Law 105-33. The contractshall include provisions for changes in terms and conditions and for rebiddingin case major changes are needed. The department shall have the right to rebidthe contract after two (2) years.

 

(b) Biennially, the department may allow the contractor toadjust the price charged for the coverage, but if the price is increased, thedepartment may, after public notice, rebid the contract.

 

(c) If the department does not receive a proposal from aninsurance company within one hundred twenty (120) days after issuing therequest for proposals required in subsection (a) of this section, thedepartment may provide services to children eligible under this act with apublic health benefit package designed to provide the same services asauthorized under the Wyoming Medical Assistance and Services Act. A medicalprovider who accepts payment for services provided under this subsection shallnot charge or attempt to collect payments in excess of the rate scheduleestablished by the department of health.

 

35-25-107. Program expenditures; monitoring; recommendations; requiredaction to limit expenditures to budget available.

 

(a) The department shall project monthly expenditures underthis act each month through the end of the biennium based upon the level ofactivity for the previous months and the trend in expenditures compared toprevious expenditures. If the projections indicate that expenditures may exceedthe federal and state funds available under this act, the department, may, byrule and regulation and subject to availability of funds, limit participationin the program under this section as follows:

 

(i) The department may impose a partial or total moratorium onnew enrollments in the programs under this act until funds are available tomeet the needs of new enrollees;

 

(ii) For current recipients of benefits under this act, priorityfor the continuation of funding shall be given to those families with thelowest incomes.

 

(b) In the last six (6) months of the biennium, the departmentshall include a projection of expenditures for the next biennium based on thespending for the current biennium unless the legislature provides for adifferent level of funding for the next biennium.

 

(c) The funding for the child health insurance program shall bedeemed to be included within the community and family health division line itemwithin the department of health budget unless a separate line item is providedin the budget bill. General fund expenditures for the child health programshall not exceed the amount needed to match federal funds without explicitauthorization enacted in the budget bill.

 

35-25-108. Implementation; duties; restrictions on the department ofhealth.

 

(a) The department shall:

 

(i) Administer this act within the fiscal constraints of PublicLaw 105-33 and subsequent federal enactments governing this program and thestate budget as enacted by the legislature;

 

(ii) Develop a state plan for child health insurance toqualified recipients under this act and otherwise provide for the effectiveadministration of this act;

 

(iii) Maintain records on the administration of this act andreport to the federal government as required by federal law and regulation;

 

(iv) Adopt, amend and rescind rules and regulations on theadministration of this act following notice and public hearing in accordancewith the Wyoming Administrative Procedure Act;

 

(v) Establish indicators for measuring access, process, qualityand outcomes effectiveness in improving children's health.

 

(b) The department shall not implement:

 

(i) The program under this act until a state plan has beenapproved by the United States secretary of health and human services; and

 

(ii) Any state plan that does not conform to the requirements ofthis act.

 

35-25-109. Repealed By Laws 2003, Ch. 99, 2.

 

35-25-110. Repealed By Laws 2003, Ch. 99, 2.

 

 

35-25-111. Participation of parents or guardians; employer premiumcontribution.

 

(a) Subject to the approval of a waiver by the United Statessecretary of health and human services and subject to available state andfederal funding, parents or guardians of children enrolled in the child healthinsurance program or the medical assistance program may be eligible forparticipation in the programs under the following conditions:

 

(i) One (1) of the parents or guardians in the household isworking at a full or part-time job;

 

(ii) If the parents are separated or divorced, the noncustodialparent shall not be eligible for participation in the program;

 

(iii) The employer of the participating parent or guardian agreesto pay for at least one-half (1/2) of the monthly premiums of the healthinsurance plan selected by the parent or guardian under the provisions ofsubsection (b) of this section. For program participants who work less than anaverage of thirty (30) hours per week, the department may waive this provisionand collect an hourly fee from the employer.

 

(b) Parents or guardians may participate in the program throughthe employer's health insurance plan or through a group plan contracted by thedepartment for program participants under the provisions of W.S. 35-25-106(a). The department shall assess the qualifying parents and guardians aparticipation fee. The amount of the fee may vary depending upon the level ofincome greater than one hundred thirty-three percent (133%) of the federalpoverty level. Parents or guardians with a household income of one hundredthirty-three percent (133%) of the federal poverty level or less shall not beassessed a participation fee.

 

(c) If an employer of a parent or guardian refuses toparticipate in the program, the parent or guardian who would otherwise qualifyfor the program under subsection (b) of this section may participate in theprogram by paying the employer's share of the premium as determined pursuant toparagraph (a)(iii) of this section. The funds from the parent or guardian maycome from a health savings account, a third party or another source.

 

(d) In the group plan offered by the department, the package ofbenefits available to participating parents and guardians may vary dependingupon qualifying household income. The plan offered by an employer is notsubject to a benchmark set of benefits.

 

(e) If the parent or guardian is covered through an employer'sgroup health insurance plan, the total amount of funding provided to the parentor guardian to participate in the employer's plan shall not exceed the costthat the department would pay for participation in the plan provided under W.S.35-25-106(a), as adjusted for parents, minus the employer's contribution underparagraph (a)(iii) of this section and the employee's contribution undersubsection (b) of this section.

 

(f) Students who are attending the University of Wyoming or astate community college shall not be disqualified pursuant to paragraph (a)(i)of this section provided they qualify under the work-study provisions of thetemporary assistance to needy families program.

 

(g) The total enrollment of parents, guardians and studentsthrough the waiver in the child health insurance program or the medicalassistance program shall not exceed three thousand seven hundred twenty (3,720)for the 2007-2008 biennium and the total enrollment for future biennia shall beas determined in the applicable budget bill.

 

ARTICLE 2 - WYOMING CANCER CONTROL ACT

 

35-25-201. Short title.

 

This act shall be known and may be cited as the"Wyoming Cancer Control Act."

 

35-25-202. Definitions.

 

(a) As used in this act:

 

(i) "CDC" means the federal center for diseaseprevention and control;

 

(ii) "County cancer resource coordinator program"means a program undertaken through a private organization, county hospital,hospital district hospital or city or county health department which provideslocal level education, outreach, patient navigation services, communityplanning and data collection in order to lessen the impact of cancer on Wyomingpeople;

 

(iii) "Department" means the department of health;

 

(iv) "Evidence based" means relying on scientificallyvalid evidence. Scientifically valid evidence relies on studies and experimentsincluding systematic reviews of multiple randomized controlled trials orepidemiological studies, one (1) or more randomized controlled trials, one (1)or more epidemiological studies and the recommendations of nationally andinternationally recognized groups of experts in the field.

 

(v) "Medicaid" means the joint federal and stateprogram of health care financing for the poor authorized by Title XIX of thefederal Social Security Act and title 42 of the Wyoming statutes;

 

(vi) "Statewide comprehensive cancer control steeringcommittee" means a committee whose mission is defined by the 2006-2010Wyoming cancer control plan and which provides advice and guidance to theWyoming comprehensive cancer control program. The committee is a privateentity whose members include government employees;

 

(vii) "This act" means W.S. 35-25-201 through35-25-206.

 

35-25-203. Cancer control plan and program.

 

(a) The department shall develop a comprehensive cancer controlplan. The department shall begin with the plan and recommendations in theWyoming cancer control plan published in October 2005 by the Wyomingcomprehensive cancer control consortium. The goals shall be to reduce thenumbers of people affected by cancer with improved prevention and educationand, for those individuals who are diagnosed with cancer, the goal shall be toprovide diagnostic, therapeutic and palliative interventions that are evidencebased, scientifically proven best of care. The comprehensive cancer controlplan may include:

 

(i) Cancer prevention and education for both the public, healthcare professionals and institutions;

 

(ii) Evidence based early detection, screening, diagnosis andtreatment;

 

(iii) Research and data collection;

 

(iv) Palliative care including pain management and other stepsto improve the quality of life of probably terminal cancer patients;

 

(v) Rehabilitation of cancer victims; and

 

(vi) Programs to assist cancer survivors in returning to normallife.

 

(b) In financing and implementing the program establishedpursuant to subsection (a) of this section the department shall consider theuse of the Medicaid program. This section does not constitute authorization toexpand the services and eligibilities of the Medicaid program which requiresspecific legislative authorization. The department may recommend suchauthorization where appropriate.

 

(c) The department may contract with one (1) or more thirdparties to develop and implement the plans authorized by this section. Anycontract awarded under this section shall be awarded on the basis ofcompetitive bids and shall include specific requirements relating to outcomebased evaluation.

 

(d) Subject to the restriction of subsection (b) of thissection, the department may accept state, federal, local and nongovernmentalfunds for developing and implementing the plans established pursuant to thissection.

 

(e) The department may solicit proposals for grants under thissection by publication of a request for proposals. Grant recipients under thissection may include local governments, private nonprofit organizations, schoolsand other organizations as appropriate. Any grants to organizations notpolitical subdivisions of the state of Wyoming or under the absolute control ofthe state shall be subject to any restriction necessary to comply with Article16, Section 6 of the Wyoming Constitution. Any request for proposals usedduring the competitive grant process shall include specific requirementsrelating to outcome based evaluation of the grant recipient's performance.

 

(f) The department shall collaborate and coordinate with publicand private entities including state and local governments and the CDC toassure maximum effective use of resources, people and money. The departmentshall take advice, as appropriate, from the statewide comprehensive cancercontrol steering committee.

 

(g) Considering funds available and the purposes for whichthose funds are made available, the department shall give emphasis to thefollowing cancer control and prevention programs:

 

(i) The county cancer resource coordinator program. Thisprogram shall be a pilot program in two (2) sites, one (1) urban and one (1)rural. Each program shall cover at least one (1) county and may cover severalcounties. The program may be expanded to additional sites if sufficient fundsbecome available;

 

(ii) Public education relating to cancer prevention andawareness for all cancers;

 

(iii) Early detection of cancer including those cancersidentified in the state cancer control plan and specifically including theWyoming colorectal cancer early detection and prevention program;

 

(iv) Programs and public education which promote the reductionof risk factors to reduce cancer and other chronic diseases within the state;and

 

(v) Programs and public education which enhance treatment andquality of care of those impacted by cancer within the state.

 

(h) The department may propose cancer control as a specificline item in its biennial budget.

 

(j) The department shall, in accordance with the WyomingAdministrative Procedure Act, promulgate rules and regulations as appropriateto implement this act.

 

(k) The department shall report on its activities, programoutcomes, conclusions and goals for the next two (2) years under this act tothe joint labor, health and social services interim committee and the jointappropriations interim committee. The report shall be due on October 1 of everyodd numbered year.

 

35-25-204. Wyoming colorectal cancer early detection and preventionprogram.

 

(a) Subject to the availability of appropriations, thedepartment shall undertake a colorectal cancer screening and prevention programfor those who qualify as specified in subsection (c) of this section.

 

(b) Initially the screening and prevention program funded underthis program shall consist of colonoscopies which shall consist of both theexamination of the colon and rectum and the removal and pathologicalexamination of polyps in accordance with the normal standards of care forcolonoscopies. After July 1, 2008, the department may, by rule and regulation,authorize other forms of screening to participate in the program provided theseother forms of screening are evidence based and are shown by the evidence to beas effective or as cost effective as traditional colonoscopies.

 

(c) Starting July 1, 2007 Wyoming residents with incomes at orbelow two hundred and fifty percent (250%) of the federal poverty level shallbe eligible to participate in this program and this shall remain the standardif the biennial budget bill does not establish a different standard and unlessa different standard is established pursuant to subsection (d) of this section.

 

(d) Eligibility for the program set forth in this section shallbe limited to individuals who are Wyoming residents and have been so for atleast one (1) year. The eligibility shall be for one (1) colonoscopy every ten(10) years, counting any done before the effective date of this act or beforethe individual became a Wyoming resident. Eligibility shall be restricted toindividuals who are at least fifty (50) years old and who have not becomeeligible for the federal Medicare program. In the event that analysis showsspending in the program will exceed the budget available, the department shallinstitute a waiting list.

 

(e) The department shall provide vouchers to eligible personsfor reimbursement for a colonoscopy at the rate paid under the Wyoming MedicalAssistance and Services Act for colonoscopies, including polyp removal. Theperson receiving a voucher under this subsection shall pay all other costs ofthe colonoscopy. When the funds appropriated for this program are expended, thedepartment shall cease issuing vouchers under this section.

 

(f) The department shall develop an internet based applicationprocess for determining individual eligibility. The result of a successfulapplication may be a voucher that the individual may present to a provider thedepartment has contracted with or may be an online statement of eligibilitythat the providers can access or both. The department may use city or countyhealth departments, other public health offices, providers, advocacy groups andany other appropriate governmental or private entities to assist individuals incompleting the application process.

 

35-25-205. Breast and cervical cancer programs.

 

(a) The breast and cervical cancer program within thedepartment is authorized to obtain private and federal grant funds and to seekappropriations for:

 

(i) Education, outreach and breast and cervical cancerscreenings for those unable to afford them;

 

(ii) Continuation of the existing pilot outreach program for themedically underserved population in the Big Horn Basin and expansion of thatprogram to other areas of the state; and

 

(iii) Implementation of the program known as the native sistersprogram for outreach to members of the Shoshone and Arapaho Tribes, providedthat any grants or contracts entered into pursuant to this paragraph shallcontain any restrictions necessary to comply with Article 16, Section 6 of theWyoming Constitution.

 

35-25-206. Pain management.

 

(a) The department may establish an acute and chronic painmanagement advisory committee consisting of the following members:

 

(i) One (1) employee of the department appointed by thedirector who will serve as the chairman of the committee;

 

(ii) One (1) member appointed by the board of medicine;

 

(iii) One (1) member appointed by the board of nursing;

 

(iv) One (1) member appointed by the board of pharmacy; and

 

(v) One (1) member of the public who has experience in painmanagement appointed by the director.

 

(b) The members of the pain management advisory committee shallserve at the pleasure of the director of the department and shall meet at leasttwo (2) times each year. The travel expenses of the members of the painmanagement committee as described in subsection (a) of this section shall bepaid by their respective departments or boards. The department shall pay theper diem and travel expenses of the member of the public appointed pursuant toparagraph (v) of subsection (a) of this section and shall provideadministrative support for the operation of the committee.

 

(c) The committee shall perform the following functions:

 

(i) Research issues associated with acute and chronic painmanagement including those issues assigned to the committee by the director ofthe department;

 

(ii) Offer recommendations to the director of the department,other state agencies and licensing boards of health care professionals regardingpolicies and programs that would manage acute and chronic pain more effectivelyor efficiently; and

 

(iii) Make recommendations regarding legislation to the directorof the department.

 

State Codes and Statutes

Statutes > Wyoming > Title35 > Chapter25

CHAPTER 25 - PUBLIC PROGRAMS

 

ARTICLE 1 - CHILD HEALTH INSURANCE PROGRAM

 

35-25-101. Uninsured child health insurance program.

 

Thereis created a child health insurance program for families with a gross monthlyincome at or below one hundred eighty-five percent (185%) of the federalpoverty level, until July 1, 2005, and thereafter, for families with a grossmonthly income at or below two hundred percent (200%) of the federal povertylevel.

 

35-25-102. Definitions.

 

(a) As used in this act:

 

(i) "Child" means a person who has not yet reachedthe nineteenth anniversary of his birth;

 

(ii) "Department" means the department of health;

 

(iii) "Federal poverty level" means the federal povertyguideline updated annually in the federal register by the United Statesdepartment of health and human services under the authority of section 673(2)of the Omnibus Budget Reconciliation Act of 1981;

 

(iv) "Private health insurance" means an individualinsurance policy or contract for the purpose of paying for or reimbursing thecost of hospital and medical care;

 

(v) "State plan" means the state plan required byPublic Law 105-33 to be submitted by the state to the United States secretaryof health and human services to receive federal funding for a child healthinsurance program;

 

(vi) "This act" means W.S. 35-25-101 through35-25-108.

 

35-25-103. Child health insurance program eligibility.

 

Subjectto approval of the state plan by the United States secretary of health andhuman services, and subject to available state and federal funding thedepartment shall provide a health insurance plan offered through a privateinsurance company licensed by the insurance commissioner to write insurance inWyoming for an eligible child whose monthly gross family income is not morethan one hundred eighty-five percent (185%) of the federal poverty level, untilJuly 1, 2005, and thereafter, whose monthly gross family income is not morethan two hundred percent (200%) of the federal poverty level. A child who isdetermined eligible to receive benefits under this section shall remaineligible for twelve (12) months as long as the child resides in the state ofWyoming and has not yet attained nineteen (19) years of age. A child'seligibility to receive benefits under this act shall be redetermined on anannual basis. A simplified application process, which includes minimumeligibility requirements, shall be provided throughout the state at variouspublic and private establishments approved by the department of health. To bedetermined eligible to receive benefits under this section, a child shall notbe eligible under the Wyoming Medical Assistance and Services Act, shall nothave been covered under another health insurance plan for a minimum of one (1)month prior to application for coverage under this act or, upon birth, thechild would not otherwise be covered by a public or private health insuranceplan. Eligibility under this section shall be determined by the department ofhealth or its designee.

 

35-25-104. Private insurance program benefits.

 

Achild eligible for services under this act shall receive benefits developed bythe health benefits committee established under W.S. 35-25-105 that includecost sharing factors, not to exceed the maximum allowable under Public Law105-33, exclusions and limitations. The benefit package shall include, at aminimum, inpatient and outpatient hospital services, physician services,laboratory and x-ray services, well-baby and well-child care including ageappropriate immunizations and the additional services of prescription drugcoverage, vision coverage and dental coverage which will include preventive andbasic services developed by the health benefits committee.

 

35-25-105. Health benefits plan committee.

 

(a) A health benefits plan committee is hereby established andshall be composed of ten (10) members, which include:

 

(i) The director of the Wyoming department of health or hisdesignee;

 

(ii) The director of the Wyoming department of family servicesor his designee;

 

(iii) The Wyoming insurance commissioner or his designee;

 

(iv) One (1) representative each, appointed by the governor,consisting of:

 

(A) An authorized insurer writing individual and group healthinsurance business in Wyoming;

 

(B) An employer;

 

(C) A parent;

 

(D) A licensed insurance agent experienced in selling healthinsurance;

 

(E) A licensed physician who specializes in pediatric care orfamily medicine;

 

(F) A licensed health care provider experienced in providingpediatric care; and

 

(G) A member of the general public.

 

(b) The terms of the committee members appointed by thegovernor shall be four (4) years. Members of the committee appointed prior toJuly 1, 2003 may continue to serve the remainder of their terms. The committeeshall review on at least a biennial basis the form and level of benefits to bemade available pursuant W.S. 35-25-104.

 

(c) The committee shall develop a package of benefits asallowed by section 2103(a)(4) of Public Law 105-33, including cost sharingfactors, exclusions and limitations.

 

(d) The committee shall submit its recommendations to thedirector of the department for approval no later than October 1, 2003, and atleast biennially thereafter.

 

(e) Members of the committee shall be reimbursed for travel andper diem in the same manner as state employees. Members may also be reimbursedfor any committee-related expenses which receive prior approval by thedepartment. Members shall not be otherwise compensated for their services.

 

(f) Committee meetings shall be open to the public.

 

35-25-106. Private health insurance plan request for proposals.

 

(a) The department shall publish notice of a request forproposals from qualified insurers to provide a health insurance plan forchildren insured under W.S. 35-25-103 of this act. The department shall awardthe contract for this service to an insurer based on price, the provision ofbenchmark services determined pursuant to W.S. 35-25-105(c), and other factorslisted in the department's request. The contract for health insurance awardedunder this section shall contain provisions with respect to exclusions fromcoverage for preexisting conditions that are no more restrictive than thosedescribed in section 2102 (b)(1)(B)(ii) of Public Law 105-33. The contractshall include provisions for changes in terms and conditions and for rebiddingin case major changes are needed. The department shall have the right to rebidthe contract after two (2) years.

 

(b) Biennially, the department may allow the contractor toadjust the price charged for the coverage, but if the price is increased, thedepartment may, after public notice, rebid the contract.

 

(c) If the department does not receive a proposal from aninsurance company within one hundred twenty (120) days after issuing therequest for proposals required in subsection (a) of this section, thedepartment may provide services to children eligible under this act with apublic health benefit package designed to provide the same services asauthorized under the Wyoming Medical Assistance and Services Act. A medicalprovider who accepts payment for services provided under this subsection shallnot charge or attempt to collect payments in excess of the rate scheduleestablished by the department of health.

 

35-25-107. Program expenditures; monitoring; recommendations; requiredaction to limit expenditures to budget available.

 

(a) The department shall project monthly expenditures underthis act each month through the end of the biennium based upon the level ofactivity for the previous months and the trend in expenditures compared toprevious expenditures. If the projections indicate that expenditures may exceedthe federal and state funds available under this act, the department, may, byrule and regulation and subject to availability of funds, limit participationin the program under this section as follows:

 

(i) The department may impose a partial or total moratorium onnew enrollments in the programs under this act until funds are available tomeet the needs of new enrollees;

 

(ii) For current recipients of benefits under this act, priorityfor the continuation of funding shall be given to those families with thelowest incomes.

 

(b) In the last six (6) months of the biennium, the departmentshall include a projection of expenditures for the next biennium based on thespending for the current biennium unless the legislature provides for adifferent level of funding for the next biennium.

 

(c) The funding for the child health insurance program shall bedeemed to be included within the community and family health division line itemwithin the department of health budget unless a separate line item is providedin the budget bill. General fund expenditures for the child health programshall not exceed the amount needed to match federal funds without explicitauthorization enacted in the budget bill.

 

35-25-108. Implementation; duties; restrictions on the department ofhealth.

 

(a) The department shall:

 

(i) Administer this act within the fiscal constraints of PublicLaw 105-33 and subsequent federal enactments governing this program and thestate budget as enacted by the legislature;

 

(ii) Develop a state plan for child health insurance toqualified recipients under this act and otherwise provide for the effectiveadministration of this act;

 

(iii) Maintain records on the administration of this act andreport to the federal government as required by federal law and regulation;

 

(iv) Adopt, amend and rescind rules and regulations on theadministration of this act following notice and public hearing in accordancewith the Wyoming Administrative Procedure Act;

 

(v) Establish indicators for measuring access, process, qualityand outcomes effectiveness in improving children's health.

 

(b) The department shall not implement:

 

(i) The program under this act until a state plan has beenapproved by the United States secretary of health and human services; and

 

(ii) Any state plan that does not conform to the requirements ofthis act.

 

35-25-109. Repealed By Laws 2003, Ch. 99, 2.

 

35-25-110. Repealed By Laws 2003, Ch. 99, 2.

 

 

35-25-111. Participation of parents or guardians; employer premiumcontribution.

 

(a) Subject to the approval of a waiver by the United Statessecretary of health and human services and subject to available state andfederal funding, parents or guardians of children enrolled in the child healthinsurance program or the medical assistance program may be eligible forparticipation in the programs under the following conditions:

 

(i) One (1) of the parents or guardians in the household isworking at a full or part-time job;

 

(ii) If the parents are separated or divorced, the noncustodialparent shall not be eligible for participation in the program;

 

(iii) The employer of the participating parent or guardian agreesto pay for at least one-half (1/2) of the monthly premiums of the healthinsurance plan selected by the parent or guardian under the provisions ofsubsection (b) of this section. For program participants who work less than anaverage of thirty (30) hours per week, the department may waive this provisionand collect an hourly fee from the employer.

 

(b) Parents or guardians may participate in the program throughthe employer's health insurance plan or through a group plan contracted by thedepartment for program participants under the provisions of W.S. 35-25-106(a). The department shall assess the qualifying parents and guardians aparticipation fee. The amount of the fee may vary depending upon the level ofincome greater than one hundred thirty-three percent (133%) of the federalpoverty level. Parents or guardians with a household income of one hundredthirty-three percent (133%) of the federal poverty level or less shall not beassessed a participation fee.

 

(c) If an employer of a parent or guardian refuses toparticipate in the program, the parent or guardian who would otherwise qualifyfor the program under subsection (b) of this section may participate in theprogram by paying the employer's share of the premium as determined pursuant toparagraph (a)(iii) of this section. The funds from the parent or guardian maycome from a health savings account, a third party or another source.

 

(d) In the group plan offered by the department, the package ofbenefits available to participating parents and guardians may vary dependingupon qualifying household income. The plan offered by an employer is notsubject to a benchmark set of benefits.

 

(e) If the parent or guardian is covered through an employer'sgroup health insurance plan, the total amount of funding provided to the parentor guardian to participate in the employer's plan shall not exceed the costthat the department would pay for participation in the plan provided under W.S.35-25-106(a), as adjusted for parents, minus the employer's contribution underparagraph (a)(iii) of this section and the employee's contribution undersubsection (b) of this section.

 

(f) Students who are attending the University of Wyoming or astate community college shall not be disqualified pursuant to paragraph (a)(i)of this section provided they qualify under the work-study provisions of thetemporary assistance to needy families program.

 

(g) The total enrollment of parents, guardians and studentsthrough the waiver in the child health insurance program or the medicalassistance program shall not exceed three thousand seven hundred twenty (3,720)for the 2007-2008 biennium and the total enrollment for future biennia shall beas determined in the applicable budget bill.

 

ARTICLE 2 - WYOMING CANCER CONTROL ACT

 

35-25-201. Short title.

 

This act shall be known and may be cited as the"Wyoming Cancer Control Act."

 

35-25-202. Definitions.

 

(a) As used in this act:

 

(i) "CDC" means the federal center for diseaseprevention and control;

 

(ii) "County cancer resource coordinator program"means a program undertaken through a private organization, county hospital,hospital district hospital or city or county health department which provideslocal level education, outreach, patient navigation services, communityplanning and data collection in order to lessen the impact of cancer on Wyomingpeople;

 

(iii) "Department" means the department of health;

 

(iv) "Evidence based" means relying on scientificallyvalid evidence. Scientifically valid evidence relies on studies and experimentsincluding systematic reviews of multiple randomized controlled trials orepidemiological studies, one (1) or more randomized controlled trials, one (1)or more epidemiological studies and the recommendations of nationally andinternationally recognized groups of experts in the field.

 

(v) "Medicaid" means the joint federal and stateprogram of health care financing for the poor authorized by Title XIX of thefederal Social Security Act and title 42 of the Wyoming statutes;

 

(vi) "Statewide comprehensive cancer control steeringcommittee" means a committee whose mission is defined by the 2006-2010Wyoming cancer control plan and which provides advice and guidance to theWyoming comprehensive cancer control program. The committee is a privateentity whose members include government employees;

 

(vii) "This act" means W.S. 35-25-201 through35-25-206.

 

35-25-203. Cancer control plan and program.

 

(a) The department shall develop a comprehensive cancer controlplan. The department shall begin with the plan and recommendations in theWyoming cancer control plan published in October 2005 by the Wyomingcomprehensive cancer control consortium. The goals shall be to reduce thenumbers of people affected by cancer with improved prevention and educationand, for those individuals who are diagnosed with cancer, the goal shall be toprovide diagnostic, therapeutic and palliative interventions that are evidencebased, scientifically proven best of care. The comprehensive cancer controlplan may include:

 

(i) Cancer prevention and education for both the public, healthcare professionals and institutions;

 

(ii) Evidence based early detection, screening, diagnosis andtreatment;

 

(iii) Research and data collection;

 

(iv) Palliative care including pain management and other stepsto improve the quality of life of probably terminal cancer patients;

 

(v) Rehabilitation of cancer victims; and

 

(vi) Programs to assist cancer survivors in returning to normallife.

 

(b) In financing and implementing the program establishedpursuant to subsection (a) of this section the department shall consider theuse of the Medicaid program. This section does not constitute authorization toexpand the services and eligibilities of the Medicaid program which requiresspecific legislative authorization. The department may recommend suchauthorization where appropriate.

 

(c) The department may contract with one (1) or more thirdparties to develop and implement the plans authorized by this section. Anycontract awarded under this section shall be awarded on the basis ofcompetitive bids and shall include specific requirements relating to outcomebased evaluation.

 

(d) Subject to the restriction of subsection (b) of thissection, the department may accept state, federal, local and nongovernmentalfunds for developing and implementing the plans established pursuant to thissection.

 

(e) The department may solicit proposals for grants under thissection by publication of a request for proposals. Grant recipients under thissection may include local governments, private nonprofit organizations, schoolsand other organizations as appropriate. Any grants to organizations notpolitical subdivisions of the state of Wyoming or under the absolute control ofthe state shall be subject to any restriction necessary to comply with Article16, Section 6 of the Wyoming Constitution. Any request for proposals usedduring the competitive grant process shall include specific requirementsrelating to outcome based evaluation of the grant recipient's performance.

 

(f) The department shall collaborate and coordinate with publicand private entities including state and local governments and the CDC toassure maximum effective use of resources, people and money. The departmentshall take advice, as appropriate, from the statewide comprehensive cancercontrol steering committee.

 

(g) Considering funds available and the purposes for whichthose funds are made available, the department shall give emphasis to thefollowing cancer control and prevention programs:

 

(i) The county cancer resource coordinator program. Thisprogram shall be a pilot program in two (2) sites, one (1) urban and one (1)rural. Each program shall cover at least one (1) county and may cover severalcounties. The program may be expanded to additional sites if sufficient fundsbecome available;

 

(ii) Public education relating to cancer prevention andawareness for all cancers;

 

(iii) Early detection of cancer including those cancersidentified in the state cancer control plan and specifically including theWyoming colorectal cancer early detection and prevention program;

 

(iv) Programs and public education which promote the reductionof risk factors to reduce cancer and other chronic diseases within the state;and

 

(v) Programs and public education which enhance treatment andquality of care of those impacted by cancer within the state.

 

(h) The department may propose cancer control as a specificline item in its biennial budget.

 

(j) The department shall, in accordance with the WyomingAdministrative Procedure Act, promulgate rules and regulations as appropriateto implement this act.

 

(k) The department shall report on its activities, programoutcomes, conclusions and goals for the next two (2) years under this act tothe joint labor, health and social services interim committee and the jointappropriations interim committee. The report shall be due on October 1 of everyodd numbered year.

 

35-25-204. Wyoming colorectal cancer early detection and preventionprogram.

 

(a) Subject to the availability of appropriations, thedepartment shall undertake a colorectal cancer screening and prevention programfor those who qualify as specified in subsection (c) of this section.

 

(b) Initially the screening and prevention program funded underthis program shall consist of colonoscopies which shall consist of both theexamination of the colon and rectum and the removal and pathologicalexamination of polyps in accordance with the normal standards of care forcolonoscopies. After July 1, 2008, the department may, by rule and regulation,authorize other forms of screening to participate in the program provided theseother forms of screening are evidence based and are shown by the evidence to beas effective or as cost effective as traditional colonoscopies.

 

(c) Starting July 1, 2007 Wyoming residents with incomes at orbelow two hundred and fifty percent (250%) of the federal poverty level shallbe eligible to participate in this program and this shall remain the standardif the biennial budget bill does not establish a different standard and unlessa different standard is established pursuant to subsection (d) of this section.

 

(d) Eligibility for the program set forth in this section shallbe limited to individuals who are Wyoming residents and have been so for atleast one (1) year. The eligibility shall be for one (1) colonoscopy every ten(10) years, counting any done before the effective date of this act or beforethe individual became a Wyoming resident. Eligibility shall be restricted toindividuals who are at least fifty (50) years old and who have not becomeeligible for the federal Medicare program. In the event that analysis showsspending in the program will exceed the budget available, the department shallinstitute a waiting list.

 

(e) The department shall provide vouchers to eligible personsfor reimbursement for a colonoscopy at the rate paid under the Wyoming MedicalAssistance and Services Act for colonoscopies, including polyp removal. Theperson receiving a voucher under this subsection shall pay all other costs ofthe colonoscopy. When the funds appropriated for this program are expended, thedepartment shall cease issuing vouchers under this section.

 

(f) The department shall develop an internet based applicationprocess for determining individual eligibility. The result of a successfulapplication may be a voucher that the individual may present to a provider thedepartment has contracted with or may be an online statement of eligibilitythat the providers can access or both. The department may use city or countyhealth departments, other public health offices, providers, advocacy groups andany other appropriate governmental or private entities to assist individuals incompleting the application process.

 

35-25-205. Breast and cervical cancer programs.

 

(a) The breast and cervical cancer program within thedepartment is authorized to obtain private and federal grant funds and to seekappropriations for:

 

(i) Education, outreach and breast and cervical cancerscreenings for those unable to afford them;

 

(ii) Continuation of the existing pilot outreach program for themedically underserved population in the Big Horn Basin and expansion of thatprogram to other areas of the state; and

 

(iii) Implementation of the program known as the native sistersprogram for outreach to members of the Shoshone and Arapaho Tribes, providedthat any grants or contracts entered into pursuant to this paragraph shallcontain any restrictions necessary to comply with Article 16, Section 6 of theWyoming Constitution.

 

35-25-206. Pain management.

 

(a) The department may establish an acute and chronic painmanagement advisory committee consisting of the following members:

 

(i) One (1) employee of the department appointed by thedirector who will serve as the chairman of the committee;

 

(ii) One (1) member appointed by the board of medicine;

 

(iii) One (1) member appointed by the board of nursing;

 

(iv) One (1) member appointed by the board of pharmacy; and

 

(v) One (1) member of the public who has experience in painmanagement appointed by the director.

 

(b) The members of the pain management advisory committee shallserve at the pleasure of the director of the department and shall meet at leasttwo (2) times each year. The travel expenses of the members of the painmanagement committee as described in subsection (a) of this section shall bepaid by their respective departments or boards. The department shall pay theper diem and travel expenses of the member of the public appointed pursuant toparagraph (v) of subsection (a) of this section and shall provideadministrative support for the operation of the committee.

 

(c) The committee shall perform the following functions:

 

(i) Research issues associated with acute and chronic painmanagement including those issues assigned to the committee by the director ofthe department;

 

(ii) Offer recommendations to the director of the department,other state agencies and licensing boards of health care professionals regardingpolicies and programs that would manage acute and chronic pain more effectivelyor efficiently; and

 

(iii) Make recommendations regarding legislation to the directorof the department.

 


State Codes and Statutes

State Codes and Statutes

Statutes > Wyoming > Title35 > Chapter25

CHAPTER 25 - PUBLIC PROGRAMS

 

ARTICLE 1 - CHILD HEALTH INSURANCE PROGRAM

 

35-25-101. Uninsured child health insurance program.

 

Thereis created a child health insurance program for families with a gross monthlyincome at or below one hundred eighty-five percent (185%) of the federalpoverty level, until July 1, 2005, and thereafter, for families with a grossmonthly income at or below two hundred percent (200%) of the federal povertylevel.

 

35-25-102. Definitions.

 

(a) As used in this act:

 

(i) "Child" means a person who has not yet reachedthe nineteenth anniversary of his birth;

 

(ii) "Department" means the department of health;

 

(iii) "Federal poverty level" means the federal povertyguideline updated annually in the federal register by the United Statesdepartment of health and human services under the authority of section 673(2)of the Omnibus Budget Reconciliation Act of 1981;

 

(iv) "Private health insurance" means an individualinsurance policy or contract for the purpose of paying for or reimbursing thecost of hospital and medical care;

 

(v) "State plan" means the state plan required byPublic Law 105-33 to be submitted by the state to the United States secretaryof health and human services to receive federal funding for a child healthinsurance program;

 

(vi) "This act" means W.S. 35-25-101 through35-25-108.

 

35-25-103. Child health insurance program eligibility.

 

Subjectto approval of the state plan by the United States secretary of health andhuman services, and subject to available state and federal funding thedepartment shall provide a health insurance plan offered through a privateinsurance company licensed by the insurance commissioner to write insurance inWyoming for an eligible child whose monthly gross family income is not morethan one hundred eighty-five percent (185%) of the federal poverty level, untilJuly 1, 2005, and thereafter, whose monthly gross family income is not morethan two hundred percent (200%) of the federal poverty level. A child who isdetermined eligible to receive benefits under this section shall remaineligible for twelve (12) months as long as the child resides in the state ofWyoming and has not yet attained nineteen (19) years of age. A child'seligibility to receive benefits under this act shall be redetermined on anannual basis. A simplified application process, which includes minimumeligibility requirements, shall be provided throughout the state at variouspublic and private establishments approved by the department of health. To bedetermined eligible to receive benefits under this section, a child shall notbe eligible under the Wyoming Medical Assistance and Services Act, shall nothave been covered under another health insurance plan for a minimum of one (1)month prior to application for coverage under this act or, upon birth, thechild would not otherwise be covered by a public or private health insuranceplan. Eligibility under this section shall be determined by the department ofhealth or its designee.

 

35-25-104. Private insurance program benefits.

 

Achild eligible for services under this act shall receive benefits developed bythe health benefits committee established under W.S. 35-25-105 that includecost sharing factors, not to exceed the maximum allowable under Public Law105-33, exclusions and limitations. The benefit package shall include, at aminimum, inpatient and outpatient hospital services, physician services,laboratory and x-ray services, well-baby and well-child care including ageappropriate immunizations and the additional services of prescription drugcoverage, vision coverage and dental coverage which will include preventive andbasic services developed by the health benefits committee.

 

35-25-105. Health benefits plan committee.

 

(a) A health benefits plan committee is hereby established andshall be composed of ten (10) members, which include:

 

(i) The director of the Wyoming department of health or hisdesignee;

 

(ii) The director of the Wyoming department of family servicesor his designee;

 

(iii) The Wyoming insurance commissioner or his designee;

 

(iv) One (1) representative each, appointed by the governor,consisting of:

 

(A) An authorized insurer writing individual and group healthinsurance business in Wyoming;

 

(B) An employer;

 

(C) A parent;

 

(D) A licensed insurance agent experienced in selling healthinsurance;

 

(E) A licensed physician who specializes in pediatric care orfamily medicine;

 

(F) A licensed health care provider experienced in providingpediatric care; and

 

(G) A member of the general public.

 

(b) The terms of the committee members appointed by thegovernor shall be four (4) years. Members of the committee appointed prior toJuly 1, 2003 may continue to serve the remainder of their terms. The committeeshall review on at least a biennial basis the form and level of benefits to bemade available pursuant W.S. 35-25-104.

 

(c) The committee shall develop a package of benefits asallowed by section 2103(a)(4) of Public Law 105-33, including cost sharingfactors, exclusions and limitations.

 

(d) The committee shall submit its recommendations to thedirector of the department for approval no later than October 1, 2003, and atleast biennially thereafter.

 

(e) Members of the committee shall be reimbursed for travel andper diem in the same manner as state employees. Members may also be reimbursedfor any committee-related expenses which receive prior approval by thedepartment. Members shall not be otherwise compensated for their services.

 

(f) Committee meetings shall be open to the public.

 

35-25-106. Private health insurance plan request for proposals.

 

(a) The department shall publish notice of a request forproposals from qualified insurers to provide a health insurance plan forchildren insured under W.S. 35-25-103 of this act. The department shall awardthe contract for this service to an insurer based on price, the provision ofbenchmark services determined pursuant to W.S. 35-25-105(c), and other factorslisted in the department's request. The contract for health insurance awardedunder this section shall contain provisions with respect to exclusions fromcoverage for preexisting conditions that are no more restrictive than thosedescribed in section 2102 (b)(1)(B)(ii) of Public Law 105-33. The contractshall include provisions for changes in terms and conditions and for rebiddingin case major changes are needed. The department shall have the right to rebidthe contract after two (2) years.

 

(b) Biennially, the department may allow the contractor toadjust the price charged for the coverage, but if the price is increased, thedepartment may, after public notice, rebid the contract.

 

(c) If the department does not receive a proposal from aninsurance company within one hundred twenty (120) days after issuing therequest for proposals required in subsection (a) of this section, thedepartment may provide services to children eligible under this act with apublic health benefit package designed to provide the same services asauthorized under the Wyoming Medical Assistance and Services Act. A medicalprovider who accepts payment for services provided under this subsection shallnot charge or attempt to collect payments in excess of the rate scheduleestablished by the department of health.

 

35-25-107. Program expenditures; monitoring; recommendations; requiredaction to limit expenditures to budget available.

 

(a) The department shall project monthly expenditures underthis act each month through the end of the biennium based upon the level ofactivity for the previous months and the trend in expenditures compared toprevious expenditures. If the projections indicate that expenditures may exceedthe federal and state funds available under this act, the department, may, byrule and regulation and subject to availability of funds, limit participationin the program under this section as follows:

 

(i) The department may impose a partial or total moratorium onnew enrollments in the programs under this act until funds are available tomeet the needs of new enrollees;

 

(ii) For current recipients of benefits under this act, priorityfor the continuation of funding shall be given to those families with thelowest incomes.

 

(b) In the last six (6) months of the biennium, the departmentshall include a projection of expenditures for the next biennium based on thespending for the current biennium unless the legislature provides for adifferent level of funding for the next biennium.

 

(c) The funding for the child health insurance program shall bedeemed to be included within the community and family health division line itemwithin the department of health budget unless a separate line item is providedin the budget bill. General fund expenditures for the child health programshall not exceed the amount needed to match federal funds without explicitauthorization enacted in the budget bill.

 

35-25-108. Implementation; duties; restrictions on the department ofhealth.

 

(a) The department shall:

 

(i) Administer this act within the fiscal constraints of PublicLaw 105-33 and subsequent federal enactments governing this program and thestate budget as enacted by the legislature;

 

(ii) Develop a state plan for child health insurance toqualified recipients under this act and otherwise provide for the effectiveadministration of this act;

 

(iii) Maintain records on the administration of this act andreport to the federal government as required by federal law and regulation;

 

(iv) Adopt, amend and rescind rules and regulations on theadministration of this act following notice and public hearing in accordancewith the Wyoming Administrative Procedure Act;

 

(v) Establish indicators for measuring access, process, qualityand outcomes effectiveness in improving children's health.

 

(b) The department shall not implement:

 

(i) The program under this act until a state plan has beenapproved by the United States secretary of health and human services; and

 

(ii) Any state plan that does not conform to the requirements ofthis act.

 

35-25-109. Repealed By Laws 2003, Ch. 99, 2.

 

35-25-110. Repealed By Laws 2003, Ch. 99, 2.

 

 

35-25-111. Participation of parents or guardians; employer premiumcontribution.

 

(a) Subject to the approval of a waiver by the United Statessecretary of health and human services and subject to available state andfederal funding, parents or guardians of children enrolled in the child healthinsurance program or the medical assistance program may be eligible forparticipation in the programs under the following conditions:

 

(i) One (1) of the parents or guardians in the household isworking at a full or part-time job;

 

(ii) If the parents are separated or divorced, the noncustodialparent shall not be eligible for participation in the program;

 

(iii) The employer of the participating parent or guardian agreesto pay for at least one-half (1/2) of the monthly premiums of the healthinsurance plan selected by the parent or guardian under the provisions ofsubsection (b) of this section. For program participants who work less than anaverage of thirty (30) hours per week, the department may waive this provisionand collect an hourly fee from the employer.

 

(b) Parents or guardians may participate in the program throughthe employer's health insurance plan or through a group plan contracted by thedepartment for program participants under the provisions of W.S. 35-25-106(a). The department shall assess the qualifying parents and guardians aparticipation fee. The amount of the fee may vary depending upon the level ofincome greater than one hundred thirty-three percent (133%) of the federalpoverty level. Parents or guardians with a household income of one hundredthirty-three percent (133%) of the federal poverty level or less shall not beassessed a participation fee.

 

(c) If an employer of a parent or guardian refuses toparticipate in the program, the parent or guardian who would otherwise qualifyfor the program under subsection (b) of this section may participate in theprogram by paying the employer's share of the premium as determined pursuant toparagraph (a)(iii) of this section. The funds from the parent or guardian maycome from a health savings account, a third party or another source.

 

(d) In the group plan offered by the department, the package ofbenefits available to participating parents and guardians may vary dependingupon qualifying household income. The plan offered by an employer is notsubject to a benchmark set of benefits.

 

(e) If the parent or guardian is covered through an employer'sgroup health insurance plan, the total amount of funding provided to the parentor guardian to participate in the employer's plan shall not exceed the costthat the department would pay for participation in the plan provided under W.S.35-25-106(a), as adjusted for parents, minus the employer's contribution underparagraph (a)(iii) of this section and the employee's contribution undersubsection (b) of this section.

 

(f) Students who are attending the University of Wyoming or astate community college shall not be disqualified pursuant to paragraph (a)(i)of this section provided they qualify under the work-study provisions of thetemporary assistance to needy families program.

 

(g) The total enrollment of parents, guardians and studentsthrough the waiver in the child health insurance program or the medicalassistance program shall not exceed three thousand seven hundred twenty (3,720)for the 2007-2008 biennium and the total enrollment for future biennia shall beas determined in the applicable budget bill.

 

ARTICLE 2 - WYOMING CANCER CONTROL ACT

 

35-25-201. Short title.

 

This act shall be known and may be cited as the"Wyoming Cancer Control Act."

 

35-25-202. Definitions.

 

(a) As used in this act:

 

(i) "CDC" means the federal center for diseaseprevention and control;

 

(ii) "County cancer resource coordinator program"means a program undertaken through a private organization, county hospital,hospital district hospital or city or county health department which provideslocal level education, outreach, patient navigation services, communityplanning and data collection in order to lessen the impact of cancer on Wyomingpeople;

 

(iii) "Department" means the department of health;

 

(iv) "Evidence based" means relying on scientificallyvalid evidence. Scientifically valid evidence relies on studies and experimentsincluding systematic reviews of multiple randomized controlled trials orepidemiological studies, one (1) or more randomized controlled trials, one (1)or more epidemiological studies and the recommendations of nationally andinternationally recognized groups of experts in the field.

 

(v) "Medicaid" means the joint federal and stateprogram of health care financing for the poor authorized by Title XIX of thefederal Social Security Act and title 42 of the Wyoming statutes;

 

(vi) "Statewide comprehensive cancer control steeringcommittee" means a committee whose mission is defined by the 2006-2010Wyoming cancer control plan and which provides advice and guidance to theWyoming comprehensive cancer control program. The committee is a privateentity whose members include government employees;

 

(vii) "This act" means W.S. 35-25-201 through35-25-206.

 

35-25-203. Cancer control plan and program.

 

(a) The department shall develop a comprehensive cancer controlplan. The department shall begin with the plan and recommendations in theWyoming cancer control plan published in October 2005 by the Wyomingcomprehensive cancer control consortium. The goals shall be to reduce thenumbers of people affected by cancer with improved prevention and educationand, for those individuals who are diagnosed with cancer, the goal shall be toprovide diagnostic, therapeutic and palliative interventions that are evidencebased, scientifically proven best of care. The comprehensive cancer controlplan may include:

 

(i) Cancer prevention and education for both the public, healthcare professionals and institutions;

 

(ii) Evidence based early detection, screening, diagnosis andtreatment;

 

(iii) Research and data collection;

 

(iv) Palliative care including pain management and other stepsto improve the quality of life of probably terminal cancer patients;

 

(v) Rehabilitation of cancer victims; and

 

(vi) Programs to assist cancer survivors in returning to normallife.

 

(b) In financing and implementing the program establishedpursuant to subsection (a) of this section the department shall consider theuse of the Medicaid program. This section does not constitute authorization toexpand the services and eligibilities of the Medicaid program which requiresspecific legislative authorization. The department may recommend suchauthorization where appropriate.

 

(c) The department may contract with one (1) or more thirdparties to develop and implement the plans authorized by this section. Anycontract awarded under this section shall be awarded on the basis ofcompetitive bids and shall include specific requirements relating to outcomebased evaluation.

 

(d) Subject to the restriction of subsection (b) of thissection, the department may accept state, federal, local and nongovernmentalfunds for developing and implementing the plans established pursuant to thissection.

 

(e) The department may solicit proposals for grants under thissection by publication of a request for proposals. Grant recipients under thissection may include local governments, private nonprofit organizations, schoolsand other organizations as appropriate. Any grants to organizations notpolitical subdivisions of the state of Wyoming or under the absolute control ofthe state shall be subject to any restriction necessary to comply with Article16, Section 6 of the Wyoming Constitution. Any request for proposals usedduring the competitive grant process shall include specific requirementsrelating to outcome based evaluation of the grant recipient's performance.

 

(f) The department shall collaborate and coordinate with publicand private entities including state and local governments and the CDC toassure maximum effective use of resources, people and money. The departmentshall take advice, as appropriate, from the statewide comprehensive cancercontrol steering committee.

 

(g) Considering funds available and the purposes for whichthose funds are made available, the department shall give emphasis to thefollowing cancer control and prevention programs:

 

(i) The county cancer resource coordinator program. Thisprogram shall be a pilot program in two (2) sites, one (1) urban and one (1)rural. Each program shall cover at least one (1) county and may cover severalcounties. The program may be expanded to additional sites if sufficient fundsbecome available;

 

(ii) Public education relating to cancer prevention andawareness for all cancers;

 

(iii) Early detection of cancer including those cancersidentified in the state cancer control plan and specifically including theWyoming colorectal cancer early detection and prevention program;

 

(iv) Programs and public education which promote the reductionof risk factors to reduce cancer and other chronic diseases within the state;and

 

(v) Programs and public education which enhance treatment andquality of care of those impacted by cancer within the state.

 

(h) The department may propose cancer control as a specificline item in its biennial budget.

 

(j) The department shall, in accordance with the WyomingAdministrative Procedure Act, promulgate rules and regulations as appropriateto implement this act.

 

(k) The department shall report on its activities, programoutcomes, conclusions and goals for the next two (2) years under this act tothe joint labor, health and social services interim committee and the jointappropriations interim committee. The report shall be due on October 1 of everyodd numbered year.

 

35-25-204. Wyoming colorectal cancer early detection and preventionprogram.

 

(a) Subject to the availability of appropriations, thedepartment shall undertake a colorectal cancer screening and prevention programfor those who qualify as specified in subsection (c) of this section.

 

(b) Initially the screening and prevention program funded underthis program shall consist of colonoscopies which shall consist of both theexamination of the colon and rectum and the removal and pathologicalexamination of polyps in accordance with the normal standards of care forcolonoscopies. After July 1, 2008, the department may, by rule and regulation,authorize other forms of screening to participate in the program provided theseother forms of screening are evidence based and are shown by the evidence to beas effective or as cost effective as traditional colonoscopies.

 

(c) Starting July 1, 2007 Wyoming residents with incomes at orbelow two hundred and fifty percent (250%) of the federal poverty level shallbe eligible to participate in this program and this shall remain the standardif the biennial budget bill does not establish a different standard and unlessa different standard is established pursuant to subsection (d) of this section.

 

(d) Eligibility for the program set forth in this section shallbe limited to individuals who are Wyoming residents and have been so for atleast one (1) year. The eligibility shall be for one (1) colonoscopy every ten(10) years, counting any done before the effective date of this act or beforethe individual became a Wyoming resident. Eligibility shall be restricted toindividuals who are at least fifty (50) years old and who have not becomeeligible for the federal Medicare program. In the event that analysis showsspending in the program will exceed the budget available, the department shallinstitute a waiting list.

 

(e) The department shall provide vouchers to eligible personsfor reimbursement for a colonoscopy at the rate paid under the Wyoming MedicalAssistance and Services Act for colonoscopies, including polyp removal. Theperson receiving a voucher under this subsection shall pay all other costs ofthe colonoscopy. When the funds appropriated for this program are expended, thedepartment shall cease issuing vouchers under this section.

 

(f) The department shall develop an internet based applicationprocess for determining individual eligibility. The result of a successfulapplication may be a voucher that the individual may present to a provider thedepartment has contracted with or may be an online statement of eligibilitythat the providers can access or both. The department may use city or countyhealth departments, other public health offices, providers, advocacy groups andany other appropriate governmental or private entities to assist individuals incompleting the application process.

 

35-25-205. Breast and cervical cancer programs.

 

(a) The breast and cervical cancer program within thedepartment is authorized to obtain private and federal grant funds and to seekappropriations for:

 

(i) Education, outreach and breast and cervical cancerscreenings for those unable to afford them;

 

(ii) Continuation of the existing pilot outreach program for themedically underserved population in the Big Horn Basin and expansion of thatprogram to other areas of the state; and

 

(iii) Implementation of the program known as the native sistersprogram for outreach to members of the Shoshone and Arapaho Tribes, providedthat any grants or contracts entered into pursuant to this paragraph shallcontain any restrictions necessary to comply with Article 16, Section 6 of theWyoming Constitution.

 

35-25-206. Pain management.

 

(a) The department may establish an acute and chronic painmanagement advisory committee consisting of the following members:

 

(i) One (1) employee of the department appointed by thedirector who will serve as the chairman of the committee;

 

(ii) One (1) member appointed by the board of medicine;

 

(iii) One (1) member appointed by the board of nursing;

 

(iv) One (1) member appointed by the board of pharmacy; and

 

(v) One (1) member of the public who has experience in painmanagement appointed by the director.

 

(b) The members of the pain management advisory committee shallserve at the pleasure of the director of the department and shall meet at leasttwo (2) times each year. The travel expenses of the members of the painmanagement committee as described in subsection (a) of this section shall bepaid by their respective departments or boards. The department shall pay theper diem and travel expenses of the member of the public appointed pursuant toparagraph (v) of subsection (a) of this section and shall provideadministrative support for the operation of the committee.

 

(c) The committee shall perform the following functions:

 

(i) Research issues associated with acute and chronic painmanagement including those issues assigned to the committee by the director ofthe department;

 

(ii) Offer recommendations to the director of the department,other state agencies and licensing boards of health care professionals regardingpolicies and programs that would manage acute and chronic pain more effectivelyor efficiently; and

 

(iii) Make recommendations regarding legislation to the directorof the department.

 

Categories