35-25-206.

35-25-206.

35-25-203. Cancer control plan and program.  (a) The department shall develop a comprehensive cancer control plan. The department shall begin with the plan and recommendations in the Wyoming cancer control plan published in October 2005 by the Wyoming comprehensive cancer control consortium. The goals shall be to reduce the numbers of people affected by cancer with improved prevention and education and, for those individuals who are diagnosed with cancer, the goal shall be to provide diagnostic, therapeutic and palliative interventions that are evidence based, scientifically proven best of care. The comprehensive cancer control plan may include:

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

(ii) Evidence based early detection, screening, diagnosis and treatment;

(iii) Research and data collection;

(iv) Palliative care including pain management and other steps to 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 normal life.

(b) In financing and implementing the program established pursuant to subsection (a) of this section the department shall consider the use of the Medicaid program. This section does not constitute authorization to expand the services and eligibilities of the Medicaid program which requires specific legislative authorization. The department may recommend such authorization where appropriate.

(c) The department may contract with one (1) or more third parties to develop and implement the plans authorized by this section. Any contract awarded under this section shall be awarded on the basis of competitive bids and shall include specific requirements relating to outcome based evaluation.

(d) Subject to the restriction of subsection (b) of this section, the department may accept state, federal, local and nongovernmental funds for developing and implementing the plans established pursuant to this section.  (e) The department may solicit proposals for grants under this section by publication of a request for proposals. Grant recipients under this section may include local governments, private nonprofit organizations, schools and other organizations as appropriate. Any grants to organizations not political subdivisions of the state of Wyoming or under the absolute control of the state shall be subject to any restriction necessary to comply with Article 16, Section 6 of the Wyoming Constitution. Any request for proposals used during the competitive grant process shall include specific requirements relating to outcome based evaluation of the grant recipient's performance.

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

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

(i) The county cancer resource coordinator program. This program 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 several counties. The program may be expanded to additional sites if sufficient funds become available;

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

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

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

(v) Programs and public education which enhance treatment and quality of care of those impacted by cancer within the state.  (h) The department may propose cancer control as a specific line item in its biennial budget.

(j) The department shall, in accordance with the Wyoming Administrative Procedure Act, promulgate rules and regulations as appropriate to implement this act.

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

35-25-204. Wyoming colorectal cancer early detection and prevention program.

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

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

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

(d) Eligibility for the program set forth in this section shall be limited to individuals who are Wyoming residents and have been so for at least one (1) year immediately prior to screening. The eligibility shall be for one (1) colonoscopy every ten (10) years, counting any done before the effective date of this act or before the individual became a Wyoming resident. However, the department on a case-by-case basis may authorize follow-up screening when medically indicated based on national evidence based guidelines. Eligibility shall be restricted to individuals who meet appropriate age requirements in accordance with national evidence based recommendations and are uninsured or underinsured. For persons who are underinsured, the program shall only pay expenses not covered by insurance. In the event that analysis shows spending in the program will exceed the budget available, the department shall institute a waiting list.

(e) The department shall provide reimbursement for an eligible person's colonoscopy at the rate paid under the Wyoming Medical Assistance and Services Act for colonoscopies, including polyp removal. The person receiving services under this subsection shall pay all other costs of the colonoscopy. When the funds appropriated for this program are expended, the department shall cease payments under this section.

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

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

(a) The breast and cervical cancer program within the department is authorized to obtain private and federal grant funds and to seek appropriations for:

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

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

(iii) Implementation of the program known as the native sisters program for outreach to members of the Eastern Shoshone and Northern Arapaho tribes, provided that any grants or contracts entered into pursuant to this paragraph shall contain any restrictions necessary to comply with Article 16, Section 6 of the Wyoming Constitution.

35-25-206. Pain management.

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

(i) One (1) employee of the department appointed by the director 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 pain management appointed by the director.

(b) The members of the pain management advisory committee shall serve at the pleasure of the director of the department and shall meet at least two (2) times each year. The travel expenses of the members of the pain management committee as described in subsection (a) of this section shall be paid by their respective departments or boards. The department shall pay the per diem and travel expenses of the member of the public appointed pursuant to paragraph (v) of subsection (a) of this section and shall provide administrative support for the operation of the committee.

(c) The committee shall perform the following functions:

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

(ii) Offer recommendations to the director of the department, other state agencies and licensing boards of health care professionals regarding policies and programs that would manage acute and chronic pain more effectively or efficiently; and  (iii) Make recommendations regarding legislation to the director of the department.

ARTICLE 3 - DIABETES CARE PLANNING

35-25-301. Diabetes care planning; reports to the legislature.

(a) The department of health shall develop a plan to reduce the incidence of diabetes in Wyoming, improve diabetes care, and control complications associated with diabetes. The plan shall include identification of goals and benchmarks. The department shall submit the plan to the joint labor, health and social services interim committee by October 1, 2014.

(b) The department of health shall track for statistical and trending analysis the following:

(i) The prevalence of all types of diabetes in the state and the financial impact that diabetes is having on the state. Items included in this assessment shall include the number of individuals with diabetes, the number of individuals with diabetes and family members impacted by prevention and diabetes control programs implemented by the department, the financial toll or impact diabetes and its complications place on the Medicaid program and the financial toll or impact diabetes and its complications place on the Medicaid program in comparison to other chronic diseases and conditions;

(ii) An assessment of the benefits of implemented programs and activities aimed at controlling diabetes and preventing the disease;

(iii) A description of the level of coordination existing between the department, other agencies and Eastern Shoshone and Northern Arapaho tribes on activities, programmatic activities and messaging on managing, treating or preventing all forms of diabetes and its complications;

(iv) Detailed action plans for battling diabetes with a range of actionable items for consideration by the legislature. The plans shall identify proposed action steps to reduce the impact of diabetes, prediabetes and related diabetes complications. The plan shall also identify expected outcomes of the action steps proposed in the following biennium while also establishing benchmarks for controlling and preventing relevant forms of diabetes; and

(v) The impact of gestational diabetes on the Medicaid population, including an analysis of cost implications, the number of pregnant women screened and diagnosed and patient outcome measures and recommended strategies to reduce the impact of the condition and to improve outcomes for this population;

(vi) The development of a detailed budget blueprint identifying needs, costs and resources required to implement the plan developed pursuant to this section. The blueprint shall include a budget range for all options presented in the plan for consideration by the legislature.

ARTICLE 4 - COMMUNITY EDUCATION PROGRAM

35-25-401. Female genital mutilation education program.

(a) The department of health, the attorney general's office division of victim services or the department of health and attorney general's office division of victim services together shall develop a community education program regarding female genital mutilation. The program shall include:

(i) Education, prevention and outreach materials regarding the health risks and emotional trauma inflicted by the practice of female genital mutilation;

(ii) Ways to develop and disseminate information regarding recognizing the risk factors associated with female genital mutilation;

(iii) Training materials for law enforcement, teachers and others who are mandated reporters under W.S. 14-3- 205(a), encompassing:

(A) Risk factors associated with female genital mutilation;

(B) Signs that an individual may be a victim of female genital mutilation;

(C) Best practices for responses to victims of female genital mutilation; and  (D) The criminal penalties associated with the facilitation or commission of female genital mutilation.

(b) Law enforcement, teachers and others who are mandated reporters under W.S. 14-3-205(a) shall incorporate the training under this section into their professional development programs and shall provide the training to employees and volunteers. To assist state and local entities in disseminating the education program under this section, the department of health, the attorney general's office division of victim services or the department of health and attorney general's office division of victim services together shall provide necessary training programs and technical assistance as requested.

ARTICLE 5 - 988 SUICIDE AND CRISIS LIFELINE

35-25-501. Definitions.

(a) As used in this article:

(i) "988" or "988 system" means the universal telephone number for the national suicide prevention and mental health crisis hotline system within the United States, operating through the national suicide prevention lifeline or its successor, maintained by the assistant secretary for mental health and substance abuse under 42 U.S.C. § 290bb-36c;

(ii) "Administrator" means the administrator of the 988 system;

(iii) "Contact" means a communication with the 988 system including a call, text or chat;

(iv) "Crisis center" or "crisis hotline center" means a center designated by the state to respond to statewide or regional 988 contacts;

(v) "Crisis facility" means a behavioral health center as defined by W.S. 35-1-613(a)(xvi), other provider under W.S. 35-1-611 through 35-1-627 or an equivalently staffed and equipped student health service;

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

(vii) "Mobile crisis team" means a team providing services outside of a hospital or facility setting:  (A) That includes not less than one (1) behavioral health care professional who is capable of conducting an assessment of a person having a behavioral health crisis, in accordance with the professional’s permitted scope of practice under state law, and other professionals or paraprofessionals with appropriate expertise in behavioral health or mental health crisis response, including nurses, social workers, peer support specialists and others;

(B) Whose members are trained in trauma-informed care, de-escalation strategies and harm reduction;

(C) That is able to respond in a timely manner and, where appropriate, provide screening, assessment, health services, stabilization, de-escalation and referrals to health, social and other services and supports as needed;

(D) That maintains relationships with relevant community partners, including medical and behavioral health providers, primary care providers, community health centers and crisis centers; and

(E) That maintains the privacy and confidentiality of patient information consistent with federal and state requirements.

35-25-502. Crisis center designation; powers and duties of the department; rulemaking; report.

(a) Not later than July 1, 2023, the department shall designate one (1) or more crisis centers to provide crisis intervention services and crisis care coordination to persons accessing the 988 system from anywhere in Wyoming, twenty-four (24) hours per day and seven (7) days per week.

(b) A crisis center designated under this section shall:

(i) Have an agreement with the national suicide prevention lifeline or its successor for participation within the 988 system;

(ii) Meet all requirements and best practices guidelines of the national suicide prevention lifeline;

(iii) Provide data and reports and participate in evaluations and quality improvement activities as required by the administrator;  (iv) Have authority to deploy crisis services, including mobile crisis teams and coordinate access to crisis services or other local resources as appropriate, consistent with guidelines or best practices established by the national suicide prevention lifeline;

(v) Meet requirements established by the national suicide prevention lifeline for serving at-risk and specialized populations identified by the substance abuse and mental health services including those with co-occurring substance use by providing linguistically and culturally competent care including training and policies for transferring a 988 contact to an appropriate specialized center or subnetwork within the national suicide prevention lifeline network;

(vi) Provide follow-up services to persons accessing the 988 system consistent with policies and guidelines of the national suicide prevention lifeline.

(c) The department shall:

(i) Implement and provide oversight of the 988 system as provided in this article;

(ii) Promulgate rules to allow appropriate information sharing between and across crisis and emergency response systems for the purpose of real-time crisis care coordination including deployment of linked crisis services specific to the crisis response;

(iii) Coordinate active collaborations, including facilitating formal agreements and establishing appropriate information sharing procedures, between any crisis center designated under this section and appropriate community partners including mental health and substance abuse disorder treatment providers, primary care providers, community mental health centers, community behavioral health centers, mobile crisis teams, hospitals, inpatient psychiatric facilities and crisis facilities;

(iv) In consultation with the national suicide prevention lifeline, veteran's crisis line and other networks approved by the substance abuse and mental health services administration, ensure consistent public messaging about the 988 system;  (v) Provide an annual report on the usage of and services provided by the 988 system to the joint labor, health and social services interim committee and the substance abuse and mental health services administration;

(vi) Review its practices under this article not less than every four (4) years to ensure that the services provided are and remain best evidence-based practices for suicide prevention.

35-25-503. Mobile crisis teams.

(a) The department may provide onsite response services to address 988 system contact through state or locally funded mobile crisis teams. A mobile crisis team under this section shall:

(i) Be designed in partnership with community members;

(ii) To the extent practical, be staffed by personnel that reflect the demographics of the community to be served;

(iii) Collect any data required by the substance abuse and mental health services administration and consistent with any requirements of the department.

35-25-504. Payment for crisis services.

(a) The department may provide payment for the provision of crisis services of a contact to the 988 system if:

(i) The person is not insured or the service is not covered by the person's health coverage; and

(ii) The service is not covered by another entity including municipal or county programs or funding.

(b) The department may explore options for appropriate coding of and payment for crisis services through the Medicaid program.

35-25-505. Advisory body.

The governor shall create an advisory body or designate an existing advisory body to provide guidance to the department, gather feedback and make recommendations regarding the planning and implementation of the 988 system under this article. The advisory body may include representatives of a designated crisis center, 911 call center, law enforcement, hospital emergency department, individuals or family members of individuals with lived experience with suicide prevention or behavioral health crisis service usage and behavioral health crisis service providers and may include members of the judicial branch appointed by the chief justice of the supreme court.

35-25-506. 988 system trust fund; reserve account spending policy.

(a) The 988 system trust fund account is created. The trust account shall consist of those funds designated to the account by law and all monies collected from federal grants and other appropriations, contributions, grants, gifts, bequests and donations to the trust fund account. The trust fund account is specifically empowered to accept grants, gifts, transfers, bequests and donations. Funds deposited within the trust fund account are intended to be inviolate and constitute a permanent and perpetual trust fund which shall be invested by the state treasurer as authorized by law and in a manner to obtain the highest return possible consistent with preservation of the trust account corpus.

(b) During each fiscal year beginning July 1, 2024, the earnings from the 988 system trust fund account are appropriated to the department for expenditure as provided in subsection (d) of this section in an amount equal to five percent (5%) of the previous five (5) year average market value of the 988 system trust fund account, calculated from the first day of the fiscal year. For purposes of making the calculation under this subsection, until the 988 system trust fund account has existed for five (5) years, the average market value of the trust fund shall be the average market value during the years that the trust fund has existed. The calculation required by this subsection shall constitute the spending policy for the 988 system trust fund account.

(c) Earnings from the 988 system trust fund account in excess of the spending policy amount established by subsection (b) of this section in any fiscal year shall be deposited by the state treasurer to the 988 system trust fund reserve account, which is hereby created. Except for monies appropriated to the department and monies deposited back to the 988 system trust fund pursuant to this subsection, funds deposited in the reserve account are intended to be inviolate and constitute a permanent and perpetual trust fund which shall be invested by the state treasurer as authorized by law. Interest and other earnings on funds within the reserve account shall be credited to the reserve account. Beginning July 1, 2024 for fiscal year 2023 and each fiscal year thereafter, the state treasurer shall transfer unobligated funds from the reserve account to the 988 system trust fund account as necessary to ensure that an amount equal to the spending policy amount established in subsection (b) of this section is available to the department, pursuant to subsection (b) of this section, for expenditure during the fiscal year. As soon as possible after the end of each fiscal year, revenues in this account in excess of four hundred twenty percent (420%) of the spending policy amount in subsection (b) of this section shall be credited to the 988 system trust fund account.

(d) Funds available to the department shall be prioritized to the extent practicable to first fund those services representing the best evidence-based practices for the prevention of suicide, which may include the following:

(i) Creating and maintaining a statewide 988 system pursuant to this article and in accordance with the National Suicide Hotline Designation Act of 2020 and the federal communication commission's rules adopted July 16, 2020 and in accordance with national guidelines for crisis care;

(ii) Supporting or enhancing the 988 system including providing for state designated crisis centers as provided in W.S. 35-25-502, providing for mobile crisis teams as provided in W.S. 35-25-503 and providing payment for crisis services as provided in W.S. 35-25-504;

(iii) Taking other actions necessary related to the administration of the 988 system as provided by this article;

(iv) Providing other goods or services, including health care services, that do not infringe on fundamental individual liberties and that, according to best evidence-based practices, are likely to lead to the prevention of suicide.

35-25-507. Immunity for telecommunications providers.

(a) A telecommunications provider shall not be liable to any person for any damages caused by any act or omission relating to the origination, transmission or termination of a contact with the 988 system unless the act or omission constitutes willful or wanton misconduct or gross negligence.

(b) As used in this section, "telecommunications provider" means any person that provides commercial landline telephone service, mobile telephone service or internet protocol enabled voice service and includes any agent or employee of the service provider.

35-25-508. Confidentiality of information.

The information obtained through the 988 system shall be considered a public record under W.S. 16-4-201(a)(v) and access to the information may be denied according to law.

35-25-509. Sunset.

This article is repealed effective July 1, 2028.

ARTICLE 6 - WYOMING ADULT HEARING AID PROGRAM

35-25-601. Wyoming adult hearing aid program.

There is created a hearing aid program for adults with hearing impairment.

35-25-602. Definitions.

(a) As used in this article:

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

(ii) "Eligible adult" means a Wyoming resident not less than eighteen (18) years of age who has been diagnosed by a physician or audiologist with a profound hearing impairment that requires hearing aids and who has a monthly modified adjusted gross family income at or below two hundred percent (200%) of the federal poverty level;

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

(iv) "Hearing aid" means as defined by W.S. 33-35- 102(a)(ii).  35-25-603. Program eligibility; benefits.

(a) Subject to available state funding, the department shall provide hearing aids for eligible adults. Eligibility under this section shall be determined by the department or its designee. To be determined eligible to receive hearing aids under this section, a person shall not be eligible to receive hearing aids through private insurance, Medicaid, Medicare or any other available third-party payor. Recipients shall not receive more than one (1) set of hearing aids under this article in any five (5) year period.

(b) An adult eligible for services under this article shall receive:

(i) Up to one (1) hearing aid per ear at a cost of not more than the rate paid for hearing aids under the Wyoming Medical Assistance and Services Act and including hearing aid insurance for loss or damage;

(ii) A hearing aid fitting at a cost of not more than the rate paid under the Wyoming Medical Assistance and Services Act; and

(iii) An initial set of ear molds at a cost of not more than the rate paid under the Wyoming Medical Assistance and Services Act.

CHAPTER 26 - AUTOMATED EXTERNAL DEFIBRILLATORS

35-26-101. Automated external defibrillators; definitions.

(a) As used in this article:

(i) "Automated external defibrillator (AED)" means a medical device heart monitor and defibrillator that:

(A) Has received approval of its premarket notification filed pursuant to U.S. Code, title 21, section 360(k) from the U.S. Food and Drug Administration;

(B) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and is capable of determining, without intervention by an operator, whether defibrillation should be performed; and  (C) Upon determining that defibrillation should be performed, automatically charges and delivers, or requests delivery of, an electrical impulse to an individual's heart.

35-26-102. Possession of automated external defibrillator.

(a) In order to ensure public health and safety, all persons who possess an AED shall:

(i) Obtain appropriate training in cardiopulmonary resuscitation (CPR) and in the use of an AED by the American Heart Association, American Red Cross or by another nationally recognized, or Wyoming department of health recognized, course in CPR and AED use and maintains currency through refresher training every two (2) years; and

(ii) Ensure that the AED is maintained and tested according to the manufacturer's guidelines.

(iii) Repealed by Laws 2005, ch. 89, § 2.

(b) Any person or entity in possession of an AED shall notify an agent of the emergency communications center and the local ambulance service of the existence, location and type of AED.

35-26-103. Limited liability for use of automated external defibrillator.

(a) Any person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical emergency, any prescribing physician who authorizes the purchase of the AED and any individual who provides training in cardiopulmonary resuscitation (CPR) in the use of an AED shall be immune from civil liability for any harm resulting from the use or attempted use of such device, unless the harm involved was caused by willful or criminal misconduct, gross negligence, reckless misconduct or a conscious, flagrant indifference to the safety of the victim who was harmed.

(b) Any person responsible for the site where the AED is located shall be immune from civil liability for any personal injury that results from any act or omission of acts that do not amount to willful or wanton misconduct or gross negligence if that person complies with the requirements of W.S. 35-26-102.  (c) Any clinical use of the AED shall be reported to the licensed physician.

CHAPTER 27 - PUBLIC HEALTH NURSES INFANT HOME VISITATION SERVICES

35-27-101. Definitions.

(a) As used in this act:

(i) "Department" means the Wyoming department of health;

(ii) "TANF" means the federal temporary assistance to needy families program authorized by Pub. L. 104-193;

(iii) "Program" means the public health nursing infant home visitation subprogram created by this act;

(iv) "This act" means W.S. 35-27-101 through