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Access To Recovery Services and Application Requirements

 

This page outlines the requirements for providing services under the Wyoming Access to Recovery (ATR) Program.  The forms and applications in each section are the ones required for that section.  If you are providing both types of services, only one ATR Business Agreement Application, which is under Clinical Services Certification, needs to be submitted with a separate Level of Services form for each type od service.  However, you will still need to submit separate authorization and certification applications.

  

New Clients:

The average ATR client uses services for approximately 90 days. In order to demon-strate that Access to Recovery can be concluded on August 2, 2007, No New Clients will be processed after May 2, 2007, 90 days prior to the end of the grant. If, on May 2, 2007, it appears that sufficient unspent funds are available to continue operations for an extended time, this deadline may be extended. If additional funds are secured prior to May 2, 2007, this deadline may also be extended.

 

New Applications

Beginning March 1, 2007, Access to Recovery will not process any new applications for vendors or service providers. Existing applications must correct any deficiencies by Wednesday, March 7, 2007, or their applications will be terminated. Current vendors have been instrumental in shaping Access to Recovery and are significant contributors to our success. It is likely, however, that some, even possibly significant, changes will occur in future contracting processes between the Wyoming Department of Health and Access to Recovery service providers. At such time as future funding becomes available and performance terms of such funding are published, ATR may again open the application process.


 

 If you plan to provide clinical services for ATR:

  • You must to be certified by the state to perform those services you plan to provide
  • You must complete and submit an ATR Clinical Services Certification Application to the division
  • You must complete and submit an ATR Business Agreement to the division
  • You must indemnify the Wyoming Department of Health from any liability stemming from the contractor’s activities. Applications must include proof of insurance, physical plant and professional, including name of applicant/contractor, coverages, effective and expiration dates, and limitations. Insurance renewal notifications must be provided to the WDH certification provider during the re-certification reviews. If you are also applying for transportation services, you must include proof of vehicle insurance.
  • You must complete and submit the WOLFS-109 form to the division if you are not in the state payment system

Forms and applications required for providing Clinical Services:

 

ATR Clinical Services Certification Application (93k, PDF)
ATR Business Agreement Application (128k, PDF)
WOLFS-109 Form (171k, PDF) 
DFS Background Check Form (85k, PDF)

 

 

 

If you plan to provide Recovery Support Services for ATR:

  • You must be authorized by the state to perform those services you plan to provide
  • You must complete and submit an ATR Recovery Support Services Authorization Application to the division
  • You must complete and submit an ATR Business Agreement Application to the division
  • You must indemnify the Wyoming Department of Health from any liability stemming from the contractor’s activities. Applications must include proof of insurance, including name of applicant/provider, coverages, effective and expiration dates, and limitations. Insurance renewal notifications must be provided to the WDH certification provider during the re-certification reviews. If you are also applying for transportation services, you must include proof of vehicle insurance.
  • You must complete and submit the WOLFS-109 Form to the division if you are not in the state payment system
  • You must complete and submit the DFS Background Check Form if you are providing child care services

Forms and applications required for providing Recovery Support Services:

ATR Recovery Support Services Authorization Application (70k, PDF)
ATR Business Agreement Application (PDF)
WOLFS-109 Form (171k, PDF)