All Roll Calls
Yes: 155 • No: 5
WyomingHB 1222026 Budget SessionHouseWALLET
AN ACT relating to the federal rural health transformation program funds; establishing the Wyoming rural health transformation program; creating an advisory committee; creating a perpetuity fund; authorizing investments as specified; creating an expenditure account; continuously appropriating an annually required distribution; providing for governance, fiscal controls, accountability and reporting requirements; authorizing expenditures, initiatives, grants and awards; providing for deposits and appropriations; requiring rulemaking; directing studies; and providing for an effective date.
Sponsored By: null Appropriations
Signed by Governor
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Bill Overview
Analyzed Economic Effects
9 provisions identified: 5 benefits, 1 costs, 3 mixed.
Education aid for Wyoming health workers
21.6% of the annual required distribution pays individual awards for nursing, EMS, clinical behavioral health, and physician education. Awards can cover tuition, fees, stipends, and training costs. Another 10.8% funds physician residencies and fellowships, with priority for family medicine and obstetrics. You must agree to work in Wyoming for at least five years after training (physicians in underserved counties). If you do not, you must repay all or part, with interest per rules. 8.2% of time‑limited funds help Wyoming colleges start and keep new training slots.
More support for rural hospitals and EMS
40.7% of the annual required distribution funds incentive payments for critical access hospitals that opt in and meet service rules. Hospitals must run a staffed 24/7 ER with stroke and trauma imaging, operate ground ambulance service in their area, offer basic labor and delivery if births exceed a state threshold, and join the statewide health information exchange. Payments can be tiered, one‑time grants, medical debt relief, or ongoing help with fixed costs. 26.9% funds EMS regionalization for joint applications by two or more ground ambulance providers in the same rural or frontier region, after the department submits a statewide model that shows no response‑time increase and full cost and staffing plans. Grants can fund ambulances, interoperable gear, readiness payments, and regional medical dispatch.
Healthy living grants and medical rides
9.8% of time‑limited funds go to Wyoming groups that boost exercise and healthy eating. Projects that show measurable gains in activity or evidence‑based nutrition get priority. 2.0% funds a statewide system to schedule and bill nonemergency medical rides, helping seniors and people with disabilities reach appointments.
New clinics and care coordination pilots
36.4% of time‑limited funds go to competitive grants to convert or expand clinics into integrated primary care sites. These sites coordinate medical care with behavioral health, obstetrics/gynecology, dental, and preventive services. Another 8.2% funds care coordination models for high‑risk people on both Medicare and Medicaid. Grants can pay capped startup costs, per‑member‑per‑month care payments, and bonuses tied to proven savings.
Telehealth and shared tech upgrades
15.1% of time‑limited funds support a technology challenge for joint applications by two or more providers. Projects must bring care closer to patients, improve data sharing, and cut administrative work. 8.2% pays to buy and run a statewide tele‑specialist platform that links local providers to specialists. 4.9% funds a centralized billing service for EMS agencies that choose to join, with possible expansion to other providers.
Perpetuity fund and annual payouts
The law creates a perpetuity fund for rural health and keeps all investment earnings in the fund. From July 1, 2026 through June 30, 2036, the annual required distribution is the greater of prior‑year program income that must be spent or 4% of total deposits. Starting July 1, 2036, it is 4% of the fund’s five‑year average market value. The treasurer must credit the annual distribution to the expenditure account by September 30. Unspent, unobligated amounts later revert to the fund. The department assigns purpose‑dedicated shares for each $1,000,000 deposited so yearly spending tracks original donor purposes. The treasurer may invest under state policy, including equities if the constitutional voting condition applies.
Tighter rules for recipients and uses
Recipients must file detailed reports on spending and results and sign performance agreements with financial targets and audits. The department can require efficiency steps and collaboration in those agreements. If a recipient misuses funds, breaks rules, or fails targets, the department can demand full or prorated repayment. Program money cannot be used for abortions or for specified sex‑trait modification procedures.
Admin funding and when projects end
2.6% of time‑limited funds pay program administration, including advisory committee costs. 4.6% of plan amounts not specifically authorized are redistributed among the authorized initiatives. Authority to run time‑limited initiatives ends when all funds set aside for them are exhausted.
Stronger oversight and public transparency
The Department of Health runs the program under an approved plan and must write rules. A nine‑member advisory committee guides the program, gives written recommendations on the annual distribution, and must approve any grant or expense over $500,000. Before a grant or expense over $500,000 is authorized, the department must give the legislature at least 10 days’ notice with key details. The state budget office must run an online portal showing current spending and activity.
Sponsors & Cosponsors
Sponsor
null Appropriations
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 3/4/2026
S 3rd Reading:Passed 26-5-0-0-0
Yes: 26 • No: 5
Senate vote • 2/25/2026
S02 - Appropriations:Recommend Do Pass 4-0-1-0-0
Yes: 4 • No: 0
House vote • 2/19/2026
H 3rd Reading:Passed 57-0-5-0-0
Yes: 57 • No: 0
House vote • 2/12/2026
H02 - Appropriations:Recommend Amend and Do Pass 7-0-0-0-0
Yes: 7 • No: 0
House vote • 2/10/2026
H Introduced and Referred to H02 - Appropriations 61-0-1-0-0
Yes: 61 • No: 0
Actions Timeline
Governor Signed HEA No. 0021
3/6/2026GovernorAssigned Chapter Number 61
3/6/2026H Speaker Signed HEA No. 0021
3/5/2026HouseS President Signed HEA No. 0021
3/5/2026SenateS 3rd Reading:Passed 26-5-0-0-0
3/4/2026SenateAssigned Number HEA No. 0021
3/4/2026S 3rd Reading:Laid Back
3/3/2026SenateS 2nd Reading:Passed
3/2/2026SenateS 2nd Reading:Laid Back
2/27/2026SenateS COW:Passed
2/26/2026SenateS02 - Appropriations:Recommend Do Pass 4-0-1-0-0
2/25/2026SenateS Placed on General File
2/25/2026SenateS Introduced and Referred to S02 - Appropriations
2/23/2026SenateH 3rd Reading:Passed 57-0-5-0-0
2/19/2026HouseS Received for Introduction
2/19/2026SenateH 2nd Reading:Passed
2/17/2026HouseH COW:Passed
2/16/2026HouseH02 - Appropriations:Recommend Amend and Do Pass 7-0-0-0-0
2/12/2026HouseH Placed on General File
2/12/2026HouseH Introduced and Referred to H02 - Appropriations 61-0-1-0-0
2/10/2026HouseH Received for Introduction
2/9/2026HouseBill Number Assigned
2/8/2026
Bill Text
Engrossed
Enrolled
Introduced
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