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
13 provisions identified: 10 benefits, 2 costs, 1 mixed.
Training help with Wyoming service commitments
The law targets 21.6% of the annual distribution for individual health training awards covering tuition, fees, and stipends. Eligible fields include nursing, emergency medical services, clinical behavioral health, and undergraduate medical education. Recipients must provide Wyoming health care for at least five years after finishing or repay all or part, plus applicable interest. Another 10.8% targets physician residency and fellowship costs, prioritizing family medicine, obstetrics, and other high-demand specialties. Physician recipients must serve at least five years in one or more underserved Wyoming counties, with repayment terms set by rule. Both award programs depend on available funds, and their target shares can change under the law’s allocation rules.
Coordinated care for high-risk Medicare-Medicaid patients
The law targets 8.2% of temporary initiative funds for competitive grants coordinating care in one or more counties. Models must serve high-risk people who qualify for both Medicare and Medicaid. Funding can cover capped startup costs, monthly payments per assigned participant, and performance payments tied to demonstrated cost savings. The committee can recommend a different share in writing based on documented need and demand. The initiative ends when available temporary funds run out.
Coordinated medical rides for seniors and others
The law targets 2.0% of temporary initiative funds for a centralized platform coordinating nonemergency medical transportation. It supports scheduling, coordination, and billing for trips to health appointments. Intended users include seniors, people with disabilities, and other eligible populations. The committee can recommend a different share in writing based on documented need and demand. The initiative ends when available temporary funds run out; the law does not specify an individual payment amount.
Grants expand rural primary care options
The law targets 36.4% of temporary initiative money for competitive grants expanding federally qualified health centers and their geographic reach. Grants support facility or practice conversions combining primary care with behavioral health, pregnancy and gynecological care, dental care, and prevention. The committee can recommend a different share in writing based on documented need and demand. Funding and grant authority end when available temporary initiative funds run out. These grants support providers; they do not create new household insurance coverage or an individual payment.
More connected care for rural patients
The law targets 15.1% of temporary initiative funds for health technology grants requiring joint applications from at least two providers. Projects must bring care closer to patients’ homes, improve systems’ ability to work together, strengthen coordination, and reduce administrative work. Another 8.2% funds a statewide platform giving health care providers remote physician-level specialty consultations. Both shares can change on written committee recommendation based on documented need and demand. The initiatives end when available temporary funds run out and do not establish direct household payments or coverage rights.
More support for regional rural ambulance services
The law targets 26.9% of the annual distribution for regional emergency medical services, subject to available funds and permitted allocation changes. Support includes ongoing readiness payments and grants for ambulances, compatible equipment, and regional dispatch. At least two ground ambulance providers serving a connected rural or frontier region must apply together. Their plan must address revenue, emergency dispatch integration, shared technology, lower administrative costs, community emergency care, and remote crisis stabilization. Before implementing regionalization, the department must submit a statewide model showing no increase in emergency response times to the designated legislative committee. It must also provide staffing projections, including volunteer impacts, inter-county governance agreements, and full costs, including long-term maintenance. Separately, 4.9% of temporary initiative funding targets voluntary centralized ambulance billing services. Billing services can expand to other providers after proving effective and financially sustainable; funding ends when temporary funds run out, and the target can change based on documented need and demand.
Rural hospital support and medical debt relief
The law targets 40.7% of the annual distribution for participating critical access hospitals, subject to available money and permitted allocation changes. Funding supports tiered incentives, one-time grants, fixed-cost payments, and medical debt relief for Wyoming residents. Hospitals must operate staffed 24-hour emergency departments with stroke and trauma imaging and provide or operate local ground ambulance services. They must join the statewide health information exchange and provide basic labor and delivery services when births exceed a department-set threshold. The law does not set individual debt-relief amounts or household eligibility rules.
Wyoming grants support exercise and healthy eating
The law targets 9.8% of temporary initiative money for competitive grants to Wyoming-based groups promoting exercise and healthy eating. Priority goes to projects showing measurable gains in exercise or outdoor recreation participation, or evidence-based nutrition practices. The committee can recommend a different share in writing based on documented need and demand. Grants end when available temporary initiative funds run out. This funding does not provide direct household payments or establish individual service eligibility.
Permanent funding supports Wyoming rural health
The law creates a permanent rural health fund managed by the state treasurer, with investment earnings kept in the fund. Each $1 million principal deposit gets one purpose-specific share; smaller deposits get fractional shares. These shares determine how annual spending is divided among purposes. From July 1, 2026, through June 30, 2036, the annual distribution is the greater of specified federally required prior-year program income or 4% of cumulative deposits. Beginning July 1, 2036, it is 4% of the fund’s average market value over the previous five years. The distribution is automatically appropriated and credited to the spending account by September 30 each year. Unspent, uncommitted money returns to the permanent fund after a reasonable period set by the department with committee advice. Investments must prioritize safety, access to cash, and returns adjusted for risk; stocks are allowed only when constitutional requirements permit. Spending must follow state and federal terms, and money spent in violation of federal terms must be returned.
Wyoming splits funding for rural health
The law creates Wyoming’s rural health program within the Department of Health, which must adopt rules and follow the federally approved state plan. In federal fiscal year 2026, 80% of Wyoming’s federal award goes into a permanent fund and 20% funds temporary initiatives. Each later federal fiscal year uses a 69.5% and 30.5% split. Temporary funding targets 2.6% for administration, including advisory committee expenses. A 4.6% share of qualifying funds not assigned to a specific initiative must be redistributed among authorized initiatives. The committee can recommend material changes to allocation targets in writing based on documented need and demand. Temporary initiatives end when their available federal funds run out.
Grants expand Wyoming health care training
The law targets 8.2% of temporary initiative funds for competitive grants to Wyoming educational institutions starting or expanding health training. Schools must commit to creating and maintaining a specified number of training positions. Eligible fields include nursing, emergency medical services, medicine, clinical behavioral health, and other health professions. The committee can recommend a different share in writing based on documented need and demand. Grant authority ends when the available temporary initiative funds run out.
Rural health funding excludes specified procedures
State agencies and recipients cannot use Wyoming rural health transformation funds for abortions. They also cannot fund specified sex-trait modification procedures defined by federal regulations. These restrictions apply alongside other state and federal legal limits. They limit this program’s spending, rather than creating a general ban on services or a household reporting duty.
Stricter spending rules for rural health providers
A nine-member voting advisory committee appointed by the governor oversees the program, with agency members and nonvoting legislative liaisons. It reviews fund operations and investments, advises on spending, and issues written recommendations requiring a department response. Grants, awards, or spending over $500,000 need written committee approval; deposits into the permanent fund are excluded. Lawmakers must receive notice at least 10 days before authorization. Permanent-fund notices must identify the recipient, amount, purpose, and key terms; temporary-initiative notices go to the Joint Appropriations Committee. Covered providers must sign performance agreements covering operating margins, cash and liquidity goals, modernization, and cost control. They must plan to reduce unprofitable or duplicate services and use shared services where feasible. Recipients must report spending, results, and proof of authorized use; covered organizations also need annual independent audits sent to the Joint Appropriations Committee. Rule violations, missed targets, misuse, or failure to make required reforms require full or partial repayment, recoverable by lawful means. The health and budget departments must maintain an electronic portal with current spending and activity reports.
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
Assigned Chapter Number 61
3/6/2026Governor Signed HEA No. 0021
3/6/2026GovernorS President Signed HEA No. 0021
3/5/2026SenateH Speaker Signed HEA No. 0021
3/5/2026HouseAssigned Number HEA No. 0021
3/4/2026S 3rd Reading:Passed 26-5-0-0-0
3/4/2026SenateS 3rd Reading:Laid Back
3/3/2026SenateS 2nd Reading:Passed
3/2/2026SenateS 2nd Reading:Laid Back
2/27/2026SenateS COW:Passed
2/26/2026SenateS Placed on General File
2/25/2026SenateS02 - Appropriations:Recommend Do Pass 4-0-1-0-0
2/25/2026SenateS Introduced and Referred to S02 - Appropriations
2/23/2026SenateS Received for Introduction
2/19/2026SenateH 3rd Reading:Passed 57-0-5-0-0
2/19/2026HouseH 2nd Reading:Passed
2/17/2026HouseH COW:Passed
2/16/2026HouseH Placed on General File
2/12/2026HouseH02 - Appropriations:Recommend Amend and Do Pass 7-0-0-0-0
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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