Rita Muñoz
Respite Consultant
Developmental Disabilities Division
186E QWEST Building
6101 Yellowstone Road
Cheyenne, WY 82002
(307) 777-3694 (office)
(307) 777-6047 (fax)
 
 

 
The Application Process

Application Form

Includes the Co-Payment Schedule

Contact Rita Munoz at 307-777-3694 for Information on how to become a State Respite Provider
 
  We would like to take this opportunity to share some information with you about the State of Wyoming Respite Program.
 
In order to meet the qualifications for the program your child must be under the age of 21, have a severe, chronic disability that is likely to continue indefinitely and results in substantial functional limitations in three (3) or more of the following areas.
 
1. Self Care
 
2. Receptive and expressive language
 
3. Learning
 
4. Mobility
 
5. Self-direction
 
6. Capacity for independent living
 
7. Economic self-sufficiency
 
We recognize how important it is for parents to be able to take a break from the care of their child (respite), for a couple of hours. It is important that the people taking care of your child provide for their safety. Individuals who want to take care for State Respite Children must go through an extensive background check to help ensure the child's safety.  Because it is often expensive to find someone to care for children with disabilities, the base rate for respite providers is $8.00 an hour. There is a co-payment system based on parental income.
 
If you would like to be considered for State respite services, please click below on the word "application". Then print a copy out, fill it in, and return it to us. The forms may appear very large on your screen, but they will print out as 8.5 x 11 inch paper.
 
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We hope you find this program helpful to your family. If you have any questions, please call us at 777-3694.