When a family hears “Community Living Services Level 3, 4, 5, or 6,” it can sound like a ranking of the person. It is not. The levels describe patterns of support tied to functional limitations and medical, behavioral, personal-care, supervision, and overnight needs. The participant remains an individual whose daily support must follow the approved IPC.

For Cheyenne families considering a residential or community-living arrangement, the practical question is whether the provider’s staffing model, setting, training, backup coverage, and communication can reliably meet the authorized level while preserving choice and community life.

Community Living Services in plain language

Community Living Services are individually tailored habilitative supports intended to help a participant acquire, retain, or improve skills for community living. The current Wyoming index includes adaptive skills, activities of daily living, medication assistance, light housekeeping, community inclusion, transportation, adult education, social and leisure skills, personal care, protective oversight, and supervision as indicated in the IPC.

CLS also includes training on objectives. Progress must be documented and shared with the participant, legally authorized representative, and case manager. Room and board are not waiver-funded CLS services.

What Level 3 generally describes

Level 3 addresses moderate functional limitations and possible behavioral support needs. The service definition calls for regular staff availability within hearing distance, periodic face-to-face contact on each billed day, and staff support through the night. The IPC must spell out overnight expectations.

This does not mean every Level 3 participant has the same schedule or goals. Shared staffing may be appropriate when the participant’s behavioral and medical supports are not intense and the approved arrangement safely meets needs.

What Level 4 generally describes

Level 4 reflects significant functional limitations and medical or behavioral support needs. Full-time staff must be available while the participant is in the service, with regular attention for training, personal care, reinforcement, positive behavior support, and community or social activities.

Overnight support must be available as the IPC specifies. The provider should be able to explain staffing during ordinary routines, appointments, community activities, evenings, emergencies, and changes in housemate or staff availability.

What Level 5 generally describes

Level 5 addresses significant and somewhat intensive functional, medical, or behavioral needs. One or more staff are expected in close proximity during most awake hours, with frequent personal attention. The current definition requires in-person support through the night as indicated in the IPC.

Participants receiving Level 5 are not eligible for remote monitoring under the current index. Families should ask how the provider maintains close-proximity support while still respecting privacy, choice, and opportunities for community participation.

What Level 6 generally describes

Level 6 reflects high medical, behavioral, or personal-care needs, with frequent support and full-time staff in immediate proximity during most awake hours. The definition anticipates the personal attention of at least one staff person unless the IPC and DHCF approval specify otherwise; occasional two-to-one support is included when written into the IPC.

In-person overnight support is required as the IPC indicates, and remote monitoring is not available for this level. A provider should demonstrate robust staffing, participant-specific training, emergency planning, documentation, and coordination capacity before accepting the referral.

Daily support, other services, and the 35-hour limit

For Levels 3 through 6, the current service index requires a minimum amount of documented provider support for payment of the daily service and defines overnight expectations by tier and IPC. Families should not use billing rules as a substitute for the person’s actual support schedule; the approved plan and safety needs remain central.

Participants receiving CLS Levels 3 through 6 cannot receive non-residential services above the current average weekly limit stated in the service index. Service times cannot overlap, and personal care is already a CLS component, so separate Personal Care Services cannot occur at the same time. The case manager should test the full weekly schedule before implementation.

Provider fit is more than the level number

A level does not describe compatibility, communication style, sensory needs, mobility, dietary routines, preferred activities, or relationships. Those details determine whether a particular home, housemate arrangement, staff team, and provider model can work.

Ask how the provider protects participant rights, supports community relationships, handles turnover, ensures backup coverage, responds to changes, and documents habilitation goals. The answer should connect to the actual participant rather than repeat a generic tier description.

What families and guardians should clarify

Ask for the level explanation in plain language and compare it with daily experience. If the description does not seem to match the person’s current needs, bring specific examples to the case manager rather than assuming the provider can informally adjust the level.

What outcome is written in the IPC, and how will the participant recognize progress?
What routines, communication preferences, risks, and rights must staff understand?
Who should be contacted when needs, schedules, health, behavior, or safety concerns change?
How will the participant exercise choice about activities, settings, and the way support is delivered?

What case managers should confirm

Confirm the LOS-based level, overnight expectations, staffing model, living setting, habilitation objectives, personal-care components, and interaction with non-residential services. Make sure the provider can meet the level consistently and the participant has meaningful choice.

Does the requested service match the assessed need and the service definition?
Are amount, frequency, duration, setting, staffing, transportation, and supervision expectations clear?
Could the schedule duplicate or overlap another waiver service or another funding source?
What documentation and team communication will show that the IPC is being implemented?

What this topic does not mean

CLS Levels 3 through 6 are not medical diagnoses, measures of a person’s worth, or permission to restrict ordinary rights. CLS is not room and board, a nursing facility, or automatically skilled nursing. Any specialized medical service must be separately authorized and delivered within the proper scope.

Questions to ask before services begin

Which CLS level is authorized and what assessment supports it?
What in-person and overnight availability does the IPC require?
Which goals require habilitation and monthly progress reporting?
How will other services fit without overlap?
What setting and staffing arrangement did the participant choose?

Frequently asked questions

Are Levels 3–6 available on both DD Waivers?

The current service index states that only Basic CLS is available through the Supports Waiver. Confirm the participant’s waiver and authorization with the case manager.

Does a higher level automatically mean one-to-one staffing all day?

No. Each level has defined proximity and attention expectations, and the participant’s IPC specifies the approved arrangement. Level 6 includes particular expectations and possible occasional two-to-one support when documented.

Can a participant at Levels 5 or 6 use remote monitoring?

No. The current index excludes remote monitoring for Levels 5 and 6.

Can Respite relieve a paid CLS provider?

No. Wyoming’s current definitions do not allow Respite to relieve a paid CLS caregiver.

Related Essential Living Support resources

Source note

Service information in this article is summarized in plain language from Wyoming Department of Health Home and Community-Based Services resources, including the Comprehensive and Supports Waiver Service Index effective July 22, 2026. The participant’s approved Individualized Plan of Care and current Wyoming Medicaid guidance control when they differ from a general educational summary.

Talk with Essential Living Support

Essential Living Support, LLC is a Wyoming DD Waiver and HCBS provider serving Cheyenne and supporting adults with intellectual and developmental disabilities. Families, guardians, case managers, and referral partners may contact Essential Living Support to discuss the participant’s authorized service, support needs, provider fit, and current availability. ELS does not determine waiver eligibility or replace the participant’s case manager or plan-of-care team.

Community Living Services Level 3 to Level 6 in Wyoming: What Families Should Know