Changes underway in Wyoming’s behavioral health system
July 2, 2024
After years of planning and coordination with partners across the state, changes to Wyoming’s behavioral health system are underway, according to the Wyoming Department of Health (WDH).
“For years, our agency has paid millions of dollars in state funds to community mental health centers to ensure that Wyoming residents have access to treatment when they seek it for mental health or substance use-related issues, regardless of their ability to pay,” said WDH Director Stefan Johanson. “This is our agency’s largest budget line item and clearly a critical one, but it has not been without challenges.”
Significant new legislation passed by the Wyoming Legislature in 2021 supported efforts to strengthen Wyoming’s behavioral health care system, with a primary goal of focusing state resources on those who need it most: adults with acute mental illness, criminal justice-involved clients, children and families in need, and low-income and poor general access populations.
“We want to ensure that people with serious mental illness who need support aren’t left behind before they reach the point of needing it. We’ve been carefully preparing for these changes, and our department and partners have been focused on answering the question, ‘What is the state government’s role?'” Johansson said.
The redesigned process aims to allocate state funding where and when it is needed most and ensure that people seeking services who qualify for financial assistance from other sources, such as Wyoming Medicaid or private insurance, can receive assistance through those sources in addition to state funds.
“When Wyoming’s community mental health system was designed, there was less financial support provided for behavioral health services through options such as private insurance, but that has since changed and there is the potential for sharing of the financial burden,” Johanson said.
“One thing you’ll notice is that all residents seeking state-paid behavioral health services must submit an application through Wyoming Medicaid. This doesn’t mean you have to be eligible for Medicaid to receive assistance, but this step checks for potential sources of payment other than the state general fund and verifies income, citizenship and residency,” said Franz Fuchs, senior policy analyst at WDH.
If an application is not submitted, WDH cannot pay for services received after July 1. “Community health centers and organizations such as Enroll Wyoming can help people fill out the necessary applications,” Fuchs said.
Because Wyoming Medicaid is also part of the WDH, using existing systems to verify eligibility and administer payments to community mental health centers is an efficient solution.
Fuchs acknowledged that some individuals will no longer be eligible for state-supported services from the Community Mental Health Center Network, including people who earn more than 200% of the Federal Poverty Level (FPL) and do not have significant behavioral health needs. People in this group who are not already insured may be able to access heavily subsidized insurance through the federal marketplace.
There are also changes to provider payments: “We’re moving from block grants to a combination of block grants, payment for service and payment for outcomes,” Fuchs said.
“The hope of many involved in this redesign is that focusing state resources on high-need patients will ultimately lead to cost savings and less strain on other elements of Wyoming’s behavioral health care system, such as frustrating wait lists,” Fuchs said. “If we can reduce repeat hospitalizations or keep patients out of institutional settings in the first place, it’s a win for patients and for the state’s facilities.”
“We are making significant change, but we know change isn’t always easy,” said Matt Petrie, WDH Behavioral Health Division senior administrator. “We are extremely grateful for the participation and willingness to collaborate from our partners at Wyoming’s Community Mental Health Centers, law enforcement personnel, local and state correctional facility leaders, judicial system representatives, Department of Family Services staff, and state policymakers.”