Changes Underway for Wyoming’s Behavioral Health System

After several 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 many years, our department has paid millions of state dollars to community mental health centers to help ensure access for Wyoming residents who sought care for mental health and substance use related issues regardless of their ability to pay,” said Stefan Johansson, WDH director. “It’s one of our largest budget items and is clearly important, but there have been challenges.” 

A significant new law passed in 2021 by the Wyoming Legislature supported efforts to strengthen Wyoming’s behavioral health system. A chief goal is focusing state resources on those who need them most: acute psychiatric adults, criminal justice involved clients, high needs children and families and low income and indigent general access populations. 

Johansson said, “We really want to help ensure high-needs people facing serious mental illness do not fall through the cracks before their needs grow. As we have carefully prepared for these changes, a focus for our department and our partners has been to help answer the question of ‘What is state government’s role?’ 

To help direct the state dollars toward where and when they are needed most, the redesigned process is meant to help ensure people seeking services who could qualify for financial help from other sources such as Wyoming Medicaid or private insurance are supported through those sources rather than through state funding alone.

“When Wyoming’s community mental health system was designed, there was less financial support available for behavioral health services through options such as private insurance. But that has since changed, which presents an opportunity to potentially share the financial load,” Johansson said.

Franz Fuchs, senior policy analyst with WDH, said “One thing people will notice is all residents seeking state-paid behavioral health services must now submit an application through Wyoming Medicaid. While this does not mean you have to be eligible for Medicaid to be helped, this step will check for other potential pay sources beyond state general funds and verify income, citizenship and residency. 

Without an application on file, WDH will not be able to pay for services received after July 1. “The community health centers and organizations such as Enroll Wyoming can help people complete the needed application,” Fuchs said.

Because Wyoming Medicaid is also part of WDH, using existing systems to check eligibility and to manage payments to the community mental health centers is an efficient solution.

Fuchs acknowledged some individuals will no longer be eligible for state-supported services from the community mental health center network. These include people with incomes over 200 percent of the Federal Poverty Level (FPL) who do not have significant behavioral health needs. For those in this group who do not already have insurance, heavily subsidized insurance is likely available through the federal marketplace.

There are also changes to provider payments. “We’re moving from block grants to a mix of block grants, service payments and outcome payments,” Fuchs said.

“The hope for many involved in this redesign effort is that focusing the state’s resources on high-needs clients may eventually lead to cost-savings and reduced pressure on other elements of Wyoming’s behavioral health system such as frustrating waiting lists,” Fuchs said. “If we can reduce repeated hospitalizations or divert people from institutional settings in the first place, that’s a win for both clients and for our state facilities.”

Matt Petry, Behavioral Health Division senior administrator with WDH, said, “We are making big changes and we certainly recognize that change isn’t always easy. We are truly grateful and want to thank our partners in Wyoming’s community mental health centers, law enforcement personnel, leaders in local and state correctional facilities, judicial system representatives, Department of Family Services staff and the state’s policymakers for their participation and willingness to work with us.”