Behavioral health overhaul will impact service users

The state has been working to overhaul and strengthen its behavioral health system since 2021, when the Wyoming State Legislature passed new laws to support the effort.

The goal, says the Wyoming Department of Health (WDH), is to focus the state’s resources on the people who need them most: acute psychiatric adults, criminal justice-involved clients, high needs children and families and low income and indigent general access populations.

“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.”

If you currently rely on state services, or if you seek them in the future, be aware that certain changes have been made to the process as part of this overhaul.

One important change is to eligibility.

According to the WDH, some people will no longer be eligible for state-supported services from the community mental health center network.

This includes anyone with an income over 200% of the federal poverty level who does not have significant behavioral health needs. For 2024, for example, this figure for a one-person household is $30,120 while, for a four-person household, it would be $62,400.

However, WDH recommends looking to the federal healthcare marketplace at healthcare.gov to potentially find heavily subsidized insurance if you do not currently have any.

The redesign aims to direct state dollars where they are most needed, so changes have been made to ensure that the appropriate checks are made for a person seeking services as to whether they qualify for financial help from sources such as Medicaid or private insurance, rather than relying solely on state funding.

“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.

Anyone seeking state-paid services will now be asked to submit an application through Wyoming Medicaid. This does not mean you must be eligible for Medicaid to access help.

The step will serve as a check for other potential pay sources and verify information such as your income, residency and citizenship. Medicaid is part of WDH, so the department is using its existing systems to perform this check and manage payments to community mental health centers for the sake of efficiency.

A third change will impact providers as payments move from block grants to a mixture of block grants, service payments and outcome payments.

“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,” said Franz Fuchs, senior policy analyst.

“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.”

The overall intent of the changes, according to WDH, is to focus resources on high-needs clients in the hope that this may lead to cost savings and reduced pressure on the system. Eventually, WDH wants to reduce repeated hospitalizations and divert people from institutional settings in the first place.

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?’”