FILE - Wyoming Capitol

Wyoming Capitol building

(The Center Square) – Wyoming’s mental health system is being redesigned to prioritize those with the highest level of need.

Passed during the last legislative session, House Bill 38 creates a tiered system in which certain populations are ranked as higher-need than others and puts them first in line for care. Currently, the system runs on a first-come, first-served basis and is funded through the state's general fund.

Hollis Hackman, federal advocacy coordinator for the Wyoming Psychological Association (WPA), pointed out this is where Wyoming diverges from most other states.

“That’s unlike many other states in the country, which provide mental health services through their Medicaid programs,” he told The Center Square.

The redesign would create three prioritized tiers, WyoFile reported. Of highest priority would be those in need of care coming out of the criminal justice system, adults with severe mental illness, and families whose mental health problems could result in a child being removed.  

In the second tier are those for whom their mental health disorders interfere with their ability to function in society, that are uninsured and whose income falls below 150% of poverty level. Those in the third category have the same economic factors as those in tier two, but their disorders do not interfere with societal function.

Hackman said WPA did not support the bill when it was under debate in the legislature because the group felt it was motivated by budget concerns rather than an aim to make mental health care better.

“We’re not really sure that the priority categories fit with what the state’s needs are in terms of mental health because there wasn’t what we would recognize as a large, statewide analysis of what the needs are in the state,” he said.

He called the bill’s focus “myopic,” adding that it doesn’t capture the big picture of Wyoming’s mental health conditions.

“We have problems with mental health in the state—we have the highest suicide rate in the country presently,” Hackman said. “That’s a problem and we can solve that by having more resources available.”

Wyoming state Rep. Lloyd Larsen, R-Lander, co-chair of the Select Committee on Mental Health and Substance Abuse and part of the redesign steering committee, argued it's a better solution than the current rule.

“It’s just a matter of good policy,” Larsen said, according to WyoFile. “Do we have an open-door policy where anybody, regardless of who they are, gets mental health services paid for by the state? And the consensus was no, that’s not the role of state government.”

Expanding Medicaid is the favored solution by Hackman and the WPA. The federal government would foot the entire bill initially, which he said is a good deal, although in a few years Wyoming would have to start paying a share.

The redesign is still far from settled, WyoFile reported. Two of three public sessions on the redesign have been held while a report expected to address repurposing of funds and implementation is due to the Joint Labor, Health and Social Services Committee on Aug. 1. Those involved expect full implementation to take years.