After several years of working to restructure state-funded community mental health centers, the Wyoming Department of Health (WDH) launched a new system on July 1st. It creates three tiers of patient categories, some of whom won't need to pay at all.
For the past 60 years, the state has run community mental health centers in every county on an open access model. Centers provided outpatient and inpatient services on a sliding scale fee tied to the federal poverty level.
Andi Summerville, executive director of the Wyoming Association Mental Health and Substance Abuse Centers (WAMHSAC), said that let a lot of people who needed these services the most fall through the cracks. But the new three tier system hopes to avoid that.
“It doesn't matter how much money you make or how much money your household has. It's not relevant at all for tier one instead of the categorical determination,” said Summerville.
Tier one patients won’t pay anything out of pocket. This includes high risk youth and families, those with severe and acute mental illnesses, and those involved with the criminal justice system. Tier two is for high needs patients and carries some financial requirements. The third tier is similar to the old system.
The biggest change for an everyday patient is a requirement to fill out a Wyoming Medicaid application. But Summerville stressed potential patients don’t need to qualify for Medicaid to get care.
Rather, the application will help the state determine where they fall under the new three tier system and whether there are federal or private insurance options that can help pay.
“If we're able to support and help more people up front [and] make sure that certain people don't fall through the cracks, we’re hoping to see some benefits overall,” said Kim Deti, WDH spokesperson.
Deti said the idea is to make sure to look at different types of coverage so that the state can save money and invest it in other areas that aren't covered by private or federal insurers.
“If we're bringing more money into the system, and we're making sure that the state dollars can really be focused on the folks that are facing serious mental illness, then that's a win,” said Deti.
The system also hopes to build a better connection and network within the state agencies and have them provide referrals.
“We are expecting agencies like DFS [Department of Family Services], Department of Health [and the] Department of Corrections to provide these referrals into the communal health centers to make sure that people know that they can access the services in this program,” said Summerville.
A law passed in 2021 by the Wyoming Legislature started the process of restructuring the behavioral health system. The chief goal was 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.