The Wyoming Department of Health (WDH) is asking for over $18.6 million in its supplemental budget request.
Unlike many other large government departments, personnel costs aren’t a large part of its spending. Approximately 90 percent of WDH spending goes out to communities or healthcare providers in the form of reimbursement for services. The remaining 10 percent goes to personnel costs. The budget requests reflect the structure of the department.
WDH Director Stefan Johansson asked to increase the Medicaid reimbursement rates for OB-GYNs from 95 percent to 105 percent, with the hope of helping to retain existing physicians and avoid further worsening of the state’s maternity care desert. He mentioned labor and delivery services have closed in the past couple of the years around the state, including a recent closing in Evanston. In 2023, 35 percent of Wyoming births were covered by Medicaid.
“[It’s] unlikely [labor and delivery] services would come back online but [it’s] a modest measure the state could take to stave off additional elimination of these,” Johansson told the committee.
Lawmakers on the Joint Appropriations Committee agreed the maternity care desert situation needs to be addressed. Chairman Sen. Dave Kinskey (R-Sheridan) said at this point it's a city problem, since rural areas don’t have services to offer anymore.
“They’re coming to Casper because their rural communities don’t have any care.”
Johansson also asked lawmakers to consider increasing reimbursement rates for home health services, specifically for children and behavioral health providers. He said home health agencies are beginning to decline to serve Medicaid clients, and also reduce or drop existing client panels, due to poor Medicaid cost coverage.
In the behavioral health sector, he said one specialization is especially in need: “Applied behavioral analysis services. These are services that are becoming more and more voluminous and frequent, especially for children on the autism spectrum. It's a new type of provider.”
The department is asking to increase Medicaid rates for physicians providing those services in the state.
In addition, WDH wants to make multiple part time or contractor positions full time. Due to the increasing aging population in the state, Johansson is requesting one full-time employee to determine long term care eligibility and help screen nursing homes through Medicaid. Currently, caseloads are 590 per worker, and this would help lower that workload.
One neutral financial implication for the state general funds would be moving 12 part-time Women, Infant and Children (WIC) program employees to full-time positions. Johansson said it would not cost the state anything, since it would be offset by federal funding until 2026. The state government budget for the 2027/28 biennium would need to find ways to pay for it.
Lawmakers will consider the asks during the legislative session in January.
