Wyoming is dropping a proposal to stretch out more than a billion dollars of federal health dollars for decades to come.
Late last year, the federal government awarded the state $205 million for the first year of the Rural Health Transformation Program. The state expects to get a similar amount for the next five years.
Since then, the state and the federal government have been figuring out specifics about how money will be spent. One sticky point has been a “perpetuity fund.”
That fund was approved by the Wyoming Legislature and would have taken about 70% to 80% of federal money the state receives annually and invested it. It was meant to make the program more sustainable than the five years the federal government has allotted it for.
“[It] would generate essentially additional revenue for the state to then stretch out over a long period, you know, 20-, 30-, 40-year timeline,” Wyoming Department of Health Director Stefan Johansson said at a May 14 legislative meeting.
However, after two months of negotiations, Johansson told lawmakers that the state has dropped that idea because of “esoteric federal regulations.” He said the state submitted a new proposal to the federal government in early May that’s similar to the previous one but doesn’t include the perpetuity fund. He said he expects approval in the coming days or weeks.
“I'll be very blunt,” Johansson told lawmakers. “There's certainly concern over sustainability of these programs.”
He said lawmakers could take action and create a perpetuity fund with state dollars instead for more targeted initiatives. He also added that he’s confident hospitals and emergency medical service (EMS) providers can make investments through the federal health dollars that will pay off beyond the five-year period.
Rather than focusing on new equipment and consultants, Johansson said Wyoming is pushing to use the money to sustain more basic care. That includes ensuring communities have 24/7 emergency services and access to labor and delivery care. Smaller hospitals could also partner with larger ones to provide elective, non-time-sensitive procedures. The state plans to offer these resources in exchange for providers making "smart and conservative” reforms to their business models, Johansson said.
His department previously also proposed using the federal money for a program dubbed “BearCare,” a public health plan that could have covered emergencies, such as getting attacked by a bear. Lawmakers decided not to move forward with that earlier this year.
Johansson said his department will request proposals from providers shortly after the federal application gets a final sign-off. Johansson said Wyoming has until Oct. 31 to obligate the first year of money. The state will then have a year to spend that money.
