After years of trying to restructure its state-funded community mental health centers, the Wyoming Department of Health (WDH) launched a new system on July 1 that separates patients into three tiers, some of which don’t have to pay anything at all.
For the past 60 years, the state has operated community mental health centers in each county under an open access model: The centers provided outpatient and inpatient services at a sliding scale fee tied to the federal poverty level.
Andy Somerville, executive director of the Wyoming Association of Mental Health and Substance Abuse Centers (WAMHSAC), said many people who need these services most have been left behind — something the new three-tier system hopes to avoid.
“It doesn’t matter how much you make or how much money your household has. It’s not a categorical determination, it’s totally irrelevant for Tier 1,” Somerville said.
Tier 1 patients have no out-of-pocket costs. This includes high-risk youth and their families, people with severe and acute mental illness, and people involved in the criminal justice system. Tier 2 is for patients with higher needs and has certain financial requirements. Tier 3 is similar to the old system.
The biggest change for routine patients receiving treatment is that they will have to fill out an application for Wyoming Medicaid, but Summerville stressed that potential patients do not need to qualify for Medicaid to receive treatment.
Rather, the application will help states determine where they fall in the new three-tier system and whether they have federal or private insurance options to help pay.
“If we can help more people up front, [and] “We’re hopeful that overall there will be some benefits, while being careful to make sure that certain people aren’t left out,” said WDH spokeswoman Kim Deti.
Deti said the state needs to look at different types of insurance so it can save money and invest in other areas not covered by private or federal insurers.
“If we can put more money into the system and really focus state funding on people who suffer from serious mental illness, that’s a win,” Deti said.
The system also hopes to build better connections and networks within state government agencies to make referrals.
“An agency like DFS [Department of Family Services]Ministry of Public Health [and the] “The Department of Corrections needs to provide these referrals to local health centers to ensure people know they can receive services from this program,” Somerville said.
Legislation passed by the Wyoming Legislature in 2021 began the process of restructuring the behavioral health care system. The primary goal was to focus state resources on those who need it most: adults with acute mental illness, criminal justice-involved clients, children and families in need of assistance, and low-income and poor general access populations.
