Committee Meeting Information

July 12-13, 2007

Wyoming State Hospital

Evanston, Wyoming

 

Committee Members Present

Senator Pat Aullman, Co-chairman

Representative Keith Gingery, Co-chairman

Senator Ken Decaria (July 13th only)

Senator Rae Lynn Job

Representative Jerry Iekel

Representative Jack Landon

Representative Jane Warren

 

Committee Members Absent

Senator Ken Decaria (July 12th only)

Senator Bob Fecht

Senator Wayne Johnson

Senator Ray Peterson

Representative Tim Hallinan

Representative Patrick Goggles

 

Legislative Service Office Staff

John Rivera, Senior Staff Attorney

Joy N. Hill, Associate Research Analyst

 

Others Present at Meeting

Please refer to Appendix 1 to review the Committee Sign-in Sheet
for a list of other individuals who attended the meeting.

 


Executive Summary

The Committee met for two days in Evanston.  The Committee toured the Wyoming State Hospital and heard testimony on adult acute psychiatric care, mental health and substance abuse work force issues, and inpatient residential treatment for mental health and substance abuse clients.  The Committee also received information about programs that have been created as a result of bills sponsored by the Committee.  The Committee directed staff to prepare legislation for consideration by the Committee at the next meeting on the issues raised at the meeting.

 

The Committee will meet again in Casper in September 27-28, 2007 to consider draft legislation.

 

 

Call To Order (July 12, 2007)

 

Chairman Aullman called the meeting to order at 8:30 a.m.  The following sections summarize the Committee proceedings by topic.  Please refer to Appendix 2 to review the Committee Meeting Agenda.

 

 

Discussion of Interim Objectives

Chairman Aullman advised that NCSL will provide an addictions training seminar September 6th through 8th in Chicago. Wyoming has been selected to participate.  Six legislators will be appointed to participate in the training.  Chairman Aullman called for volunteers interested in participating.

 

Mr. Rodger McDaniel advised that six members of the executive branch have been appointed to participate in the training, including: Wendy Curran, Bob Lampert, Joan Evans, Tony Lewis, Mary Flanderka and Korin Schmidt.

 

Representative Gingery stated the Committee will meet one more time, perhaps in Jackson in September, either before or after the Council of State Governments conference.  He went over some things that have fallen off of the Committee's list of potential issues, including:

 

Representative Gingery would like to discuss at this meeting inpatient psychiatric beds and substance abuse treatment needs,  Representative Warren’s workforce concerns, and the whether the regional pilot project should be expanded to other regions, continued as is, or terminated.

 

Chairman Aullman added that the Committee is scheduled to receive by the next meeting a report on the psychological needs of returning armed forces personnel.  

 

Tour of Wyoming State Hospital (WSH)

Dr. Pablo Hernandez provided a notebook with pertinent information regarding the WSH (Appendix 3).  He discussed the utilization of the buildings at the WSH.  Currently there are only three hospitals around the state that have been designated to take Title 25 patients, including Wyoming Behavioral Institute in Casper, Pineridge Hospital in Lander and Cheyenne Regional Medical Center. 

 

After the discussion, Committee members were taken on a tour of the WSH.

 

WSH Adult Acute Care Program (Geriatric Patients)

 

Dr. Hernandez described acute psychiatric patient care in a hospital setting which WSH provides.  Patients are accepted as a result of court orders under Title 25, involuntary commitments, and W.S. 7-11-301, forensic evaluations.  In the last 4 years, WSH has not been able to accept voluntary acute care patients.  In addition, the designated hospitals are also full, so they are unable to respond to acute care needs of other patients.  Geriatric patients are taking up beds that are more appropriate for acute adult patients that could be treated and released in 6-8 weeks.  Some of the geriatric patients are coming from nursing homes as a result of violent behaviors.  It is nearly impossible to return a violent person back to nursing home.   In addition, those 14 geriatric beds will be occupied long-term, which prevents WSH from accepting voluntary admissions.   In response to a question from the Committee, Dr. Hernandez said he would work with Dan Lex to obtain data on the number of facilities that are able to treat patients with Alzheimer's Disease.

 

The WSH cannot hire people due to salary issues, which also diminishes their ability to open vacant buildings at the facility.  The energy industry pays higher wages, thus making recruitment by the WSH extremely difficult.   Currently, there is a waiting list of 24 patients at WSH, who are being treated at designated hospitals or other facilities.  Many of these patients require treatment of longer duration.  There will be a group of geriatric forensic patients who will not leave the hospital due to their age and the nature of the crimes they committed.  Also, many of the aging civil patient population will not return to their communities and will stay at WSH instead.  The state must decide what the role of the WSH should be now and for the next 20 years.  The system of mental health care in communities needs to improve also because WSH cannot be responsible for all persons with mental illness.   If  WSH could hire 14 additional staff, WSH could open the facility having 14 empty beds.   Authorizing another 18 positions could result in another 22 long-term care beds being available. 

 

Dr. Brent Sherard, Director, Wyoming Department of Health (WDH), stated the whole system is backed up as a result of Title 25 commitments, and health care issues in general.  The WDH needs to focus on advanced planning for geriatric and other patients and submit that plan to the State Building Commission (SBC) as part of a master state facility plan, integrating with other state and private institutions as well.  There is a lot of overlap among many of the state institutions.  This master plan, however, is a longer term solution.  Governor Freudenthal and other SBC members seem to be in favor of this approach in general.  The major problem is the aging of Wyoming's population.  Staffing is also a problem, primarily for certified nursing assistants, but more psychiatrists and advanced practice psychiatric nurses are needed in communities around the state also.  As an employer, the state has trouble offering the same incentives that private industry can.  Increasing WSH salaries would have an impact upon other state and private providers as well.

 

Representative Gingery  stated the 14 beds for geriatric patients was removed from the bill last session, in part because the Legislature authorized funding 2 years ago for a facilities study at WSH there was a desire to hold off  on those additional beds until the facility study report was submitted.  He asked if the report would be ready by September 1 of this year.  Dr. Hernandez replied that he has no control over that study because the Department of Administration & Information is charged with conducting the study. He will check to see if the report will be available for the September meeting.

 

Senator Job asked what are WSH needs for the next 5 years.  Dr. Hernandez stated WSH is lacking in sufficient geriatric mental health care ability.  The WSH needs at least 26 beds in the next 5 years.  Acute inpatient hospital psychiatric beds are a secondary need.  It is necessary to decide if the WSH or community care will provide for acute mental health care. 

 

 

Implementation of Programs Created by 2006-2007 Legislation

 

Programs Created by 2007 SF 76, Expenditures and Outcomes

Mr. Bob Peck, Chief Financial Officer, WDH, distributed Appendix 4, containing data on the expenditures authorized under 2007 SF 0076, as prepared by Ms. Carol Day.  Mr. Peck explained funding has only been available since July 1, 2007.  The WDH worked on getting contracts prepared to be ready by the July 1, 2007 implementation date.

 

 

Children’s Mental Health Waiver

Ms. Korin Schmidt, WDH, provided an update on waiver.  She distributed Appendix 5, the April-June, 2007 quarterly report of the Children's Mental Health Waiver. Program referrals did not pan out like originally projected.  Only four referrals have been received to date.

 

Representative Gingery commented  that he is concerned about the appearance that people are not using the program because the system appears too rigid.    He asked if the program could be remodeled to add flexibility.  Ms. Schmidt  replied that the WDH is looking at alternatives. 

 

Ms. Peggy Nikkel, Director, Uplift, said she had high hopes initially, but the program has not been used much yet.  The first year is not a failure, but a learning experience.  The WDH is listening and looking at more flexible ways to restructure services, facilitate recruitment of a respite providers and addressing paperwork concerns.  A key concern for parents is to have respite without having to relinquish custody.  Most parents want access to Medicaid when they can’t get access through KidCare or private insurance due to their income or costs of treatment.  Provider access is a problem in each region in the state. 

 

Wyoming Client Information System (WCIS), 2007 HB 0133

Mr. McDaniel provided an update on WCIS.  He reminded the Committee that at the last meeting questions were raised about using clients' social security numbers (SSN) as identifiers.  Most states use the SSN to track the client. WDH has determined, after consultation with providers, that the SSN was the most practical way to track clients within the system.   He then distributed Appendix 6, a flowchart illustrating how WDH planned to protect clients' identities within WCIS, and Appendix 7, the WDH Policy and Informed Consent Procedures.

 

Dr. Sherard added that WDH is a very complex organization. WDH began 1½ years ago to revamp WCIS.  There are many databases within WDH that do not talk to each other.  Input from various stakeholders and WDH employees were considered to address system issues.  WDH has been inputting data from the past couple of years and is now inputting 2008 data.  WYPOMS is now connected with WCIS.  The project is moving along well. 

 

Ms. Schmidt stated WDH only receives SSNs if clients have signed a permission form.  SSNs are encrypted.  Only high level IT people can decrypt the numbers, which are not seen in their actual form. 

 

Chairman Aullman asked for public comment regarding the SSN issue.

 

Dr. David Birney, Director, Peak Wellness Center,  expressed concerns about how the SSN issue is going to impact the system.  Some clients will not consent to have their SSNs released.  If there is a high refusal rate, it will impact the entire database.  The WDH has been very open in this discussion.  He hopes another methodology will come about eventually and will be able to accomplish the goals of 07HB133.  Confidentiality and privacy are important issues in mental health counseling. 

 

Ms. Nikkel has spoken with clients, consumers and family members.  They are concerned about privacy and health information.  The key questions were whether HIPPA guidelines would still be followed and whether the family had the choice with respect to providing the SSN and if they chose not to provide the SSN, would they still receive services.  The Governor has indicated that HIPPA will be followed, clients will have the choice whether to provide an SSN and providers may be reimbursed for services, even  if the SSN is not provided. 

 

Mr. McDaniel stated that he will monitor the level of voluntary compliance and if compliance is too low, he will come back to the Committee to discuss alternatives. 

 

SPF-SIG Grants

Ms. Mary Flanderka, WDH, explained the WDH had concerns with the 12 grant applications received from the counties.  Coupled with the SAMSHA  recommendation that there be one statewide program, the grant applications were rejected in favor a single program. The state is in the third year of  a five year, $11 million prevention grant.  The WDH is working on strategies for prevention activities and data collection.

 

Representative Gingery expressed concern that the funds were not directed to the counties with very severe problems.  After an explanation that the state had limited discretion in its use of the federal funds, he asked what could the state do to address the identified needs of the severely impacted counties.  Mr. Rodger McDaniel, Deputy Director, WDH, said the bulk of what the state spends on prevention is from federal funds.  The Select Committee might want to consider funding prevention efforts using state funds.  Ms. Flanderka said it would take about $50 thousand per county if the state were to use general funds to assist the 12 counties that were identified as having a severe alcohol abuse problem.

 

Beer /Alcohol Taxes

Mr. McDaniel said he has ordered, and will provide to Committee members, a book by Joseph Califano that focuses on prevention among young people.  The book is called “High America”.  Mr. Califano advises focusing prevention efforts on the age group, 10-12 years of age because tobacco use within that age group provides an 85% predictor of adult alcohol and tobacco usage.  He also describes deterrents to tobacco use by juveniles, including increasing taxes to make them unaffordable to young people.    Smoking on a regular basis by juveniles in Wyoming has declined from the mid-30% range in the late 1990s to 22% currently, but we have reached the point of diminishing returns unless new efforts are made.

 

 

Workforce Needs

 

Wyoming Association of Mental Health and Substance Abuse Centers (WAMHSAC)

Dr. Birney stated the salary increases authorized last session are making it easier to recruit people.   This will be an ongoing battle, though, because the recruitment pool is very small in Wyoming.  Not many young people are going into this field.  Retention is a big issue also.  One of WAMHSAC's major reasons for attending this meeting was to support Representative Iekel’s bill from last session, which is being considered by this Committee for potential sponsorship. 

 

08LSO-0043.W1, Mental Health Professions Practice Act – Amendments

Chairman Aullman advised the Committee will consider this bill, but will not vote on the bill because the Committee does not have a quorum on this day of the meeting.  The goal of this bill and of the Committee in considering this topic is to create greater flexibility for professional individuals to become licensed and available for work in the area of mental health counseling.

 

Representative Iekel explained the bill.  After questions from the Committee, relating to why some language has been repealed and recreated in new subsections and the problems with redefining prohibited sexual intimacy, Representative Iekel was asked to work with staff to address the issued identified by the Committee and present a revised version of the bill at the next Committee meeting.

 

08LSO-0044.W1, Psychologist licensure

Representative Warren explained the bill she had sponsored last session was intended to reduce barriers for individuals seeking to practice in Wyoming by amending provisional licensure requirement to allow such licensure without strict supervision requirements.  This is a national trend.  The bill also cleans up the Mental Health Professions Practice Act.  She introduced  Mr. Mark Watt representing the Mental Health Professions Licensing Board, who would explain specifics of the bill.

 

Mr. Watt stated the bill had five main points:  to change the definition of the "practice of psychology";  to remove language relating to school psychologists, since there were only two in the state;  to make some distinctions and remove others;  to ease provisional licensure requirements for those coming into the state; and, to allow for more psychologists to access programs such as health service corps to  help with college loan assistance, etc.

 

Representative Gingery asked about the powers and duties of the Board  and whether the Board had any staff.   Mr. Watt replied that the Department of Administration and Information provides staff assistance, but that staff is over utilized by numerous boards.  He believes it would be more efficient and less expensive for the Board to have its own staff.  Representative Gingery asked if other licensing boards in state have their own counsel, as proposed in this bill.  Mr. Watt  stated that if the Board disagrees with the Attorney General, the Board cannot currently seek outside counsel for second opinion.  He pointed out the State Board of Medicine employs its own outside counsel.   The Attorney General's Office assisted in drafting this provision in the bill.  Representative Gingery suggested getting an opinion from the Attorney General before the next meeting with respect to the Board being authorized to hire outside counsel because it may get awkward if the Board counsel says one thing and the Attorney General says another.

 

Meeting Recess

 

The Committee recessed at  5:07  p.m.

 

 

Call To Order (July 13, 2007)

 

Chairman Gingery called the meeting to order at 8:35 a.m.  Having a quorum, the Committee approved the minutes of the April 19-20, 2007 meeting.  The following sections summarize the Committee proceedings by topic.  Please refer to Appendix 2 to review the Committee Meeting Agenda.

 

 

Workforce Needs (continued from previous day)

Chairman Gingery stated the Committee will consider the proposed legislation at the next meeting after the bills have been revised.

 

Representative Warren described the original intent of the Committee, when it increased funding for mental health and substance abuse services, was to address the perceived need, but she doesn’t think there is enough workforce to address the complex issues of substance abuse.  There is little training available in substance abuse therapy and co-occurring conditions, which affects 80% of clients served in the state.  She recommends the Committee should look more closely at the workforce situation to determine what the actual need is and what is needed to support workforce development and training, including scholarships, education and training tracks.  She suggested looking to the Blueprint for the States for more ideas and recommendations.

  

LSO Survey of WAMHSAC Facilities

Ms. Joy Hill, LSO, explained the survey she was directed to develop at the last meeting.  The survey was sent to 26 providers, but only 12 responded and, of those, only 4 provided data that could be analyzed.  Therefore, the survey results are of limited value and LSO is unable to draw meaningful conclusions from the data collected.  The responders, on a scale of 1-10, averaged 8.5 on the question of how severe they believed the shortage of provider staff was to meet the needs of clients in the state.  Some of the reasons cited for the shortage included low salaries, cost of  housing, isolation, licensure requirements and a lack of adequate education or training opportunities.

 

After questions about the response rate, Senator Job asked staff to provide a list of providers who responded and those who did not respond.  Senator Decaria suggested that if a majority of providers did not respond to the survey, perhaps they don't believe there is a shortage of staff. Perhaps the Committee is trying to solve a nonexistent problem.  Representative Landon said that if no solid conclusions can be drawn from the survey, maybe the providers and the WDH could collaborate with the University of Wyoming and community colleges to create educational and training opportunities.  Representative Warren said her substance abuse assessment bill appears to have created a problem with timely assessments, which has frustrated courts, and she assumed there was a shortage of providers, but the LSO survey may point to the fact that the shortage of providers may not be as significant as she believed.  Senator Job added that the Committee appears to be searching for solutions for a problem that is not well documented in the first place.  There may not be much here to be done legislatively on this matter at this time.

 

Mr. Mark Russler, WAMHSAC President-elect, stated that there is a shortage of licensed addictions therapists (LATs) to supervise others who are seeking to become LATs, which contributes to the shortage that may exist.  Senator Job requested that Mr. Russler provide the Committee with information about the Mental Health Professions Licensing Board, its staff, how often it meets to consider license applications and the process used.  Representative Iekel said he would invite Veronica Skoranski to the next meeting to explain the licensing process.

 

Wyoming Dept of Health

Dr. Sherard commented that Wyoming is classified as a mental health professional shortage area.  He provided a brief update on the loan repayment program.  The appropriation ($996 thousand) for the last biennium for the loan repayment program has been exhausted.  For the current biennium, $5 million was appropriated. Recipients in the program commit to working in the state for up to 3 years.  He will get the data relating to recipients who are still here practicing in the state, how many have repaid the loan and left for other states and other relevant data for the Committee.  He advised the WCIS is up and running.  In response to Committee questions about WCIS, Dr. Sherard stated client information is being provided to the WDH and being analyzed.

 

Mr. McDaniel stated that there does not appear to be a shortage of staff for group therapy, but there may be shortages for one-on-one therapy. Both may be necessary as treatment options, depending on the client's needs at a particular stage of treatment.  He will analyze WCIS data to determine outcomes in group and one-on-one therapy to see if WDH is paying too much for one-on-one therapy.  He recommends two options the Committee would do well to explore include required annual training for health care professionals, social workers and the legal profession in the area of substance abuse and addiction.  He would like to bolster requirements for non-LAT individuals working in the addictions field.  The WDH is developing questionnaires that physicians can provide to patients, similar to the New Mexico program Mr. McDaniel described at the last meeting that has proven very successful.

 

Some concerns were expressed with continuing education requirements on substance abuse, including some physicians appear to be reluctant to a requirement for specific continuing education, and it is difficult to find continuing education classes specifically focused on substance abuse and addiction. 

 

Dr. Hernandez  recommended  developing a workforce that is significant to Wyoming which has changed culturally.  Absence of workforce training that addresses cultural issues, such as deaf population and multi-lingual individuals.  The state needs to move from a mono-cultural view to a culturally diversity view.   Ms. Nikkel echoed what Dr. Hernandez said regarding culturally and age appropriate providers.  Very few providers are appropriately trained to provide children’s mental health services.

 

Residential Treatment¾Substance Abuse

Chairman Gingery advised the Committee will be focusing this discussion on whether to expand, continue or terminate the regional pilot project authorized by the Legislature.

 

WAMHSAC

Dr. Birney provided an update on the regionalization pilot project (see Appendix 8, Casa de Paz progress report) that was awarded to the Cheyenne Regional Medical Center.  Peak Wellness runs the Casa de Paz Crisis Center under the grant.   The Center provides social detoxification, crisis stabilization and inpatient substance abuse treatment.  On average, three of the four beds are occupied with an average stay of 16.6 days per client.  He explained the differences between social detoxification and crisis stabilization, and how the Center is staffed.  He strongly urged Legislature to fund this program again, and to expand the regionalization process to other regions of the state as quickly as possible, in particular the social detoxification and crisis stabilization components. 

 

Ms. Day stated that getting the project up and running was very slow for a variety of reasons, but it is proving to be a very effective project.  The research supports the provision of crisis stabilization.  It would be worthwhile to expand regionalization.  While true regionalization would include inpatient care, the absence of that component is not a reason to hold up expansion of the crisis stabilization component.  The WDH can have cost estimates for expansion by the next meeting.

 

In response to a question from Chairman Gingery, Dr. Birney said transportation in a large region would be handled by picking up the patients wherever they are and transporting them to the crisis stabilization center.  It may be worthwhile to think about whether or not it may be necessary to provide for an additional crisis center for the larger geographic regions, such as the western third of the state.

Mr. Mike Huston, Director, Central Wyoming Counseling Center (CWC), explained the data contained in the email he sent to Mr. Rivera (Appendix 9). WAMHSAC facilities have about 193 residential beds, plus new beds just opened by WYSTAR in Sheridan (Appendix 10).  The new facility at CWC will also add 86 additional beds.  With the completion of the CWC facility and the new WYSTAR beds, WAMHSAC facilities will have around 300 beds, which does not include beds operated by other private providers.  While he would like his new facility to be 100% occupied, he is calculating a 75-80% bed-day utilization.  He rarely gets clients who have insurance.  Many are coming from the criminal justice system and cannot afford full cost of the treatment.

 

Mr. McDaniel advised that the current waiting lists of various facilities may include the same individual who has applied for admission at several facilities, so it is important to view those numbers with caution.  WCIS will assist by developing a non-duplicate waiting list.

 

Chairman Gingery said that it sounds like we are doing well in some areas, but not others.  Perhaps it is necessary to do more in Sweetwater, Fremont and Laramie counties.  Mr. Huston stated he has many referrals from the tribes in Fremont county.  The state needs a program you can build around the native culture.  It is difficult to treat clients if the treatment is culturally inappropriate.

 

Mr. Jerry McAdams, Director, Fremont Counseling Center,  stated that his program cannot afford the $8 million to build a new facility.  The federal government provides less money that the state does, but developing services for the tribes should be a joint effort of the federal and state governments and the tribes.  He is more concerned with meeting staffing needs than with building a new facility.

 

Mr. McDaniel advised patience to see how the new beds that are becoming available through the regional pilot project and other providers before funding new beds, but it may be necessary to address hot issues such as more statewide beds for women and children as described earlier by Dr. Birney. 

 

Dr. Birney added that, based on national projections, he predicts a need for 500 additional beds in Wyoming, but he is not suggesting that number of beds should be funded now.

 

Ms. Nikkel stated that another gap is residential treatment for adolescents.  There is a need for more services so the child doesn’t have to go too far from the community.  The system should be less punishment-driven.

 

Chairman Gingery asked Committee members where they would like to go on the issues presented.  The general consensus was that treatment options for mothers and children and treatment accessibility in Fremont County stood out the most as needs to be addressed, but it might behoove the Committee to monitor how the new beds becoming available in the near future may address those needs.  In particular, the needs on the Wind River Reservation need to be better defined.

 

Inpatient Psychiatric Treatment

WDH

Dr. Sherard  suggested looking at item 4 on the WAMHSAC handout (Appendix 11) which recommends creation of a task force consisting of the WDH, WSH, WAMHSAC, Wyoming Hospital Association, Wyoming Association of Psychiatric Physicians and consumer groups to design a statewide plan for psychiatric inpatient care.   The task force would report back to the Committee by the Fall of 2007.  This task force could operate without legislative directive.  Committee members agreed that may be a good idea and suggested that the Departments of Corrections and Family Services should be participants in the task force.

 

WSH

Dr. Hernandez forecasted needs of  the WSH.  Forty-two beds for acute psychiatric care are needed today.  In next 5 years he will need 28 beds for geropsychiatric care.  Anywhere between 15-20 beds will be required for other needs, including persons who may not fit in group homes.  At least 20 beds will be consistently needed for "not guilty by reason of mental illness" patients.  Another 44 beds will be needed for forensic needs.  There is a hospital in Nebraska that is interested in becoming a designated hospital for Wyoming.  Torrington already transports Title 25 emergency detainees to the Nebraska hospital.  Dr. Hernandez has heard that Campbell County Hospital is going to increase the number of acute psychiatric care beds. 

 

Representative Landon would like WSH to explore the idea of not having a geriatric nursing home atmosphere at WSH.  Perhaps there could be state-assisted nursing homes to provide the care rather than having it provided at WSH.  Dr. Hernandez agreed with the wisdom of that suggestion.  He will have a report of all nursing homes in Wyoming that will be interested in taking a Title 25 elderly person with special needs within the next 6 months.  He has not been able to admit people into nursing homes partly due to the lack of treatment capacity.  Dr. Sherard said the task force will look at that issue also. 

 

Senator Decaria was concerned that it is impossible to get a physician to go into a nursing home, let alone a psychiatrist.  WSH has a better level of care than might exist in nursing homes.

 

Ms. Helen Mertz, WSH,  believes that once someone is admitted to WSH they get excellent care.  The waiting list for the WSH is now down to 24, but that is still too many.  The WSH needs to be able to respond more quickly to these people.  In response to a question from Chairman Gingery, Ms. Mertz said the designated hospitals beds filled up quickly and the waiting list still exists.. 

 

Mr. Gary Parker, WSH,  added that demand is ever increasing while resources remain constant.  He recently attended a workshop on the elderly and believes most nursing homes are not equipped to deal with the mentally ill geriatric patient.

 

Wyoming Behavioral Institute (WBI)

Mr. Bill Sexton, CEO of WBI,  discussed the level of care provided at WBI.  He distributed Appendix 12 describing WBI's role in regional inpatient treatment.  The facility has contracts with 9 counties.  WBI is designed as a short term acute facility and doesn’t deal with the geriatric population.  Only 15% of their patients end up in WSH.  The average length of stay is 7 to 8 days and the patient is ready to return to the community.  WBI has telepsychiatry capabilities and want to branch out with that capability.  The facility has 3 child psychiatrists now.  About 50% of WBI's patients are private pay.

 

Wyoming Association of Psychiatric Physicians

Dr. O’Ann Fredstrom, described treating psychiatric patients in a community without an inpatient psychiatric facility, specifically services provided to persons held before and after W.S. 25-10-109 and 110 hearings.  She favors a statewide conference of law enforcement officials, judges and prosecuting and defense attorneys to promote uniformity in procedures and outcomes.

 

WAMHSAC

Mr. Russler believes the most important issues facing the Committee could be addressed by authorizing a regional pilot project in the Northwest region of the state. 

 

Committee Discussion

After Committee discussion of issues it should continue pursuing, Chairman Gingery directed staff to prepare the following, as necessary, for consideration at the next meeting:

 

The next meeting of the Committee was tentatively scheduled for September 27-28, beginning mid-day on Thursday and continuing on Friday until Committee business was completed.  The meeting will be held at the Central Wyoming Counseling Center in Casper, Wyoming.

 

 

Meeting Adjournment

There being no further business, Chairman Gingery adjourned the meeting at 4:19 p.m.

 

Respectfully submitted,

 

 

 

 

Senator Pat Aullman, Cochairman                               Representative Keith Gingery, Cochairman

 

 


 

 

 

 

 

 

 

 


Appendix

 

Appendix Topic

 

Appendix Description

 

Appendix Provider

1

 

Committee Sign-In Sheet

 

Lists meeting attendees

 

Legislative Service Office

2

 

Committee Meeting Agenda

 

Provides an outline of the topics the Committee planned to address at meeting

 

Legislative Service Office

3

 

Wyoming State Hospital Notebook

 

Provides the history, purpose, strategic plan and other information pertinent to the Wyoming State Hospital

 

Wyoming State Hospital

4

 

FY2008 Funding Obligations under 07 SF 76

 

Provides a spreadsheet describing the expenditures by the Wyoming Department of Health (WDH) under 07 SF 76

 

Wyoming Department of Health

5

 

Children's Mental Health Waiver Quarterly Report

 

Summarizes the activities of the Children's Mental Health Waiver Program for the Quarter April-June, 2007

 

Wyoming Department of Health

6

 

Flowchart: Protecting Wyoming Client Information System (WCIS)

 

Provides a flowchart illustrating the steps WDH client information will go through to ensure confidentiality of clients' personal information

 

Wyoming Department of Health

7

 

WDH Policy and Informed Consent Procedures

 

Provides the policy and procedures the WDH will use to protect client information under WCIS

 

Wyoming Department of Health

8

 

Casa de Paz Progress Report

 

Reports the activities of the Southeast Regional Pilot Project authorized by  07 SF 76, since its inception 05/21/07

 

Peak Wellness Program

9

 

Report on the number of available beds in facilities operated by WAMHSAC members

 

Reports the number and nature of beds available in facilities operated by WAMHSAC members and the waiting lists of applicable facilities

 

Central Wyoming Counseling Center

10

 

Report on WYSTAR residential treatment services

 

Reports the number and nature of treatment services available at WYSTAR in Sheridan

 

WYSTAR

11

 

WAMHSAC Recommendations for improvement in inpatient treatment services

 

Provides recommendations from WAMHSAC to the Select Committee with respect to issues that could help improve inpatient treatment services in Wyoming

 

Dr. David Birney

12

 

Wyoming Behavioral Institute's (WBI) Role in regional inpatient treatment services

 

Describes the inpatient treatment services WBI provides under  a  9 county agreement

 

Wyoming Behavioral Institute

 

 


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