SWEETWATER COUNTY — The Sweetwater County commissioners unanimously approved two Southwest Counseling Service agreements for FY25 during their meeting Tuesday.

The first agreement was the Treatment Agreement with the Wyoming Department of Health’s Behavioral Health Division, which is Southwest Counseling’s primary contract with the state and helps fund all outpatient services and their residential beds, Southwest Counseling Service Director Linda Acker said.

This contract totals $8.5 million, which is approximately $1 million less than the current fiscal year’s contract. Acker said it’s $938,141 less, due to the state’s behavioral health redesign. According to the Wyoming Department of Health’s Behavioral Health Redesign report, dating back to 2021, the redesign aims to define a set of “priority populations” to be the primary focus for services provided by state dollars in behavioral health centers; establish a system of three tiers by which these populations should be prioritized for funding; and direct the Department of Health to proceed with reform and redesign of the state-funded mental illness and substance use disorder treatment system.

“It’s less [money] because the behavioral health redesign starts July 1, which is a major change in how Southwest Counseling will be paid,” Acker said. “We used to get paid on a grant position where we’d get 1/12 of the dollars. Now we have to have people enroll into the tier system, and we will be going after each individual for payment. What that million dollars is really about is ‘outcomes’. It’s to incentivize the centers to really encourage their clients to do better in our communities.”

Through this redesign, centers can get some of that funding back by participating in the state’s pilot project, in which treatment for up to 900 behavioral health clients state-wide can be partially reimbursed based on their community engagement and integration. The clients selected for this pilot project will be assessed on community engagement, including whether they have a job in the community and a place to live, among other standards. For retired or disabled clients, their engagement will be based on how socially engaged they are in the community.

“If we do really well in those areas, we’ll submit that to the state and they’ll reimburse us on a per member, per month [basis]. The maximum payment will be $1,400 per client,” Acker said.

Acker believes this is a reasonable change by the state and thinks it’s great for the clients to ensure they’re being supported and engaged in the community. However, she also understands that they’ll only be able to draw down a portion of the available reimbursement, as not every client will be excelling in every area. She said the state is anticipating that the larger facilities, such as in Cheyenne, Gillette, and Rock Springs, will make up the majority of the 900 available spots in the pilot project, meaning Rock Springs has a good chance of being reimbursed for several clients.

The second agreement approved by the commissioners was for a $516,896 grant to go toward Crisis Interventions services, and the addition of four sub-acute residential beds. Southwest Counseling already has five beds, meaning they will have a total of nine residential beds. Acker said that while this is very positive, the negative is that the grant funding will start July 1 and conclude at the end of August 2025. She said Southwest Counseling will most likely not continue the services provided through this grant once it reaches its term, as this is one-time American Rescue Plan Act funding.

Acker explained to the commissioners that for a client to be assigned a sub-acute bed, they must be evaluated by a licensed clinician at Southwest Counseling to ensure they’re going into the beds voluntarily. This means they can also leave at any time but are encouraged to stay until they are stabilized.

She also reported that Southwest Counseling serves around 3,000 clients a year, but there are many more people in the community who go without treatment.

“There’s so many more people who are in need of mental health services and substance abuse services, and one of the barriers is money, as well as stigma, of course… but that should not be a barrier at Southwest Counseling,” Acker said.