(Lander, Wyo.) – In presenting the Wyoming Department of Health’s study of the Wyoming Life Resource Center, WDH Director Tom Forslund asked the Interim Joint Labor, Health, and Social Services Committee or the legislature at large to help him figure out his facilities’ missions for the future.
Citing that he does not recommend forced transfers of clients out of the WLRC, among other items, he asked for direction in clarifying the mission of the facility. “We need as a state to truly clarify the mission of the Wyoming Life Resource Center facility,” Forslund said.
He said that another state study, coming from outside of his department, is set to identify later this month roughly $50 million in upgrades to the Wyoming State Hospital and roughly $40 million to the WLRC. He noted that both facilities have expertise in areas that the other could benefit from, along with the fact that WLRC has turned into more of a long-term care facility and the state hospital also has begun having more long-term patients take up beds that were originally intended for acute care.
Forslund said before the state starts allocating funds for facility improvements, it should clarify how it wants the various facilities to operate.
The WLRC study, as directed by the legislature in the last session, focused on two aspects: the possibility of transferring clients into the community and finding efficiencies that can be implemented.
Owing to the fact that 44 percent of 90 WLRC clients have lived there for more than 40 years, and 68 percent more than 11 years, he believes there would be a danger to their health if they were rapidly transferred into the community.
The report also states that while clients with similar needs assessments are being treated for roughly $100,000 cheaper in community programs, community providers say they would need time to prepare to take a flood of clients should there be forced transfers. Some community providers also said they couldn’t promise they would be able to take some of the clients with the highest needs.
With regard to fiscal efficiencies, the WLRC reportedly had higher per client costs compared to the national average of similar facilities. Several opportunities to create efficiencies were identified, which if implemented in total would result to $4-5 million decrease in costs.
Right now the WLRC has a budgeted staff to client ratio of 4.7 to 1. WDH recommends decreasing that to 3.5 to 1, which was the benchmark set by the 1990s Weston lawsuit. This would result in a decrease of 114 budgeted positions. As of March 2013, 381 of the 429 budgeted positions were filled. This reduction could be done, Forslund said through attrition, incentives or forced eliminations. He said he preferred attrition and incentives.
Eliminating staff meals, as currently provided, could result in saving more than $1 million. Also there was a recommendation to possibly outsource food service.
Resizing the Horizons Healthcare Center is another opportunity identified. This is the medical care side of the facility, which Forslund said is under utilized. Contracts for similar services through local hospitals could prove more fiscally efficient, he said.
Outsourcing dental care is another opportunity. Co-Chairwoman Rep. Elaine Harvey said she liked this idea because it got the clients into the community more so that they are not “so isolated.” Another opportunity would be to reevaluate off-campus programming, which would save funds but keep the clients on campus more.
Co-Chairman Sen. Charles Scott noted that there would be millions in savings for transferring the clients into the community programs. Forslund said one current barrier for voluntary transitions is that the clients would have to be put on the Medicaid waiver waiting list, without any guarantee of funding. He said if the state wanted to move that direction, addressing that barrier would need to happen.
Scott also suggested as plans move forward to build new or upgrade existing facilities, it could look at bidding projects for the purpose of privatizing some services. Forslund said there could be problems with the state maintaining the safety net services its required to have.
Rep. Eric Barlow and Harvey both raised concerns that similar services were being provided to people at drastically different costs, and Barlow asked if the department had considered a funding model to match what community providers charge. Forslund replied that he would work in whatever budget is given him.
Following the meeting, the committee took a tour of the WLRC. The public and press were not allowed to come. Read the complete study here.