Regionalization of mental health proposed; BHB Counseling concerned about clients

Big Horn Basin Counseling Executive Director Darwin Irvine is concerned about talks from legislators around the state on a regionalization system for mental health care.

He said Big Horn Basin Counseling Services began as a private, non-profit organization in the 1970s and followed President John F. Kennedy’s recommendations for mental health. “Wyoming is the only one with the system he recommended, community mental health and abuse centers,” Irvine said.

“We were all set up as non-profits so we could accept payment on a sliding scale, like we do today,” Irvine said.

For Big Horn County, the state contracts are the backbone for the BHBCS financial health. He said private insurance and Medicaid do “OK” in payments, but they see a lot of clients who don’t have either private insurance or Medicaid.

The state contract provides mental health and substance abuse counseling to individuals, couples and families who can’t afford it, Irvine said.

He said the current system in Wyoming is for one center in each county. Big Horn Basin Counseling has been able to utilize funding to operate and maintain two full-time offices, one in Lovell and one in Basin. He said the Basin building is paid for and the Lovell building is nearly paid for.

BHBCS boasts two full-time psychologists and little staff turnover.

Irvine said while the viability of the services in Big Horn County is strong there is talk of regionalizing the mental health system in Wyoming and that could hurt services in the county.

“While across the country there is an outcry for more mental health services, some Wyoming legislators are talking about regionalization, which means a decrease in services. Wyoming is currently ranked low among the states in its mental health services, but I think we’ve (BHBCS) done a pretty good job,” Irvine said.

Most clients pay on average $50 per session, Irvine said, which means they don’t have money for traveling for counseling across the county. He said he sees the need for two offices in Big Horn County the same as there is a need for two circuit court offices, noting, “Most of their clients and most of ours don’t have money for transportation.”

Irvine said the legislators encouraged the counseling services to provide “same day service” whenever possible, but this year each state department faced an 8 percent cut and he said the mental health division of the Wyoming Department of Health received about a 13 percent cut. “We’re one of the smallest portions of the Department of Health budget, but we received the largest cut,” Irvine said.

He said the pay in Wyoming for licensed therapists is horrible. He said state law requires therapists to have a master’s degree, and starting salary for a 12-month contract that includes on-call work starts about $37,000.

“We’ve done as well as anyone. We have one of the best staffs,” Irvine said. He said BHBCS will be able to handle the cuts by not filling a current vacant position on staff.

“This regionalization idea, first brought up by the Division of Behavioral Health and some legislators, is of great concern because it could impact our services and our staff,” Irvine said. He said the idea is very preliminary. One idea is to have current centers bid to be the regional center and BHBCS could bid; however, if they weren’t the winning bid, the services they now offer could change.

Some counties have already voluntarily gone to regional centers and are asking that the state statute that requires a center in every county be changed.

Besides impacting services and staff, Irvine said a regionalization plan would impact other agencies. “Regionalization is supposed to be a way to save money, but Irvine said it will just mean a cost shifting to hospitals and law enforcement. “We see people before they end up with one of these places,” he said.

The core outpatient services need to remain as they are in the state, he said, noting some services are already regionalized such as the crisis home in Worland and the group home in Cody.

“We need our clients’ help. They need to speak up for our services to the county commissioners and local legislators,” Irvine said.

Any change in the way the mental health is delivered in the state will require legislative action.

Contact information for state legislators representing various parts of Big Horn County are as follows:

Rep. Elaine Harvey, 307-548-7866,

Rep. Mike Greear, 307-388-3399,

Rep. Nathan Winters, 307-864-3690,

Sen. Ray Peterson, 307-548-6405,

Sen. Gerald Geis, 307-347-6443,