CHEYENNE – The 988 system for suicide prevention and mental health crises is one step closer to having a permanent funding source in Wyoming.
Members of the Wyoming Legislature’s Joint Revenue Committee voted Monday to sponsor a bill that would establish the suicide and crisis lifeline for the long term. They also supported moving $40 million from the Legislative Stabilization Reserve Account – also known as the “rainy-day fund” – to a 988 system trust fund account.
An additional $6 million from the LSRA would go toward a reserve account if the bill was passed as is.
“This bill represents a historic investment in suicide prevention in the state of Wyoming,” said Andi Sommerville, executive director of the Wyoming Association of Mental Health and Substance Abuse Centers. “It’s something that has transcended federal administrations. It’s taken a long time to get here.”
The national 988 system was implemented in July following Congress’s enactment of the National Suicide Prevention Lifeline in 2020, as well as the Federal Communications Commission issuing operational regulations this summer. It was designed for people at risk of suicide or in a mental health crisis to gain access to care quickly, similar to the 911 number.
Individuals who text or call 988 receive a response from a group of lifeline crisis centers, two of which run 24-7 in Wyoming. This was made possible following the Legislature’s decision during the budget session to appropriate $2.1 million in American Rescue Plan Act funds and $400,000 from the general fund budget for the local, full-time coverage hotline.
However, stakeholders such as Sommerville expressed concern that there wasn’t a long-term funding source after 2024. It is one of the reasons the 988 suicide prevention bill was presented.
The bill also would establish a crisis center, outline the duties of the Wyoming Department of Health and clarify the payment process for crisis services.
Rep. Steve Harshman, R-Casper and co-chairman of the Revenue Committee, said he wanted to ensure residents who were in crisis weren’t going to be billed for services. In the past, there were residents who were committed to a mental health institution and faced a $12,000 bill when they came out.
A provision of the bill states that the Department of Health will provide payment if the service is not covered by the patient’s health coverage, or if it isn’t covered by another entity, including municipal or county programs. WDH may also explore options for appropriate “coding of and payment for crisis services through the Medicaid program,” but is no longer required to do so after the word “shall” was amended out of the bill Monday.
Wyoming Department of Health Director Stefan Johansson said he didn’t want to generalize how billing for health care services might impact a person’s mental health, or the decision to take their own life, but he was optimistic about the ongoing behavioral health redesign.
“Folks who who don’t have access, or have access to affordable insurance, do struggle accessing health care, and can potentially, on the financial side, face some pretty significant challenges,” he said in response to co-Chairman Sen. Cale Case, R-Lander. “Fortunately, though, with the services and the providers that I just mentioned, at the community level, we have the ability in our community mental health centers and the various providers that we contract with for those services, we have the ability to look the other way on insurance status. And that’s a really healthy component of this system.”
Case said he appreciated the fact that services would provided, regardless of insurance or wealth, but he wanted to recognize there may be more clients brought to the suicide hotline due to lack of insurance. He said the circumstances could be overwhelming or too much to cope with if there are health issues – mental or physical – that they are unable to get help for.
“Conceptually, I would certainly agree with your sentiment that that’s likely,” Johansson said. “It’s a possibility that folks who find themselves in these situations could be exacerbated by their financial situation.”
There are many risk factors that contribute to suicide, not just financial difficulty.
The American Foundation for Suicide Prevention reports that stressors such as mental health conditions; traumatic life events; prolonged stress such as bullying, relationship issues or unemployment; and a family history of suicide can contribute.
Wyoming has not been immune to these issues. It is ranked the least-healthy state in the nation related to suicide by the United Health Foundation, and has nearly double the U.S. suicide rate. While the national rate is 14.9 deaths due to self harm per 100,000 population, Wyoming’s is 29.9, according to data from the Centers for Disease Control and Prevention.
Access to mental health care, community support and limited access to lethal means can act as preventative factors. The Wyoming Department of Health said that “numerous studies have shown that lifeline callers are significantly more likely to feel less depressed, less suicidal and more hopeful after speaking to a lifeline crisis counselor.”
The lifeline has been one of the solutions discussed by lawmakers throughout the previous session and the current interim, and suicide prevention has been made a priority by Gov. Mark Gordon in his current first and upcoming second terms.
“The hotline is not the only solution,” said Phyllis Sherard, a retired employee from Cheyenne Regional Medical Center. “(But) it’s an important, important component of how you get these people to care.”
Sherard was one of many stakeholders who voiced her support for the bill during Monday’s Revenue Committee meeting. She was joined by mental health providers such as the executive director of Wyoming Lifeline, Ralph Neider-Westerman.
Westerman argued the importance of having a local, 24-7 hotline, because it gives residents a person to connect with in the rural West who understands where they come from. He said the stigma of suicide is also tremendous, and it contributes to the high number of deaths.
He said he hopes the lifeline can continue with sustainable funding, because then “more people understand that the service is available to them, that they don’t need to sit in quiet, in fear, in despair – that we are there to help them.”
Wyoming Business Alliance President Cindy Delancey said the 988 program was a tool, and the first step was to provide stability. She said by creating the trust fund, it wouldn’t be subject to the ebbs and flows of the general fund.
“To have this resource available really fills that space of preventative treatment, very much the way that we all know that changing the oil in our car is a nice way to preserve the engine,” she said. “Just by taking that step, we really encourage you to continue to help people be able to stay in their home, get treatment in their community, instead of being locked in a very unpleasant situation in Evanston to ensure that they don’t hurt themselves or someone else, which is really the criteria for a Title 25 commitment.”
Although there were many advocates for the bill, some legislators were wary of the cost. Rep. Chuck Gray, R-Casper, said he supports the hotline, but he doesn’t believe the LSRA is the proper funding source. He said there were one-time funds in the budget bill for the program.
Others, such as Rep. Mike Yin, D-Jackson, said the point of the bill was to create the trust fund. He said the hotline wouldn’t be able to continue without long-term funding.
The 988 suicide prevention bill will be considered by the 67th Wyoming Legislature during the general session that begins Jan. 10.