Staffing shortages at state-run behavioral health and long-term care facilities have reduced the number of staffed beds and increased the state's reliance on expensive contract labor, Wyoming Department of Health officials told the Mental Health & Vulnerable Adult Task Force on June 30.

"Our current census is is 80," Stefan Johansen, director for the Wyoming Department of Health, said of the Wyoming State Hospital, adding the facility is built for 104 beds but the staffed capacity is about 80. The hospital's biennial operating budget, he said, is "around $91,000,000." Johansen said the department has about 1,400 authorized positions and that most are field-based in facilities or public-health offices.

That shortfall has two concrete effects, Johansen told the task force: fewer staffed beds to accept civil and forensic patients, and increased spending on contracted nurses and direct-care staff to maintain operations. Johansen said the department is "projecting to spend, just under $17,000,000 in contract labor." He and other presenters tied those staffing gaps to longer waits for court-ordered forensic evaluations and to challenges in discharging patients who are clinically ready but have no appropriate community placement.

Why it matters: The department's psychiatric hospital in Evanston is the state's only state-operated psychiatric inpatient facility; limited staffed capacity affects judges, jails, hospitals and law enforcement statewide when people ordered for Title 7 (criminal forensic) or Title 25 (civil commitment) evaluations or treatment cannot be admitted promptly.

What the department reported

- Wyoming State Hospital capacity and use: facility built for 104 beds; staffed capacity approximately 80; current census reported as "80." Budget on a biennial basis: "around $91,000,000." (Stefan Johansen)

- Vacancies and turnover: Johansen presented vacancy data showing high direct-care and nursing vacancies at multiple campuses; examples cited in the presentation included approximately 67% CNA/DSP vacancies at the Life Resource Center in Lander (May data) and nursing vacancies ranging across facilities, with the state hospital near 40% vacant in nursing classifications on the department's internal summary.

- Contract labor: The department uses agency staffing to maintain bed capacity; Johansen said the state has grown contract labor spend over recent years and is "projecting to spend, just under $17,000,000 in contract labor."

- Tradeoffs: Johansen said the department can either reduce staffed bed capacity to match state employees on the payroll (which would lengthen court and emergency-department wait lists) or continue using contract labor (which increases operating costs and makes recruiting state staff harder because contractors can pay substantially more).

Correctional system impacts

Dan Shannon, director of the Wyoming Department of Corrections, told the task force the correctional system houses a large population with mental-health needs and that vacancies also affected custody and programming. Shannon described his department's experience with raising pay to improve retention and said corrections had improved employee retention to about 91% and that staffing vacancies had dropped to roughly 10.95% overall, but added that correctional facilities still rely on contracted medical and behavioral-health providers and that staffing shortages contributed to temporary out-of-state inmate placements earlier in the budget cycle.

Discussion and next steps

Task force members and agency officials discussed recruitment and retention efforts, including nonwage approaches such as tuition reimbursement and education leave that Johansen said had shown early gains in CNA recruitment at the state hospital. Johansen told the group the legislature's prior decisions repositioned state facilities'missions toward short-term acute stabilization and targeted long-term care, which in turn requires coordination with community providers to create appropriate step-down placements.

The task force did not take formal action. Members requested updated vacancy and contract-labor figures and asked agencies to return with policy options that could reduce reliance on contract staffing or expand community placement capacity.

Ending

Officials said bed capacity and staffing will remain a priority for the task force; the Department of Health agreed to provide updated vacancy and contract-labor numbers and to outline policy options the group could consider in future meetings.