Posted: Thursday, November 8, 2007 12:00 am
Star-Tribune Editorial Board
Wyoming has an obligation to provide care for its most fragile residents, including psychiatric patients, those with developmental disablities, and the elderly poor. In this sparsely populated state, there aren't enough community programs available in many areas to meet all of these special health care needs - so state programs are a key factor.
Star-Tribune health reporter Allison Rupp's recent series on the state facilities shows that Wyoming generally is doing a good job of providing such care. But it has opportunities to improve.
Wyoming residents have been cared for at these state facilities for more than 60 years. As the population ages due to medical advances, patients' needs are changing, too. A review of the five state-operated health care facilities should benefit patients while finding better ways for Wyoming to use its resources.
Brent Sherard, director of the state Department of Health, wants to see a comprehensive master facilities plan completed. The goal is to be more cost-effective and to operate the institutions as a regional health care system, rather than as autonomous facilities.
The Legislature should cooperate and fund the study. Lawmakers who have complained that the facilities lack direction should welcome the opportunity to help them improve.
Each of the five institutions has a special mission. Patients with mental health issues are treated at the State Hospital in Evanston, while those who have developmental disabilities or those with acquired brain injuries receive care at the State Training School in Lander. Buffalo is the location of the Veterans' Home. The elderly have two options, depending on their needs: the Pioneer Home, which is an assisted living center in Thermopolis; and the Wyoming Retirement Center, a nursing home in Basin.
Even before a master study, the Department of Health is developing creative ways to better serve people. One that makes a lot of sense is moving geriatric psychiatric patients from the State Hospital - which usually has a waiting list - to the State Training School. Sherard said the Training School has the space and staff to handle their needs.
Another idea that has merit is a pool of traveling nurses who can work at different facilities. The cross-training necessary would improve their skills and help provide services at locations that often have nurse vacancies, including the Retirement Center.
A state plan needs to examine whether any services now offered by the facilities could be offered more cost-effectively if they were privatized.
Money isn't the only factor to consider when it comes to providing health care for special populations. Specialized care can be extremely expensive. As Sherard noted, many patients can't afford private nursing home care.
Sherard made an important observation about some older patients who regard the Training School as their home:
"Is it the humane thing to do, to leave them in their home?" Sherard said. "Probably, yes. Is it the most cost-effective? Probably not."
Humanity is still a vital part of the health care equation, as it should be. In state government's appropriate search to make services help pay for themselves, let's not forget Sherard's words.