The Wyoming Healthcare Commission has provided a forum to discuss health care issues - the uninsured, provider shortages, rising costs - for more than five years.

It has created a database tracking all health care professionals in the state to assess shortages, prevented policy makers from making costly decisions regarding malpractice insurance and helped turn some ideas into Wyoming policy.

But it also has struggled to keep an executive director, received complaints from the Legislature and, at times, lacked authority to make significant changes.

The commission is scheduled to expire on June 30, and people on the commission and close to it have begun discussing what comes next.

Opinions vary, ranging from extending the commission another four years to not having any specific entity charged with health care advising, monitoring or policy-driving.

With President-elect Barack Obama and a new administration taking office later this month, health care reform promises to be major topic of discussion, said Susie Scott, current executive director of the commission.

"There needs to be some structure in place that has the ability to communicate with the federal government and the Department of Health and Human Services about how to implement a statewide health care program," she said.

The entity needs to help monitor state health care programs and look down the road 10 to 15 years at health care in Wyoming, she said.

She would like to see the current commission temporarily extended until November 2009 to coordinate discussions about what a health care policy organization should look like.

The commission completed a report analyzing health care policy organizations from other states, and Scott said Wyoming should "cherry pick" ideas from them.

"It wouldn't be extending the work of the commission as it is now," Scott said. "It would be coming up with a better idea."

What happens next for the commission depends greatly on what occurs in the Legislature. The commission was created through the Legislature in 2003 and extended in 2006 to this year.

Rep. Jack Landon Jr., R-Sheridan, said he e-mailed a proposal to the Legislative Service Office last week to draft a bill that would extend the life of the commission until 2013.

"They add some value to the considerations that the Legislature might want to take up," Landon said. "They provide well-critiqued research on options we might want to explore."

Several changes his proposal makes are adding legislators to the commission and better focusing the group's tasks.

Sen. Charles Scott, R-Casper, said he did not think he would be able to pass a bill extending the commission in the Senate even if he wanted one.

"It's the appropriate time for it to just plain sunset," Charles Scott said.

He said the commission has done considerable work and saved the state money. But because it was a citizen commission, it sometimes fell apart and "made some false starts" when it came to grappling with the complicated issues.

The state senator said he would like to see a planning and evaluation council, possibly within the Wyoming Department of Health, to offer expertise on health care policy. He was not sure what this would look like, but it would not be able to be put together until the next biennium.

In the short term, Gov. Dave Freudenthal does not believe the state needs a health care organization, said Wendy Curran, the governor's health policy adviser.

"The commission has a limited life span, and he believes it has reached that," Curran said. "The concern is, if you set up a separate entity, you take away the responsibility from other entities to step up and do the work."

The governor's office thinks it is time for the Legislature and the executive branch to take some of the "tremendous amount of data" the commission has collected over the past five and a half years and implement policy, she said.

Still, the governor thinks the commission served an important purpose.

"They kept us from venturing into areas that could have been bad," Curran said. "He also credited them with keeping us from doing something that wouldn't have worked."

Dr. Brent Sherard, medical director of the Wyoming Department of Health, said the commission has done "an excellent" job of evaluating health care problems. He said something needs to help continue the discussions the commission has started.

Sherard said the organization should have a close relationship with legislators, which was at times a fault of the current commission, and include broad representation.

"A commission, or whatever it is called, an organization, needs to reach out to the people of Wyoming in a really aggressive way to solicit as many opinions as possible," Sherard said.

The health department would support a bill that would create such a group.

"These problems affect all of us," Sherard said. "I think we all realize the importance of health care, but the frustration is we don't know how to fix it."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.