LARAMIE -- A legislative task force will hand over to the state’s Joint Appropriations Committee this month a draft bill that is expected to lead the University of Wyoming to privatize the operations of its two Family Medicine clinics in Cheyenne and Casper.
Those clinics are common residency sites for UW medical students. After Gov. Matt Mead requested in 2012 the clinics reduce their reliance on the general fund, the clinics have received increased Medicaid- and Medicare-related reimbursements after becoming designated as a Federally Qualified Health Center.
Clinic revenue is now expected to be $16.7 million during the 2019-2020 biennium, up from $10.7 million in the 2015-2016 biennium. With the increased federal reimbursements, clinic revenue is now 51 percent of the clinics’ budget.
That increased reliance on federal funding means more federal requirements, including having a community board. The clinics are currently overseen by the Educational Health Center of Wyoming.
According to a memo from the board’s co-chairs, Sen. Fred Baldwin, R-Kemmerer, and Rep. Sue Wilson, R-Cheyenne, federal auditors said in 2017 the board “does not have the expected authority over federal dollars or budgeting.”
State processes mean clinic revenues must be legislatively appropriated back to clinics, and the task force’s memo means the status as a Federal Qualified Health Center is “at risk for this noncompliance, with a potential loss of the funds.”
To ensure federal funding remains constant, UW now wants the clinics’ community board to incorporate itself as a nonprofit, akin to the privatization method undergone by Ivinson Memorial Hospital in 2017.
“We’re using the county health model, but twisting it a little bit,” Legislative Service Office staff attorney Heather Jarvis said.
Unlike Ivinson, UW would like the clinics’ personnel to remain as university employees.
At its Friday meeting of Select Committee on Family Medicine Residency Programs, task force members considered — and rejected — a more complicated version of the draft bill which would have put greater rules on any privatization.
Those rules would been “blatantly unconstitutional,” said Sen. Charles Scott, R-Casper.
The rejected draft bill would have required a new corporate nonprofit to identify “specify funding sources for employee salaries, retirements, insurance and other benefits.”
Instead of having the nonprofit pay the employees, the current plan would have UW bill the nonprofit for services rendered.
Scott said the bill needs to provide significant flexibility to ensure the clinics remain viable.
Even with the increased federal reimbursements, he said, the clinics are likely to remain “economically fragile because you’re dealing with a low-income population.”
Meredith Asay, UW’s interim director of governmental relations, said Friday she plans to work before the 2019 legislative session to hopefully get full support from the Board of Trustees.