Medicaid Waiver For Tribes On Wind River Reservation A Done Deal...Almost

Apr 30, 2015

The Fort Washakie Health Center is the oldest Indian Health Services facility in the country
Credit Melodie Edwards

In the recent legislative session, lawmakers approved a Medicaid Waiver for tribes on the Wind River Indian Reservation that could give the tribes federal money to expand healthcare.  But there’s still one more hurdle: approval by the Center for Medicaid Services, a federal agency.

Representative Lloyd Larsen of Lander says he expects the process to go smoothly. “We don’t expect the application process to take too long because they’re working closely with CMS.”

Northern Arapaho Councilman Richard Brannen served for years as director of Indian Health Services. He says the goal for the waiver is expanding services to get the life expectancy of tribal members up—right now it’s only 49 years.

Part of it is respecting them and saying what do you need to make yourself whole again.

“The governor’s supplemental budget for one year was $16.9 million dollars,” Brannen says. “So that would almost triple what we have now for direct care for our patients. It’s significant.”

Brannen says the tribes are eligible for federal healthcare money even though the state voted not to expand Medicaid because Wyoming is obligated by treaty to provide healthcare to the tribes.  He says the tribes hope to develop a so-called medical home model that interprets health care broadly, even offering transportation and parenting classes and the like. Brannen calls this whole person care.

“We’re looking at a totally integrated health care system which doesn’t just involve the clinics. It involves the whole community,” he says. “The key is the patient owns their own health care. They’re responsible for their health care. Part of it is respecting them and saying what do you need to make yourself whole again.”

Brannen says, if all goes well, the state may use the tribes’ medical home model as a template for other health services around the state.

He says once the application is approved, funding for preventative care and new facilities could begin as soon as next year.