Over the course of the past eight years, Wyoming, a rural state home to 580,000 people, has been increasingly investing in trauma-informed care across sectors, garnering participation from both public and private partners. Senior executives in the state, including the governor’s Health and Human Services Advisor and Medicaid Medical Director, have championed the integration of trauma-informed practices and policies. By working across sectors, leveraging promising practices from other states, and investing in training efforts, Wyoming is demonstrating a multi-pronged approach to addressing trauma.

Trauma-Informed Training and Cross-Sector Engagement

For more than six years, Health and Human Services Advisor Jen Davis in Governor Mark Gordon’s office has engaged partners across government agencies and in the philanthropic community to champion training efforts that have spread across the state via the train-the-trainer model.

School social workers have implemented trainings in the majority of Wyoming’s 48 school districts, which Davis credits with fostering an increased understanding of ACEs, trauma, and protective factors among educators and Department of Education staff and creating a more supportive learning environment for children.

The Wyoming Children’s Trust Fund also coordinates trainings and has been a key partner in the development of a two-year pilot program designed to help jurisdictions build self-healing communities and address trauma by tapping into existing community resources. To fund the pilot, which is currently in the planning stage, Wyoming is braiding funding from 13 different sources, including the state Department of Health, the Department of Family Services, the Preschool Development Grant, and three philanthropic partners (the Hughes Charitable Foundation, the John P. Ellbogen Foundation, and the Wyoming Community Foundation) that the state engaged early in the process. Public and private sector partners, philanthropies, and nonprofits also came together in October 2022 for Governor Gordon’s Mental Health Summit, which featured representatives from all three branches of government and focused on ACEs, childhood trauma, and developing a common agenda for addressing mental health issues. As Davis describes it, “cultivating partnerships across agencies and philanthropy has been a marathon, not a sprint, but the payoff has been cross-sector buy in that has allowed Wyoming to continue to expand its trauma-informed work.”

Multi-State Collaboration

Building multi-state partnerships and leveraging best practices from other states has been an integral component of Wyoming’s success. As part of the National Governors Association Center for Best Practice’s ACEs Learning Collaborative, Wyoming engaged with Delaware, Maryland, Pennsylvania, and Virginia and learned about work in California and Tennessee through technical assistance. Through this multi-state collaboration Dr. James Bush, Medical Director of Wyoming’s Medicaid program, learned about the California ACEs Aware initiative and reached out to the state to learn more. The Aurrera Health Group team was able to support Dr. Bush by providing information about ACEs Aware and assisting the state with getting access to California’s on-line training for physical and behavioral health care providers. The training is free and available to anyone.

Medicaid and ACE Screening

Leveraging training and resources from California, Wyoming is now incorporating payment for ACE screening into its Medicaid program. Wyoming health care providers must take the Becoming ACEs Aware in California training and attest to completing it in order to bill Medicaid for screening. The state plans to use the ACE Questionnaire for Adults along with the Pediatric Traumatic Stress Screening Tool developed by the University of Utah for pediatric settings, and will open codes for billing soon. Dr. Bush hopes that by educating a wider range of providers about trauma, Wyoming can “improve the integration of physical and mental health care and increase access to trauma-informed care in various settings.”

Pathways to Resilience was pleased to have Dr. Bush and Ms. Davis join the State Policy Roundtable in September, where they made connections with fellow state leaders and shared ideas for how to leverage Medicaid funding to advance trauma-responsive policies that support low-income families.