Natrona Collective Health Trust CEO, chairman respond to former board member’s allegations

CASPER, Wyo. — On Tuesday night, Jen True, Natrona County’s appointed board member to the Natrona Collective Health Trust, resigned from her position, effective immediately.

After announcing her resignation, True made a number of allegations about the conduct and candor of the Health Trust, accusing the agency of mishandling funds, “straying from its founding mission,” and more.

True also accused the trust of using “its position of power to impose ideological conformity.”

Following True’s resignation, Oil City News spoke with both the CEO of the trust, Beth Worthen, and the other county-appointed board member, Eric Nelson, who also serves as the board’s chairman.

Both Worthen and Nelson stated that while they were not surprised by True’s resignation, they were surprised by the means in which she did it.

“I was not apprised,” Nelson stated. “I don’t think any of us knew ahead of time that that, exactly, was going to happen. When Jen resigned, it wasn’t anything that we necessarily knew about ahead of time, but we’re not super surprised.”

When asked if True’s behavior had indicated her dissatisfaction with the board beforehand, Nelson and Worthen declined to comment.

“We’re not going to comment on a member’s performance, or behavior, or attendance or anything like that,” Nelson said. “That’s an internal issue for the trust. We would just thank her for her service and wish her the best going forward.”

Nelson said that he expects that the board of county commissioners will appoint another person to serve on the board, as they have the ability to appoint two members to the collective trust. Nelson, himself, is the other appointee.

True made a number of allegations in her speech to the Natrona County Board of County Commissioners, many of which centered around how the collective trust spends its money.

“Rather than prioritizing community impact collaboration and responsible stewardship, the trust has developed a culture of spending, marked by extravagant expenditures, self-promotion and a troubling lack of fiscal accountability,” True said. “Since my appointment in March 2024, I have witnessed decisions that prioritize institutional self-interest over community well-being.”

True stated that the trust increased staff salaries by over 14% and “reduced community giving by 4%.”

Nelson said that when the trust hired its first CEO, Meredith Benton, they did so with a salary recommendation from recruiters. However, Nelson said, they didn’t have any type of system in place that could compare it to other similar organizations in a similar market. Therefore, when they hired Worthen in 2024, the trust hired the Croner Company to conduct a market analysis in order to develop a compensation structure to ensure that the structure was competitive, equitable and reasonable. Nelson said the Croner Company specialized in working with private foundations in the nonprofit sector.

“The Executive Committee, of which I was a part at the time, as the finance chair, worked with Croner to ultimately adopt a methodology to set the salary of the CEO, which then was subsequently adopted for the rest of the staff.”

Despite allegations to the contrary, Nelson said that the board did not just listen to the recommendation and immediately adopt it.

“We had multiple meetings,” Nelson said. “My recollection is that we had three meetings where we asked them to go back and pull additional comps. We pressed them on their assumptions. And then, ultimately, we became satisfied that it was a fair and accurate methodology, and so the salaries did increase. I’m not sure if it was a 14% increase, but it did increase. And that’s how and why.”

Nelson said that there were different factors to consider with regard to the trust’s budget, and Worthen agreed.

“One of our most important obligations that we have, as a result of the transaction [of Banner Health purchasing Wyoming Medical Center], is that each year we contribute 3.3% of our net assets to Banner Wyoming Medical Center each year. And what that translates into is that when we have a budget, about 60% of our budget each year goes straight to Banner Wyoming Medical Center to be spent at Banner Wyoming Medical Center.”

Worthen said that money could be spent on a number of different things that the trust actively monitors, including imaging equipment, new ambulances, new types of electrophysiology equipment and more.

“That is something that we are absolutely tied to,” Worthen said, “and so, depending on what the market does each year, that point in time that’s captured at the end of the year is what indicates that 60% of our budget. So, the market did really well last year, so our anticipated number that we would give to Banner Wyoming Medical Center went up. It went up about 5%, which was about $500,000.”

Worthen also said they’ve added new expenditures to their budget, including hiring the services of the healthcare compliance and consulting firm PYA, which will provide independent monitoring services.

“So, the adjustment to salaries was part of those increased operational expenses that has an impact elsewhere in our budget,” Worthen said. “But we’ve also got a strategy in place that the board adopted to closely monitor any savings that we have throughout the course of the year, which we’ll sweep into our grants budget.”

The Natrona Collective Health Trust, per its website, offers grant money to a variety of “qualifying organizations whose work benefits the residents of Natrona County. … Nonprofits currently receiving boost grants from the Trust are not eligible to receive general operating grants.”

The trust has specific focus areas for the money they give, which includes early childhood development; adverse childhood experiences, or ACES; positive childhood experiences, or PCES; mental and behavioral health services; advocacy; and more.

Two-year grants are offered to organizations that meet specific criteria during each spring and fall grant cycle. Up to $80,000 is given each year for the two-year grant period.

“I think that’s something that our board and the staff will be really engaged in this year,” Worthen said, “making sure that all of our savings that we are able to capture throughout the year goes straight to grants, so that we keep our nonprofit partners whole. That’s a really important part of our mission.”

Nelson added that he was curious about the collective trust’s expenditures for operations and administration, and how they compared to their peers.

“We were able to have some data from the Kansas Health Foundation, from the Montana Health Foundation, Reach Healthcare Foundation and the Headwaters Foundation, which are all healthcare conversion trusts similar to ours,” Nelson said. “And when we compare across the board, we have the lowest expense ratio of any of them. Our CEO salary is the lowest as a percentage of assets, yet we have the highest rate of contributions, gifts and grants paid out.”

Nelson said those other foundations were chosen based on their similar size, location and services as compared to those of the Natrona Collective Health Trust.

“So when we talk about ‘Are we being good stewards of the funds and being good fiduciaries?’ I believe that we are,” he said. “We’ve seen our investment portfolio grow far beyond where we started four years ago while, at the same time, granting around $50 million, between what we’ve given to Banner Wyoming Medical Center, which is $37 million, and then $13 million in grants. So it’s absolutely a balance between meeting our current obligations and making our nonprofit partners whole, ensuring that this foundation can exist in perpetuity to serve the healthcare needs of the residents of Natrona County.”

Worthen said that serving Natrona County isn’t just about giving money to nonprofit organizations, either.

“We don’t just do grant-making,” she said. “We do other programs. We do community engagement initiatives, like the Natrona Council for Safety and Justice. We do policy and advocacy work. It’s not just about making grants, or even monitoring the contractual obligations made by hospitals. It’s really looking at what the root challenges are to healthcare in our community. Where are the gaps that can’t be bridged with programming, or with new kinds of initiatives? It’s about adjusting quickly to really address the conditions that are on the ground at that time. It’s about policy and advocacy work, to change the systems that are creating those disparities in healthcare in general.”

Worthen said that the goal and the mission of the Natrona Collective Health Trust is to address those conditions and act accordingly. She believes that the staff and the board have been doing that.

Another allegation that True made was regarding which organizations the trust offered grants to.

“Granting decisions are not being made primarily on the quality of services provided, but rather on a self-defined policy that prioritizes political ideologies,” True said. “This was most clearly exemplified by the trust’s refusal to fund the Wyoming Rescue Mission, due to its faith-based staffing policies. Instead of assessing organizations on their ability to effectively serve the community, the trust has used its position of power to impose ideological conformity.”

Both Nelson and Worthen denied any desire to “impose ideological conformity.”

“We don’t want to get into individual grant decisions,” Worthen said, “but grant decisions are made based on alignment with our mission, with our goals. Our website has a rubric, which is our transparent way of showing that these are the kinds of things that, in our research, we found to be best practices in terms of programs and services that are offered.”

Worthen said that organizations are not “looked over” because of faith.

“[Jen True] did mention inclusivity in her statement, in connection with the rescue mission decision,” Worthen said. “And what I would say is that we are committed to treating people, treating organizations, with fairness and dignity and respect. That said, we know that there are individual organizations that have different practices, different ways of doing work that they find to be very successful and, indeed, legal. That is absolutely something that they’re able to do. It just might not be a good fit to be a partner with the health trust, and that’s OK. They’ll find other partners; they’ll find other funders that are in that alignment. We might not be for everyone, and that’s OK.”

The Wyoming Rescue Mission does, indeed, have other partners and funders that ensure it is able to serve Natrona County in the manner in which it sees fit. Pro Republica, a database that details nonprofit financial standings, reports that in 2023 the Wyoming Rescue Mission had a revenue of $4.98 million, with expenses totaling $4.09 million.

In the end, Worthen and Nelson said that True has the right to say, and believe, what she wants. However, the trust’s website has a section labeled “Transparency” for a reason — it’s one of the most important aspects of the job.

“Having a Health Conversion Foundation here in Wyoming, whose purpose is for the benefit of Natrona County residents, is both a tremendous responsibility that we don’t take lightly and it’s a tremendous opportunity for the community,” Worthen said. “These last couple years, as we’ve formed, as we’ve developed, as we’ve learned more about what the needs are in our community, I think there’s a pretty incredible chance to make the health and wellbeing of our community better. And I welcome partnership, whether it’s through the county commission or other partners in our community. I think we all have the same goal, and I think that this is a great opportunity that we can leverage for the benefit of our residents.”