Natrona County Collective Health Trust faces questions on Banner monitor methods, transparency

CASPER, Wyo. — Natrona County commissioners pressed Natrona Collective Health Trust representatives Tuesday for details regarding the monitoring of Banner Wyoming Medical Center and the trust’s transparency.

Commissioners raised questions about the timeline for receiving requested information, the scope of an outside consultant’s stakeholder meetings and the accessibility of the trust’s audit report, signaling a heightened level of scrutiny over the trust’s operations and oversight responsibilities.

Casper City Attorney Eric Nelson, who also serves as the Collective Health Trust’s chair, opened his report with a reminder that the trust has retained PYA, an outside consultant, to assist with monitoring obligations related to Banner Wyoming Medical Center. Nelson said the monitoring work is progressing well, with an update expected in just a few months.

Nelson acknowledged receipt of a letter from the commissioners that was sent late last week with additional information requests. Answering a question on a timeline for answers, Nelson said it would depend on how fast the trust’s executive committee could meet and receive guidance on what information could be shared in an executive, or closed, session.

Commissioner Peter Nicolaysen questioned whether PYA had met with the Memorial Hospital Board of Trustees or the county commissioners. Trust CEO Beth Worthen said that because the monitor is independent, she was unaware of who it had met with. Citing an article stating PYA was meeting with stakeholders, the commissioner pressed on who the monitor had met with.

“I would think that the Memorial Hospital Board of Trustees and the Board of County Commissioners would be stakeholders to the Banner-Collective county agreement,” he said.

When Worthen said she’d provide PYA with the commissioners’ information to reach out, Nicolaysen said it would seem if the trust is advertising that PYA is meeting with stakeholders, it would have met with the trustees and commissioners.

Nelson acknowledged that both entities are stakeholders and said he would convey the commissioners’ desire to meet with PYA, while also noting the need to maintain the monitor’s independence.

“We don’t want to taint the process and we don’t want it to look like it’s staff-driven or that it’s board-driven or that we’re trying to reach any kind of predetermined outcome, if you will,” Nelson said.

Nicolaysen said he would be disappointed if PYA’s findings are released in June and the monitor had not conferred with the Memorial Hospital Board of Trustees or county commissioners.

“Basically, if you come and say, ‘These are the findings,’ I’m going to think they’re incomplete,” he said.

Nicolaysen also raised concerns about the Collective Health Trust potentially acting as a gatekeeper for information provided to PYA as the public portal resides on the trust’s website. The commissioner added he’s heard public concerns the trust may not forward information to PYA if that information contains a complaint about the trust. Worthen said an email address exists for direct submissions to PYA.

Commissioner Dallas Laird asked Nelson for his definition of stakeholder so he could “make sure you grasp we’re talking about the same thing.” Nelson said his definition includes anyone seeking medical care in Natrona County, residents and elected officials.

Nicolaysen also asked about board vacancies, learning that the county appointee position is currently the only one open. Jen True resigned from her position in March after serving on the board for a year, stating the organization has “strayed” from its founding mission.

Nelson, responding to Nicolaysen on what’s needed in a potential candidate, said anyone who is willing to “roll their sleeves up, come to the board, do the work and not be afraid to bring their opinion” would be a welcome addition.

Pressed by Commission Chair Dave North on the results of the Collective Health Trust’s audit, Worthen said that information was included in the preliminary report the commissioners had already received. That report was not readily available to the public.

Attention briefly turned to the trust’s spring grant cycle. Worthen said the cycle is open now, and the trust is reviewing applications. She added there will be a fall cycle this year.

Correction, April 3, 2025: Eric Nelson’s title has been corrected to Casper city attorney.