Rooted in community. Driven by trust.

The Natrona Collective Health Trust is a health conversion foundation: a private foundation created when a nonprofit hospital is sold to a nonprofit health system. We are accountable to the IRS, our bylaws, and the community we serve. We invest in the health and well-being of Natrona County residents through grantmaking, research, advocacy, community programming, and capacity building for the nonprofit organizations that deliver health-related services in our community. We invest more than $4 million annually in direct community grants, programs, and advocacy across nearly 100 organizations and initiatives.

In 2020, Banner Health acquired Wyoming Medical Center (WMC), and the assets of WMC transferred to the Wyoming Medical Center Foundation, the organization that would become Natrona Collective Health Trust: a private foundation tasked with stewarding these assets and reinvesting them in the health and well-being of Natrona County residents. The funds are held in an endowment and invested to generate returns that fund our annual grantmaking and operations. The money did not come from taxes, government appropriations, or individual donations. It came from a community asset, and it exists to serve the community in perpetuity.

The conversion that created the Trust also established a permanent obligation: each year, the Trust must distribute at least 3.33% of its total assets to Banner WMC. This is a fixed, non-negotiable requirement built into our governing agreements. It does not change based on our budget, our priorities, or the hospital’s needs. It is the cost of the structure that makes everything else possible. The Trust, as a private foundation, is also required by the IRS to distribute at least 5% of its assets annually. The Banner distribution counts toward that requirement — it is not separate from it. The remainder funds our grantmaking, programs, and advocacy.

The Trust’s creation is tied to the conversion of Wyoming Medical Center to Banner Wyoming Medical Center. As part of that conversion, a transactional agreement was established that defines certain obligations and restrictions for the Trust, including annual contributions to Banner WMC, restrictions on financially supporting competing providers in the same market, and monitoring Banner’s commitments made at the time of the transaction.

Beyond the monitoring role, the Trust has limited influence over how Banner WMC operates. Banner WMC’s accreditations and standards of care are regulated by governmental bodies, including the Wyoming Department of Health and the Centers for Medicare and Medicaid Services.

The Trust operates independently. Our board makes its own funding decisions and sets its own strategic direction. Banner Health does not control, direct, or approve our community investments.

The Trust’s investment portfolio is approximately $308 million (as of year-end 2025). We began with $250 million.

The Trust, as a private foundation, is required by the IRS to distribute 5% of its assets annually. Of that, 3.33% must go to Banner Wyoming Medical Center. This is a fixed obligation that does not change from year to year. The remaining distribution funds our grantmaking, programs, advocacy, and operations. Following years of significant growth in our investment portfolio, we have been able to increase our total distribution beyond the 5% minimum, directing more resources into community investment while continuing to meet the Banner obligation and preserving the endowment’s long-term value.

Since inception in 2020 through year-end 2025, the Trust has invested approximately $66.7 million:

• Banner Wyoming Medical Center distribution: $46.4 million
• Grants, programs, and advocacy: $20.3 million

Our audited financial statements and 990s are available on our Financials page, linked below.

Since inception in 2020 through year-end 2025, the portfolio generated approximately $129 million in total investment returns, an increase of roughly 52% on the original endowment. Of those returns, approximately $81 million funded the Banner WMC distribution, grants, programs, and operations, and the remainder was retained as endowment growth. The endowment now stands at approximately $308 million, up from the $250 million starting point.  This growth occurred despite periods of market volatility, including a portfolio decline of nearly $33 million in 2022, reflecting a combination of strong positive returns in multiple years and continued disciplined management aligned with the Trust’s long-term objectives.

Two things make that possible.

First, the endowment is invested for the long term. We hold a diversified portfolio designed to generate returns that, over a multi-year horizon, exceed our annual distributions and operating costs. In strong market years, returns substantially outpace outflows. In weaker years like 2022, the portfolio absorbs losses without disrupting our community investments, because the structure has been built for decades, not quarters. By the end of 2023, the portfolio had fully recovered from the 2022 loss.

Second, the 5% minimum distribution requirement is calibrated to be sustainable. It is set at a level that, combined with disciplined investment management, allows the endowment to fund meaningful annual community investment while preserving purchasing power for future generations. The Trust is designed to exist in perpetuity. Growing the endowment during a period of active spending is not evidence that we are hoarding money. It is evidence that the permanent structure is working as intended.

Our current strategic plan is linked below. The Trust is completing a new strategic plan in fall 2026. We will publish a plain-language summary of that plan on this website and share it through community presentations, our email newsletter, and local media. We believe the community has a right to understand not just what we’ve done but where we’re going and why. 

No. The Trust’s funds were created through a specific legal transaction that established a private charitable trust. They were never public funds, and they were never destined for county coffers. If the Trust did not exist, these dollars would not exist as a community resource at all. The conversion that created them would have simply been a private transaction.

It is also worth noting that without the Trust, the Banner WMC distribution would not exist either. The Trust is required to transfer 3.33% of its total assets to Banner Wyoming Medical Center every year. That transfer supports the region’s largest employer and Wyoming’s only Level II trauma center. The Trust is the mechanism that turns a one-time conversion into two permanent streams of community benefit: the hospital distribution and the community investments funded by grantmaking, programs, and advocacy. Neither stream would exist without the Trust.

Our annual budget is currently approximately $17 million. Here’s how that breaks down: 

Around 54% goes to the Banner Wyoming Medical Center distribution. This is a contractual obligation established by the governing agreement that created the Trust. It is not discretionary spending. It is a required transfer to Banner WMC as part of the conversion agreement. More than half of our annual budget goes to this single obligation.

Around 25% goes to grants and programs. This is the money that flows directly into the community through general operating grants, advocacy, research, community programming, independent monitor of BannerWMC  transaction commitments, capacity building, scholarships, translation services, the Imagination Library, and our collaborative initiatives like NCSJ and the Youth Mental Health Collective.

Around 21% goes to operations. This covers staff salaries and benefits, office operations, technology, professional development, legal counsel, investment management, facility operations, communications, and other administrative costs necessary to manage a permanent endowment and a $4 million grantmaking portfolio.

When measured against the total budget, our operating costs represent around 21%. When measured against the portion of the budget the Trust actually controls, excluding the required Banner distribution, operations represent roughly 45% of spending. This is consistent with foundations that maintain active programming, conduct original research, and provide direct capacity building rather than operating as pass-through funders.

As a private foundation, the Trust is legally required by the IRS to distribute 5% of its assets annually through grantmaking, programs, and advocacy. Of that required distribution, the Trust is legally required by its governing agreements to distribute 3.33%, or more than half of the annual spend, must go to Banner WMC. The remainder is what funds everything else the Trust does in the community.

We believe in paying our staff competitively because we ask them to do complex, skilled work: managing a multimillion-dollar grantmaking portfolio, conducting community research, facilitating multi-agency collaboratives, navigating state policy, and building relationships with nearly 100 partner organizations. We apply the same logic to our own operations that we apply to our partners: stability and fair compensation produce better outcomes than running lean to the point of dysfunction.

Our home at 421 S. Center St. is not just our office. It is a free community resource available to any mission-aligned organization for meetings, trainings, events, and programming. We are also launching a Trust-funded program series in the space in the second half of 2026.

The decision to invest in this space was an economic one. The Trust was previously outgrowing its rented office space. Purchasing and renovating a permanent space eliminates ongoing lease costs, builds equity in a community asset, and provides the kind of functional meeting and convening space that Casper’s nonprofit sector has long lacked.

The renovation also put construction dollars into the local economy, contributed to downtown Casper’s commercial vitality, and created a visible, accessible location where community members can interact with the Trust directly.

We understand this is a point of criticism for some. We’d invite anyone who has questions about the space to stop by and visit, see how it’s being used, and decide for themselves whether it’s serving the community.  

The Trust’s investment portfolio is managed through an Outsourced Chief Investment Officer (OCIO) relationship with Commonfund, an institutional investment manager that specializes in endowments, foundations, and mission-driven nonprofits. Commonfund manages approximately $30 billion in assets and is registered with the SEC as an investment adviser, subject to full fiduciary standards and regulatory oversight.

The OCIO model means Commonfund handles portfolio management, manager selection and due diligence, risk management, reporting, and ongoing education for our board, all within a single fee structure. Our board selected Commonfund through a formal Request for Proposals (RFP) process that compared fee structures and service models across peer institutions and determined this structure to be the most cost-effective approach for managing a permanent endowment with intergenerational obligations. 

The cost of our OCIO relationship is not a single advisory fee. It covers discretionary portfolio management, manager sourcing and due diligence across multiple asset classes, risk management, compliance, reporting, operational support, impact investing guidance, and ongoing board education. A fair comparison with alternatives would require adding up all of those services individually.

When our board evaluated this through the RFP process, we found our fee structure to be competitive with peer institutions of similar size. The relevant question is not “is this number large?” but “are we getting appropriate value, and are our returns supporting the mission?” We believe the answer to both is yes. Investment management costs are disclosed in our 990, which is publicly available on our Financials page below. 

Our funding decisions are informed by research, community data, and direct engagement with the organizations and populations we serve. We commission studies like justice system mapping, health care economic impact analyses, our Pathways to & Through Houselessness report, and others to understand where the needs are greatest and where investment will have the most impact. We conduct site visits with every funded partner, host community summits and focus groups, and work with collaborative initiatives like NCSJ and the Youth Mental Health Collective to identify system-level gaps.

We do not fund based on personal relationships, political alignment, or favoritism. We fund based on community health need, organizational capacity, and alignment with our mission.Every grant goes through a review process that includes staff assessment and overall programmatic board approval.

The single largest line in our budget is the required annual distribution to Banner Wyoming Medical Center, which on average over the past 5 years has accounted for 58% of our total expenditures. This is a contractual obligation established by the governing agreement that created the Trust. It is not a discretionary grant, and the Trust does not direct how Banner uses those funds – although they do report to us how it’s used each year. It is the cost of the Trust’s existence: the conversion that created our endowment came with this permanent obligation attached.

Around 25% of our total budget, approximately $4 million annually, is what the Trust invests directly into the community through direct community grants, programs, and advocacy. This is the money we control, and it is where our mission lives.

Our largest community investment is multi-year general operating grants, which provide flexible, unrestricted funding to nonprofits that serve Natrona County’s health needs. We do this because research consistently shows that multi-year unrestricted funding is the most effective way to strengthen organizations. It lets them pay competitive wages, retain staff, cover operational costs, and respond to emerging needs without spending every dollar on a single approved use.

Beyond general operating grants, we fund and operate:

• Advocacy and policy work, including civic engagement and voter education
• The Wyoming Nonprofit Network (WNN), which provides training, consulting, and capacity building to nonprofits statewide
• Grant writing support for organizations that need help accessing other funding sources
• Translation services so organizations can serve non-English-speaking populations
• MPA/MSW/LPC scholarships to grow the professional workforce in our community
• The Imagination Library, which puts books in the hands of children and their caregivers from birth to age five
• Community case management for individuals with complex, overlapping needs
• Event sponsorships that connect community members to health-related resources
• Natrona Council for Safety & Justice (NCSJ) and the Youth Mental Health Collective (YMHC), collaborative initiatives that coordinate system-level responses to justice and youth mental health challenges
• The Collective Space, a free community meeting and event space available to mission-aligned organizations
• Research and data projects that inform both our own decisions and the broader community’s understanding of local health issues

Because it works better. When a funder restricts a grant to a specific program, the organization still has to pay rent, keep the lights on, cover insurance, and make payroll for the people who run that program. Restricted funding creates a paradox where an organization can have money for a program but not enough money to actually operate.

General operating funding lets organizations make their own decisions about how to allocate resources. They know their communities and their operations better than any funder does. Our job is to invest in organizations we believe in and then trust them to do their work. That is not a lack of oversight. It is a deliberate philosophy supported by evidence from the philanthropic sector.

We do conduct site visits with every partner, and we do track outcomes. We simply don’t do it by requiring partners to spend their time filling out compliance reports for us instead of serving their communities. 

Health is not limited to hospitals and doctors. The conditions that most affect whether people in Natrona County are healthy include housing stability, food access, childhood development, economic security, behavioral health, substance use, domestic violence, civic engagement, and social connection. These are called social determinants of health, and they are the areas where community-level investment has the greatest impact on long-term health outcomes.

When we fund the Casper Boxing Club and similar organizations, we are investing in youth mental health, physical fitness, and an alternative to the justice system for at-risk kids. When we fund Hope House, we are investing in recovery and reentry for men leaving incarceration, which directly reduces recidivism, emergency room visits, and the community costs of homelessness. When we fund Parents as Teachers, we are investing in healthy child development during the most critical window of brain development.

Every organization we fund connects to health. If it doesn’t, we don’t fund it. 

Sustained funding is not favoritism. It is how effective philanthropy works. The community health challenges in Natrona County are not problems that get solved in a single grant cycle. Mental health access, housing instability, substance use, childhood adversity, and domestic violence require sustained investment over time. The organizations addressing these issues need stable, predictable funding to retain staff, maintain services, and build the kind of trust with their clients that produces real outcomes.

That said, we are not static. New organizations receive funding in every cycle. Our portfolio has grown over the years as new needs and new organizations have emerged. We also invest in capacity building through the Wyoming Nonprofit Network to strengthen local nonprofit organizational infrastructure, including operational efficiency, internal controls, and board governance, helping organizations that are not yet grant-ready prepare for future funding opportunities and become more stable and sustainable. 

Since inception in 2020 through year-end 2025, the Trust has distributed approximately $66.7 million total, including the required annual distribution to Banner WMC. The outcomes listed below were produced by the community investment portion of that total: approximately $20.3 million in grants, programs, and advocacy directed into Natrona County.

Some specific outcomes from across our portfolio:

• • CWCC expanded crisis beds from 5 to 24, launched a mobile crisis co-response team with law enforcement, and opened a diversion court at both the municipal and district court levels
  • Parents as Teachers expanded by 9 families and added a Spanish-speaking family advocate, with a waitlist of 15 families
  • The Wyoming Department of Health changed its rules to expand service eligibility for high-needs infants, a policy change that our advocacy directly supported
  • Trust-funded organizations like Kind Grounds, Hope House, and the Salvation Army WYStep program have housed, supported, and provided reentry services for hundreds of individuals
  • The Youth Mental Health Collective has conducted juvenile justice mapping, launched youth focus groups, and is building a coordinated response to a measurable increase in youth mental health crises
  • NCSJ developed an interactive criminal justice system map, supported the Pathways report on houselessness, and facilitates the Situation Table, a multi-agency collaborative that catches individuals before they fall through the cracks
  • WNN has provided board training, strategic planning, and capacity building to nonprofits across the state

We do not claim sole credit for these outcomes. The organizations we fund did the work. What we can say with confidence is that Trust funding made these specific things possible, and that the community investment dollars that produced them represent a fraction of our total budget, because the single largest line item every year is the required distribution to Banner WMC.

The Trust’s grants, programs, and advocacy generate measurable returns for the broader Natrona County economy in the form of jobs created and/or supported, local spending generated, and more.

But the full economic picture is larger than our grantmaking. The Trust channels money into Natrona County’s economy through two mechanisms. First, the required annual distribution to Banner Wyoming Medical Center, 3.33% of our total assets every year, supports the region’s largest employer, Wyoming’s only Level II trauma center, and a hospital system that is central to the county’s economic infrastructure. Second, our community investments fund nearly 100 organizations that employ people, attract federal and state dollars into the county, reduce demand on emergency services, keep families housed and working, keep kids in school, and keep people in recovery and out of the justice system.

In 2026, those two mechanisms together move over $13 million into the local economy: $9 million through the Banner distribution and $4 million through community grants and programs. Add in the operational spending that goes to local staff salaries, contracted services, and vendors, and the Trust’s total annual economic contribution to Natrona County is substantially larger than what most people assume when they think of us as “a nonprofit that funds nonprofits.”

The Collective Space renovation put construction dollars into local contractors and contributed to downtown Casper’s commercial vitality. Our investment in WNN strengthens nonprofits statewide, many of which bring external funding into Wyoming. Our grant writing support has helped partner organizations access federal, state, and foundation funding that would have gone to other communities without it.

The Trust is not a charity that gives money away. It is a permanent economic engine that converts a one-time conversion event into an annual, multi-stream investment in the community’s health, infrastructure, and economy, and it does so in perpetuity. 

You probably do, whether you know it or not. If you’ve used a community garden, attended a free event at David Street Station, had a child participate in youth sports or summer camp, used the library, visited the Nicolaysen Art Museum or the National Historic Trails Center, or benefited from crisis services being available when you or someone you know needed them, you’ve interacted with the ecosystem the Trust supports.

More broadly, a community with strong nonprofit infrastructure is a community with lower crime, fewer people in crisis, fewer preventable emergency room visits, more stable families, and a more resilient local economy. These things affect everyone’s quality of life, property values, and tax burden, regardless of whether you personally walk through the door of a funded organization. 

The Trust is a nonpartisan private foundation. We do not endorse candidates, contribute to political campaigns, or align with any political party.

Being nonpartisan does not mean that we are neutral – not when it comes to health. We do invest in advocacy, because health policy decisions made at the state and local level directly affect whether Natrona County residents can access care, afford housing, find behavioral health treatment, or navigate the justice system. Advocacy is how a community translates research into action and how the people most affected by policy decisions get a voice in making them.

Advocacy is essential to generational change in health because it shapes the policies, systems, and social conditions that determine long-term well-being, things money alone can’t fix. While funding can support programs, sustained advocacy drives the structural changes and public will needed to create healthier environments for future generations.

Some of our advocacy work, including Medicaid expansion research, civic engagement programming, and voter education, may be perceived as politically aligned. We understand that perception. But expanding health care access, increasing voter participation, and ensuring informed civic engagement are not partisan positions. They are investments in a healthier, more engaged community, and they are grounded in the data we publish and the research we commission.

We invite anyone who believes our advocacy work is politically motivated to read our Root Causes series, review our research, and evaluate whether the positions we take are driven by evidence or ideology. We believe the evidence speaks for itself.

Our grantmaking is open to any nonprofit organization serving Natrona County’s health-related needs. Grant applications are accepted during published grant cycles and are available on our website. We also provide capacity building through WNN specifically to support organizations that may not be well-established or well-connected.

That said, we do practice relational grantmaking, which means our staff invest time in getting to know the organizations and communities we serve. We conduct site visits with every funded partner. We attend community events. We participate in collaborative tables and working groups. Over time, this builds relationships, and those relationships are what allow us to understand needs, spot gaps, and make informed funding decisions.

Natrona County has about 80,000 people. In a community this size, professional networks overlap. Our staff know the nonprofit leaders they work with. That is a feature of doing relational, trust-based grantmaking, not evidence of cronyism. If knowing the people you fund were disqualifying, no local funder could ever make a grant in a small community. No community foundation, no United Way, no city government would qualify.

Every funding decision goes through a structured process. Staff conduct assessments. The program team reviews recommendations. The board approves overall grant programs. No individual staff member can unilaterally decide to fund an organization, and staff recuse themselves from decisions where they have a personal or professional conflict of interest. The question is not whether relationships exist. It is whether there are safeguards to ensure those relationships do not override good judgment. There are.

We recognize that from the outside, this can look like a closed network. We are working to change that by being visible, communicative, and open about how we make decisions.

For years, the Trust operated with a philosophy that the work should speak for itself. That led to a culture of doing the work quietly and not investing in the kind of public engagement that builds understanding and trust.

We are changing that. This FAQ is part of that change. So is our rebuilt website, our community presentations, our published research, and our growing public communications. We are also investing in making Collective Space a genuinely open, welcoming community resource.

If you want to engage with the Trust, here’s how:

• Visit the Collective Space for one of our public events or programming
• Read our research and Root Causes series to understand the data behind our decisions
• Attend a community presentation by Beth Worthen, CEO of The Trust, at local civic and business groups
• Contact us directly at [email protected] or 307.243.2160
• Review our financials, 990s, and policies below
• Meet with one of our program staff to learn more about our work.

We don’t have all the answers, and we don’t claim to. But we are committed to being accessible, transparent, and open to conversation.