Governor Tony Evers' first biennial budget invests more in health care than any other budget in Wisconsin’s history. By recognizing that health care is a cornerstone of workforce and economic development in all communities across the state, this budget makes critical investments for all Wisconsinites. View the highlights of the Department of Health Services 2019-2021 budget.
What is included in the budget?
- Personal Care Services: Many seniors and people with disabilities are able to remain in their homes and live independently if they can get help with tasks like getting in and out of bed, personal hygiene, preparing meals, and getting dressed. The budget increases funding for personal care services to help seniors and people with disabilities stay in their homes by providing a $91 million increase over the biennium.
- Nursing Homes: In the last three years, 21 nursing homes have closed. The budget increases funding for nursing homes by $74 million.
- Direct Caregivers: The budget increases funding by $67 million to improve wages for direct care staff in long-term care to attract high-quality workers and increase care quality. By increasing wages, we will be investing in communities throughout Wisconsin and fostering economic growth. These additional funds will help ensure dignity and independence for Wisconsin seniors and people with disabilities.
- Children's Long-Term Support Waiver Program: The budget provides $89.6 million for the Children’s Long-Term Support Waiver Program, which serves children with disabilities. The budget implements a ‘No Wrong Door’ policy to help families navigate the children’s long-term care system through implementation of a statewide contract for intake, application, and screening functions.
Wisconsin is expected to have 1.1 million residents ages 65 and older in 2020, growing to 1.54 million in 2040. By then 58% of seniors will be 75 and older. With these dramatic increases, the budget expands services to ensure older adults have the resources they need to maintain their health and independence.
- Aging and Disability Resource Centers and Dementia Care Specialists: According to the Alzheimer’s Association, in Wisconsin, there are 194,000 caregivers of a loved one with Alzheimer’s disease, spending 220 million hours providing care. Supporting these caregivers is a critical component of helping people with dementia live their best life. Dementia care specialists help people with dementia and their caregivers by providing resources, support, cognitive screenings and promoting dementia-friendly communities. The budget increases the number of dementia care specialists throughout the state by nine positions. This includes one tribal dementia specialist.
- Assisted Living Facility Quality: Demand for assisted living facilities has grown with the aging population and consumers’ preferences for more home-like living settings in which they can receive long-term care services. The budget provides funding for health and safety oversight of assisted living facilities.
Hospital Payments & Rural Critical Care: To ensure hospitals continue to provide high-quality care, the budget directs DHS to increase hospital reimbursement rates. Many Wisconsin hospitals are the cornerstone of the economy in small communities; this provision will foster economic growth and financial stability for these critical community anchors. The budget also includes a $9.9 million Rural Critical Care Hospital Supplement.
Crisis Intervention Services: County human services agencies are a key component of the state’s behavioral health system as one of the primary providers of services to both Medicaid and non-Medicaid individuals. Counties also have primary responsibility for responding to individuals in crisis. Our current system limits critical access, hampers coordination with the acute/primary and long-term care systems and puts financial strain on counties. To ease these challenges, the budget improves access to mental health treatment by providing $13.3 million for the Medicaid Crisis Intervention benefit.
The budget also expands the Medicaid Crisis Intervention benefit so it can be used for all individuals in crisis, not just mental health. For example, this improvement will help residents affected by dementia or substance use disorders.
- Providers: The budget directs DHS to increase payments for providers to ensure access to quality care for all Wisconsin communities. DHS will target funding to highest need geographic areas or service categories.
- Suicide Prevention Grant: Suicide is a leading cause of death and it is preventable. Recognizing the importance of prevention efforts to save lives, the budget approves $100,000 for suicide prevention activities.
- Addressing Substance Use Disorders: From 2013-2017, Wisconsin has seen a 39% rise in overdose deaths and a 72% increase in hospital emergency room visits for people affected by substance use disorders. Over that same timeframe, kids entering the foster care system due to parental substance use have increased by 108%. To address these critical issues, DHS will implement a hub-and-spoke model to provide care coordination in two rural areas and one urban area. Under the proposal, the “hubs” ensure the integration of a full range of primary health care and substance use disorder services.
- Child Psychiatry Consultation Program (CPCP): The Wisconsin Child Psychiatry Consultation Program (CPCP) provides consultation, education, and referral support to enrolled primary care providers caring for children and adolescents with behavioral health concerns. The budget increases funding by $500,000 for the CPCP.
- Youth Crisis Stabilization Facility: The budget provides ongoing funding for a youth crisis stabilization facility that will provide short-term residential mental health services to prevent unnecessary hospitalizations of children whose needs are greater than what is available in their community but not severe enough to warrant commitment to an institution.
- Peer-Run Respite Center for Veterans: The budget provides $1.8 million over the biennium to fully fund a peer-run respite center for veterans. This center will provide peer support services and hospital diversion services at no cost to veterans struggling with a mental health or substance use disorder.
In Wisconsin, both children and adults in the Medicaid program lack access to basic dental services. Access to dental care for children enrolled in Wisconsin Medicaid ranks 45th in the nation. The budget includes funding to increase grants to non-profit dental providers and sustain the Division of Public Health’s Oral Health Program.
- Dental Services for Individuals with Disabilities: The budget provides $2.5 million for dental services to improve access for people with disabilities.
- Oral Health Program: The Oral Health Program promotes and improves oral health care for Wisconsin residents of all ages. It includes a variety of programs such as the Seal-A-Smile Program, the Donated Dental Service Program, and a variety of fluoride programs. The budget increases funding by $2 million over the biennium to serve more children. The budget also gives the Oral Health Program more flexibility in the way that it utilizes funds and provides them to local public health departments.
Addressing Rural and Urban Disparities
- Childhood Lead Poisoning Prevention: The budget provides $14.2 million in lead testing and abatement funding to address the issue of childhood lead poisoning. The abatement program will protect children from lead poisoning by removing lead paint hazards from their homes. Children under the age of six are most susceptible to the effects of lead poisoning. Homes with lead hazards are disproportionately found in low-income neighborhoods and communities of color. Lead abatement will address health disparities, improve the quality of housing, and keep future generations from lead exposure.
- Telehealth: While we are addressing the current workforce shortages, we need to do more to provide access to our current providers. The budget expands access to telehealth services under Medicaid by allowing reimbursement for more services and in more settings, such as the patient’s home.
- Dispatcher Assisted CPR: The budget provides $105,900 per year to assist 911 centers in administering CPR when someone calls 911.
- Birth to 3 Program: The Wisconsin Birth to 3 Program serves children under the age of 3 with developmental delays and disabilities and their families. The budget provides $1.125 million increase each year of the biennium for the Birth to 3 Program.
- Infant Mortality Prevention: The budget directs DHS to dedicate resources to exclusively work on infant mortality to improve birth outcomes and reduce the infant mortality rate. This staff will help strengthen the public health infrastructure and support local efforts addressing infant mortality.
- Minority Health Grant Program: The Minority Health Grant Program is targeted to racial/ethnic minority community-based organizations and tribes in Wisconsin. The purpose of the community grants is to support the work of organizations serving communities of color, especially those organizations that are located in areas where health disparities are high. The budget provides $250,000 in increased funding each year and gives priority to applicants providing maternal and child health services.
- Vaccination Outreach and Education: Immunizations, also called vaccinations, are one of the greatest achievements in public health. Vaccines prevent disease in people who receive them. Additionally, if enough people in the community are vaccinated, the entire community can be protected because there is little opportunity for an outbreak to occur. The budget provides $100,000 for a statewide, science-based public outreach effort related to vaccinations.
- Wisconsin Well Woman Program: This program provides critical preventive health screening services, including cancer screening, to women age 45-64 making less than 250% FPL, or about $31,000 per year for a single person who works full time. The budget increases funding for the Wisconsin Well Woman Program by $100,000 annually.
Care and Treatment Centers
DHS is investing in behavioral health services and support at DHS 24/7 direct care and treatment facilities to better serve Wisconsin residents with mental health and substance use disorder needs.
- Youth in the Juvenile Justice System: The budget provides $59 million for a capital project to construct 50 new beds at Mendota Juvenile Treatment Center. The budget also provides staff and funding for 14 new beds in the center’s existing space. The expansion will allow Mendota Juvenile Treatment Center to provide evidence-based treatment to more youth in the juvenile justice system with significant mental health concerns and behavioral health challenges. The expansion will also provide services to female youth for the first time, as well as serve more male youth.
- Winnebago Mental Health Institute: The budget provides 51 additional positions and $11.2 million over the biennium. DHS will implement a new staffing model at Winnebago Mental Health Institute to stabilize staffing needs. This new model will create and fully staff an admissions unit that will become the primary entry point for patients at the facility.
We still have work to do
Expanding Health Care Coverage
While Medicaid expansion was not included in the final budget, expanding coverage and saving state dollars remain a top priority. Because we did not expand Medicaid this year, Wisconsin will lose out on $1.6 billion in new federal funding for high-quality health care coverage for 82,000 residents, and will spend an additional $324.5 million dollars in state tax dollars. DHS will continue building awareness about the benefits of expanding health care coverage and working toward better health and well-being for all Wisconsinites.
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