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Wisconsin Intellectual and Developmental Disabilities and Mental Health (IDD-MH) System Improvement

Wisconsin IDD-MH System Improvement aims to improve systems and services for people who have intellectual and developmental disabilities and mental health (IDD-MH) needs.

Wisconsin IDD-MH System Improvement started in 2022 when the National Center for START Services evaluated the state’s service system for people with IDD-MH needs. This work was previously called the Wisconsin START Initiative during the time when it focused on the START evaluation. The name changed because we are moving to the next phase of the project. 

Key actions

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Wisconsin IDD-MH System Improvement Report

The Wisconsin Department of Health Services (DHS) released the Wisconsin IDD-MH System Improvement Report on June 25, 2024.

Get all the details

The report has all details about the initiative. It also gives 37 specific recommendations for improving systems and services for people with IDD-MH needs in Wisconsin.

Hear from the project team

DHS held a briefing on the report on June 17.

View the slides in English (PDF), Spanish (PDF), and Hmong (PDF), and view the Report briefing transcript (PDF). And, get the Subcommittee Survey Results Summary (PDF).

Don’t want to read the whole report? Find the most important takeaways below.

Report executive summary

In 2022, the Wisconsin Department of Health Services (DHS) contracted with the National Center for START Services. START stands for Systemic, Therapeutic, Assessment, Resources, and Treatment. They looked at the state’s service system for people who have intellectual and developmental disabilities and mental health (IDD-MH) needs. The evaluation resulted in the START Scan (PDF). The START Scan found five main areas for improvement. It recommended Wisconsin:

  1. Improve crisis services
  2. Expand training and education for providers
  3. Increase availability of outpatient and preventative mental health services
  4. Improve coordination between service systems
  5. Improve supports for those with IDD-MH needs so they have a better quality of life

This helped DHS learn how effective services and supports are for people who have IDD-MH needs in Wisconsin. Around 1,380 partners participated in this process. This was Phase 1.

Phase 2 of the project aimed to create recommendations based on the findings of the START Scan. The goal was to improve supports and services for adults and children who have IDD-MH needs statewide.

To do this, DHS brought together partners with different perspectives, experience, and expertise from around the state to form several different kinds of teams. First, DHS formed a steering committee with DHS staff and IDD-MH partners. This team would organize the work and lead the other teams.

Next, DHS created a survey to find other people who wanted to improve the IDD-MH service system. Around 400 people responded. They all became members of the large work group, helping to create a statewide, collaborative effort. This helped make sure the project was not owned or managed by DHS, but by all advocates and organizations who participated.

The steering committee then created five subcommittees. There was one for each of the five themes from the START Scan. Around 100 people in total from the large work group were selected to become members of the five subcommittees (around 20 people per subcommittee). Their main task  was to create the recommendations in this report with input from the large work group.

DHS and the steering committee held a kick-off webinar for the work group on September 14, 2023. It introduced this project and explained the role of the large work group. Their primary role was to give input and feedback to the subcommittees. As this project continued, the large work group grew to about 1,300 members.

An internal work group of DHS staff helped organize and guide this work.

The subcommittees met every other week from mid-September 2023 through early January 2024. During that time, they:

  • Reviewed the findings of the START Scan
  • Discussed Wisconsin’s history of what did and did not work previously
  • Developed recommendations to make IDD-MH services and supports better

In November and December of 2023, each subcommittee sent a survey to the large work group to get their input on the draft recommendations. The subcommittees reviewed the survey feedback and finalized their draft recommendations. Then, they submitted them to the steering committee in early January 2024. A smaller group of steering committee members then met to look at how they could combine the recommendations. This small group had representation from each of the five subcommittees. They saw eight focus areas, or types, of recommendations that affected all five themes from the START Scan.

The eight focus areas included:

  1. Regional supports: Wisconsin could bring more resources and supports closer to where people are living to help them avoid crises and help if crises happen.
  2. Expand access to psychiatric and behavioral health services: The state could explore ideas to get more doctors and mental or behavioral health providers. Wisconsin especially needs providers who know how to best serve people who have IDD-MH needs. The state could also explore ideas for how to make sure more people can access providers.
  3. Rate and billing code improvements: Wisconsin could find ways to improve pay so that more providers are interested and able to serve people who have IDD-MH needs.
  4. Technology related: Partners and providers could look at ideas for how technology can be used or improved to make it easier for people to find information and help.
  1. IDD-MH specific training: Wisconsin could look at how to provide training to families, providers, leaders, and others. Training would help them learn more about people who have IDD-MH needs and how to support them better.
  2. System review: The state could explore how to make it easier for people to get the right supports and services.
  3. System navigation: Wisconsin could find strategies to help people get the services and supports they need when their needs change or they are moving.
  4. Oversight and process improvement: The state could improve services and make sure the best methods are being used.

The steering committee decided to present this report organized into these eight focus areas. This replaced the original plan to organize ideas by the five themes from the START Scan.

The group finalized 37 recommendations to improve supports and services for adults and children who have IDD-MH needs. The steering committee decided to include all the recommendations in this report. This is because the recommendations have different complexity and needed resources, partners, and amounts of time to achieve. The committee hopes that by presenting all the recommendations, a mix of shorter- and longer-term recommendations may be worked on during the Implementation Phase, but that none will be lost. The steering committee feels it is important to have some quicker success in improving the system. This will help keep the interest and momentum needed to achieve longer-term change going.

The steering committee also felt that it was important to prioritize the recommendations. The steering committee members were sent a survey to rank their top 10 recommendations overall. That ranking is shared in this report.

DHS facilitated a wrap-up webinar for the large work group before the report was published to thank participants for their involvement, discuss next steps, and share the report.

The next phase (Phase 3) of this project will be the Implementation Phase. Recommendations will be selected for follow-up and detailed plans will be developed. This is when recommendations turn into actions that will improve the IDD-MH service delivery system.

The steering committee wants to thank everyone who has been involved with this project. All the interest, participation, and support for this work has been greatly appreciated. It will have a significant impact on improving services and supports for people who have IDD-MH needs. It took all partners working together to get to this point. It will continue to take everyone working together in the Implementation Phase to successfully complete this work!

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Last revised June 25, 2024