Finally, a Mental Health Budget
For years the end of the budget process has meant continued disappointment for mental health consumers, family members and advocates. Not this year. The budget that the Governor signed on Sunday had the single largest increase in general purpose revenue targeted to mental health initiatives in the memory of most advocates. This included:
- $10.2 m. to pay the “state share” of Medicaid for the Comprehensive Community Services benefit.
- $3.7 m. to ensure the availability of Coordinated Service Teams for children with serious emotional disturbances in all counties/tribes.
- $1.3 m to develop and pilot peer-run respite services to prevent the need for more costly crisis and inpatient services.
- $535,000 to create an Office of Children’s Mental Health to coordinate programs and policies across various state departments serving children with mental disorders and their families.
- $524,000 to allow psychotherapy services in the home for children and youth and their family. While we support this service enhancement we are concerned that lack of reimbursement for travel time and expenses may undermine utilization.
- $12.5 m. to increase forensic treatment services at the two state mental health institutes in order to reduce time individuals are waiting in jail to receive needed evaluation and treatment.
Most of these items represent priorities that advocates have promoted for many years through the Wisconsin Council on Mental Health, which is currently chaired by MHA’s Director of Public Policy, Shel Gross. Ongoing meetings with the Governor’s staff and staff from the Department of Health Services during 2011 and 2012 paved the way for the initiative, which was one of the first the Governor announced as he rolled out his budget. These items had strong support in the Joint Finance Committee which made only minor changes to the proposals.
While advocates were disappointed by the failure of the Governor and Legislature to expand Medicaid to those up to 133% of the federal poverty level, the Governor’s decision to expand Medicaid to childless adults up to 100% FPL with the full Medicaid benefit will have a positive impact on the significant number of people with mental illnesses below this level who are currently uninsured. It will also provide new revenue for counties who are currently serving these individuals using local tax levy.
Mental Health advocates can now focus their energy on ensuring that these initiatives are implemented in a way that will improve outcomes for adults and children with mental disorders. We have already begun talking with the Department of Health Services about how we can work with them on this. This is a different start to the new fiscal year than what we have been accustomed to, but we could get used to it.
Watch MHA’s Director of Public Policy, Shel Gross, discuss the Governor’s mental health proposals on a special Wisconsin Eye broadcast along with Rep. Sandy Pasch, Barbara Beckert from Disability Rights Wisconsin and Hugh Davis, from Wisconsin Family Ties. Click here >>
Speaker’s Task Force on Mental Health Releases Final Report
The Speaker’s Task Force on Mental Health released its final report. The recommendations in the report are expected to be introduced as separate bills during the remainder of this legislative session. The task force leads were Rep. Eric Severson (Chair) and Rep. Sandy Pasch (Vice-Chair). Read the report >>
Investing in Wisconsin: Governor Scott Walker Announces Mental Health Funding in Upcoming Budget
Today, Governor Scott Walker announced a near $30 million investment in state taxpayer funds for mental health programs to enhance and expand services provided by state and local governments to individuals living with mental illness. The initiatives being funded in the budget will build on proven, evidence-based strategies, expand successful programs, and address the most urgent needs identified by patients and families receiving care, providers, and advocates throughout the state. Read the Press Release >>
Mental Health America of Wisconsin “Ecstatic” About Governor’s Mental Health Proposals
(Madison, Feb. 6, 2013) Mental Health America of Wisconsin (MHA) wishes to express its deep appreciation to Governor Walker for the mental health proposals he announced today. “To say that we, and other mental health advocates, are ecstatic may be an understatement,” said Shel Gross, Director of Public Policy. “The items the Governor included in his proposal represent some of the top priorities we have identified for the budget, and some have been top priorities for many, many years.” Read the Press Release for details >>
Meaningful Consumer Involvement - Nothing About Us Without Us
A lot of the time bad policy can be avoided if the right people are at the table. The disability mantra—nothing about us without us—applies to people with mental illnesses as it does to people with other disabilities.
But what does it mean to include consumers or family members in policy making? Last year United We Stand Wisconsin (UWSW), a statewide mental health consumer organization, developed a consensus statement on meaningful participation. The Wisconsin Council on Mental Health (WCMH) endorsed these principles and forwarded them to each of the state agencies represented on the WCMH. The response has been very encouraging to say the least.
The Department of Health Services has been re-energizing their efforts to engage consumers after filling their vacant Consumer Affairs Liaison position. You can email Faith Boersma if you want to get information about her efforts and how you can become more involved in policy development.
We learned from the Division of Vocational Rehabilitation that individuals interested in becoming active on the Rehabilitation Council, which oversee and advises on voc rehab services, can do so upon request. As a result, one of the WCMH members is joining that body.
Today a group of individuals will be meeting with the Department of Children and Families’ (DCF) Child Welfare Advisory Council. Eloise Anderson, DCF Secretary, sent the invitation in response to the WCMH letter. Addressing the mental health needs of both children and biological family members involved in the child welfare system is of utmost concern if we are to maximize successful family reintegration and to ensure that youth are cannot be returned to their family of origin are able to move toward successful life functioning.
And recently a group of mental health consumers met with staff from the Department of Corrections to explore how consumers could be more involved in both policy and in supporting inmates with mental illnesses. There is a commitment to a follow-up meeting and some tentative understanding about directions for moving forward.
If you’re interested in learning more about UWSW you can join their Google Group at: : http://groups.google.com/group/united-we-stand-wi/topics
2013-2015 Budget Process Begins
Mental Health Funding and Access to Services
Much of the budget advocacy over the past five years has been based on the Funding and Access paper developed by members of the Wisconsin Council on Mental Health, and its committees, in 2008. You can review this paper here.
The paper led to the commission of the Mental Health and Substance Abuse Infrastructure Study, which built on it’s findings. You can find that report at: http://www.dhs.wisconsin.gov/rfp/DMHSAS/docs2012/RFP1740/MentalHealthandSubstanceAbuseInfrastructureStudyFinalReport12-18-09.pdf
We are less than half way through the state’s two-year budget cycle but planning is beginning for the next one, which begins on July 1, 2013.
On May 25th Shel Gross, MHA’s Director of Public Policy, led a delegation of consumers, family members and other advocates who are connected with the Wisconsin Council on Mental Health (WCMH) to meet with Governor Walker’s budget and policy staff. At the meeting the group reviewed preliminary budget priorities developed through the WCMH, which Shel chairs (see link below). The two-hour meeting found the Governor’s staff interested and engaged, seeking to further understand the issues and solutions. The group will follow up with staff at the Department of Health Services (DHS), with whom they have had monthly meetings over most of the past year, as the DHS develops their budget recommendations for the Governor. Meetings with other departments are also in the planning stages.
By working with both the departments and directly with the Governor’s office we hope to be able to identify some areas of common interest that can be moved forward in the 2013-2015 budget. However, the priorities also include a number of policy issues that can be moved forward even as the budget process unfolds. We’ll keep you posted. Read the WCMH 2013-2015 State Budget Priorities >>
Certified Peer Specialists
One of the major transformation in the mental health system has involved the growing role of people with mental illness as providers within the system. Certified Peer Specialists (CPS) are persons who have not only lived the experience of mental illness but also have had formal training in the peer specialist model of mental health supports for adults. Peer specialists are working in all types of mental health settings, from inpatient hospital to crisis services to outpatient settings. MHA employs peer specialists in our Strong Families/Healthy Homes program. To find more information about certified peer specialists check out these websites:
Wisconsin Association of Peer Specialists: This site has been developed to be a resource, advocacy and continuing education tool for all Peer Providers, in Wisconsin and Nationwide, to assist them in their pursuit of the development, education and sustainability of the profession of Peer Provider.
Wisconsin Peer Specialist Employment Initiative: Information on how to become a peer specialist, finding jobs as a peer specialist, quarterly newsletter and more.
Electronic Medical Records
The national movement towards increased use of electronic medical records has significant implications for mental health consumers. As efforts to integrate care across mental health and primary care move forward, the interest in and need to integrate records is not far behind. But given the historical stigma related to mental illness, some mental health consumers have concerns about what information is available to which providers without their written informed consent.
This is not an easy issue. Consumers understand that providers need to know about all the medications they are taking to make sure they don’t prescribe something that will cause an adverse reaction with their current medications. And most consumers like the idea of all their providers working together in an informed way. But many would like to stay in control of this process. So how do we find a balance that works?
Currently in Wisconsin health care providers can share the following information about you from your mental health treatment records without your informed consent:
Name of your provider of services for mental health or alcohol or drug abuse treatment.
Dates you received services.
Medications, allergies, diagnoses, diagnostic test results (e.g., lab tests, EKGs; not psychological testing) and symptoms.
Demographic information (e.g. name, address).
This information can be shared with any provider involved with your care who has a need to know the information. Sharing of any additional information, such as admission or discharge summaries, psychological testing or treatment plans would require a written release of information.
For more information see the attached guidance memo.
For information on the Wisconsin Statewide Health Information Network: http://www.wishin.org/
For information for consumer advocates see: http://www.nationalpartnership.org/site/PageServer?pagename=issues_health_it_advocates
Survival Coalition of Wisconsin Disability Organizations
The Survival Coalition represents about 40 consumer, provider and advocacy organizations addressing the needs and interests of people with disabilities in Wisconsin. Survival Coalition has been on the forefront of the movement to end waiting lists for community care for people with developmental and physical disabilities, an effort that has resulted in the Family Care program. The Survival Coalition budget priorities will be posted here when finalized.
Additionally Survival Coalition drafted a set of principles reflecting the values that should be applied to the decision-making process. Importantly, Survival Coalition stresses the need to look at increasing revenues as well as cutting costs and services. Read the Statement of Principles. While developed for the 2009-2011 budget process these principles remain relevant today.
Mental Health Parity