Disability Community Opposes Wisconsin’s Plan for Saving $500m. in Medicaid
Mental Health America of Wisconsin has joined with other disability consumer, family, provider and advocacy organizations in opposing key aspects of Wisconsin’s request to the federal Center for Medicaid and Medicare Services for a waiver of Medicaid requirements that was required under a budget repair bill passed by the State Legislature early in 2011. The Survival Coalition of Wisconsin Disability Organizations, of which MHA is a member, has found that the proposal will likely have a significant negative impact on low-income individuals with disabilities as well as other low-income individuals who rely on Medicaid for their health care. You can view the letter to the federal Department of Health and Human Services Secretary Kathleen Sebelius and the attachment to that letter here. Additionally you can view a letter Survival Coalition sent to Wisconsin Department of Health Services (DHS) Secretary Dennis Smith on March 31, 2011 with our recommendations for achieving savings here.
While MHA is very concerned about the potential impact of 55,000 people losing Medicaid if this waiver is not approved, a provision of the legislation requiring DHS to seek the waiver, we believe that the waiver requirements would be even more harmful, both in terms of the number of people potentially losing health care coverage and the coverage available to those who continue to receive Medicaid. Those 55,000 would be adults with incomes above 133% of the poverty level (with the exception of pregnant women). However, the reality is that Wisconsin Medicaid could choose to eliminate coverage to this group at any point even if the waiver were approved. Therefore, this is not an either/or choice but potentially a choice between one or both cuts going into effect.
It is important, also, to understand that neither the waiver request nor the alternative elimination of eligibility for 55,000 Medicaid recipients would affect individuals who are on Medicaid due to a disability (such as those who qualify for SSI or SSDI); those often characterized as elderly, blind or disabled. There are other initiatives that DHS is pursuing that do potentially effect these groups. A freeze on Family Care enrollment has already been implemented as part of the 2011-2013 state budget. The DHS is saying that they hope to lift this freeze in the near future but they have not provided a definite time frame. The DHS is also proposing to move a large number of people with disabilities into medical homes. These medical homes will be coordinated care systems which hope to improve care and save money. Few details are available about these medical homes but MHA is involved in discussions with the DHS about these projects. People with mental illness are a target population for this initiative. Medical homes have the potential to be a very positive option for individuals who are not currently receiving coordinated care.
Shel Gross
Mental Health America of Wisconsin
BadgerCare Plus Standard Plan,Wisconsin Medicaid and Proposed BadgerCare Plus Benchmark Plan Covered Services Comparison Chart
Disability Organizations Give New Budget Failing Grade for People With Disabilities
The Survival Coalition of Wisconsin Disability Organizations representing more than 40 member groups is giving the new biennial budget failing grades in its support of Wisconsin’s most vulnerable citizens. The report card assesses impacts on people with disabilities based on funding and policy decisions contained in the new budget. Funding for community-based long-term adult care and public education both received F grades; funding for long-term community-based supports for children, transportation, mental health, and county-based programs all received D’s. Read the Press Release or the Full Report >>
Public Policy Update: How Did Mental Health Fare in the State Budget?
You would think this would be a pretty simple question to answer, but the fact that it is not says much about funding for mental health services. About the only place there was budget language specific to mental health services was in the Department of Corrections budget. Their funding was increased for a women’s treatment unit at the Wisconsin Resource Center and a conditional release program, as well as fully funding the Becky Young fund which supports access to mental health and substance abuse services in support of reintegration into the community.
But there were many cuts in the budget which are likely to impact mental health services; we just don’t know exactly what that impact will be. For instance, the Department of Health Services has authority to develop a plan to reduce Medicaid expenditures by $500 million. Given that Medicaid is a significant funding source for mental health services, this could have a huge impact—or not. Similarly, reductions to both county shared revenues and youth aids will reduce overall funds available to counties. Since counties provide about half of all funds for public mental health services, this is likely to have an impact at the local level. But exactly what that impact will be will not be known until counties complete their 2012 budgets later this year. The Family Care freeze will similarly impact overall county finances, and therefore impact what funds are available for mental health services.
There are other examples, but you get the idea. There is no identifiable mental health system, with clear funding and accountability. We have programs and funding streams and they interact in various different ways across the state. So there will be at least 72 answers to the question of how mental health fared in the state budget. Maybe more.
2011-2013 State Budget
Items of interest to the mental health community in Wisconsin
The Wisconsin Council on Mental Health (WCMH) has identified the following priorities for the 2011-2013 state budget.
Based on these priorities, and on statement then gubernatorial candidate Scott Walker made at a forum in Milwaukee during the campaign the WCMH sent the following letter to the Governor-elect.
Although written in 2008, the WCMH's Funding and Access to Services briefing paper still provides a good background to public mental health system funding. This paper outlines the factors that are undermining the public mental health system and identifies a variety of potential solutions. The core argument is that a variety of trends have resulted in counties bearing an increasing share of the burden for mental health services at a time when they are constrained in their ability to collect property tax revenue to support human services. The Governor and Legislature must find some way to provide relief to counties, which are charged with administration of the public mental health system. Read the Mental Health Funding and Access to Services briefing paper.
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.
Links:
Advocacy
Current Bills
Mental Health Parity