Governor Evers Makes Historic Investments in Health Care Coverage and Access
For Antigo Times
The Department of Health Services (DHS) Secretary Designee Andrea Palm highlighted critical portions of Governor Evers’ 2019-2021 DHS budget proposal, which was introduced recently.
“Governor Evers’ budget makes historic investments in the health and well-being of every Wisconsinite,” said Secretary Designee Palm. “Through critical investments in our providers and health care workforce, this budget recognizes that health care is a cornerstone of economic development in communities all across the state.”
Governor Evers’ 2019-2021 budget proposal expands affordable health care coverage to 82,000 Wisconsin citizens. The savings from this expansion leverages over $1.5 billion in new federal funding to invest in the health care and well-being of every citizen. The budget improves access by investing in providers and technology to further help meet rural access needs. It seeks innovative and commonsense solutions to preventive care, behavioral health, long-term care, and public health. It will reduce overall health care costs by covering more people, reducing uncompensated care, and expanding access to preventive services.
Some of the highlights include:
Expanding Medicaid will enable an estimated 82,000 individuals to access affordable health coverage. A single person working full time, earning between 100% of the federal poverty level (FPL) to 138% FPL, makes about $12,000 to $17,000 per year. This budget proposal will generate $324.5 million, which is invested back in health care to expand services and improve access to care across the state.
The budget proposes to extend postpartum coverage for pregnant women in Medicaid. Currently, Medicaid covers pregnant women up to 60 days after the birth of their child. The budget proposes to extend coverage for a full year to help maintain access to coverage and improve health outcomes for moms and their babies.
Governor Evers’ budget proposal guarantees all eligible children with disabilities who have long-term care needs can access care in their communities by eliminating the current Children’s Long-Term Support Waiver Program waitlist. The Governor’s budget proposes a ‘No Wrong Door’ policy to help families navigate the children’s long-term care system by integrating intake for children with disabilities.
Additionally, the budget invests in the Birth to 3 Program to help kids who have lead poisoning access early intervention services by expanding eligibility in the program to include children with elevated lead levels.
Gaps in health care access are happening all around the state, forcing people to forgo care or drive hours to get the care they need. Governor Evers’ budget invests in nursing homes, assisted living facilities, hospitals, direct-care workers, doctors, and counties to make sure Wisconsinites are getting the care they need. The budget proposes to increase provider payments to help attract and retain medical professionals in Wisconsin.
“Governor Evers’ budget invests funding from the Medicaid expansion to help address health care needs throughout the state,” stated Secretary Designee Palm. “The budget improves health care quality and access by addressing provider reimbursement, tackling workforce shortages, and providing coverage for additional services and benefits.”
To ensure hospitals have adequate resources to continue to provide high-quality care, Governor Evers’ budget proposes to increase hospital payments by $367 million over the biennium. The budget proposal also increases payments to physicians by $69 million over the biennium to improve access to quality health care.
The budget makes key investments in counties to help them adequately meet the needs of the overburdened mental health crisis system. To ease these challenges, DHS will share the cost for crisis services by investing $39.7 million over the biennium and expanding Medicaid reimbursement for crisis services to include substance use disorder and dementia crisis.
Governor Evers’ budget proposes an additional $12.1 million over the biennium to make prescription drugs more affordable by eliminating the copay for Medicaid and BadgerCare Plus members.
The budget proposes a significant package of dental measures, including $48 million in new critical access payments to Medicaid providers, licensing dental therapists, increasing grants to non-profit dental providers, expanding the Division of Public Health’s Oral Health Program, and increasing payments for providers to help people with disabilities have increased access to dental services.
Wisconsin is expected to have 1.1 million residents ages 65 and older in 2020, which will grow to 1.54 million individuals in 2040. By then 58% of seniors will be ages 75 and older. With these dramatic increases, we must act to expand services to ensure older adults have the resources they need to maintain their health and independence. To help address these challenges Governor Evers’ budget invests in:
- Healthy Aging Through Evidence-Based Prevention Programs
- Assisted Living Facility Quality
- Dementia Care Specialists
Governor Evers’ budget bolsters access to long-term care for seniors and people with disabilities by increasing payments to nursing homes and assisted living facilities by $71 million over the biennium. Additionally, the Governor’s budget increases the personal care rate by $16.7 million over the biennium to help people remain in their homes while having access to needed services.
Governor Evers’ budget goes beyond addressing coverage and access issues; it proposes solutions to challenges such as behavioral health care integration and community health. It addresses critical staffing shortages in DHS secure facilities that operate 24/7.
“Wisconsin has a long history of leadership and innovation in health care,” said Secretary Designee Palm. “This budget seeks to build on that legacy by investing in preventive care, managing chronic diseases, and focusing on the integration of behavioral health in the health care system.”
Since 2013, overdose deaths have increased by 39% and hospital emergency room visits have increased by 72% for people affected by substance use disorders. Large parts of the state do not have adequate access to medication-assisted treatment and recovery supports for individuals with opioid use disorders. DHS proposes to implement a Medicaid health home hub-and-spoke model in two rural areas and one urban area in the state. Under the proposal, the “hubs” would ensure the integration of a full range of primary health care and substance use disorder services.
Governor Evers’ budget proposes a new community health benefit to help address the non-medical drivers of health among Medicaid members such as homelessness, safe housing, and access to nutritious food. By addressing core social determinants, health and well-being will improve. Governor Evers proposes $45 million over the biennium to launch this critical investment in preventive measures to reduce health risks while improving overall health.
DHS runs 24/7 direct care and treatment facilities. Governor Evers’ budget makes critical staffing investments to DHS facilities that will better serve Wisconsin residents with severe mental health and substance use disorder needs. The budget:
Invests in a new staffing model at Winnebago Mental Health Institute to help stabilize staffing and reduce overtime. Winnebago Mental Health Institute provides psychiatric care and treatment services for people referred by county agencies and courts.
Continues increased staffing at Wisconsin Resource Center to provide services for substance use disorders. Wisconsin Resource Center provides specialized treatment services for people with severe and persistent mental health needs referred by the Department of Corrections and courts.
Increases staff at Sand Ridge Secure Treatment Center to continue to offer treatment to patients with severe mental health challenges who are involved in the forensic system.
Expands Mendota Juvenile Treatment Center to provide services for youth with significant mental health concerns and behavioral health challenges. Mendota Mental Health Institute provides psychiatric care and treatment services for adults referred by county agencies and courts as well as juveniles referred by the Department of Corrections.