Gov. Evers Makes Historic Investments in Health Care Coverage and Access

Today, the Wisconsin Department of Health Services (DHS) highlights critical portions of Gov. Evers’ 2023-2025 DHS budget proposal, which was introduced February 15, 2023. Gov. Evers dubbed it a “breakthrough budget,” leveraging Wisconsin’s unprecedented surplus to make investments in Wisconsin’s health care, behavioral health, public health, emergency response, and long-term care systems.

“To support a healthier Wisconsin, we need to ensure every Wisconsinite and every community has the supports provided in this budget that invests in our working families and drives economic growth,” said DHS Deputy Secretary Standridge. “Gov. Evers’ historic biennial budget makes critical investments in public health, health care workforce, mental and behavioral health treatment, and emergency medical services that prioritize the health and well-being of every Wisconsinite.”

Some of the highlights include:

Expanding Medicaid Coverage

For the third consecutive biennium, Medicaid expansion is the cornerstone of the budget proposal for DHS. This would expand high-quality, low-cost health care coverage to an estimated 89,700 additional Wisconsinites. The American Rescue Plan Act (ARPA) of 2021 also created an enhanced federal matching rate for newly enrolled members, which would generate $1.6 billion in state savings and bring in additional federal dollars over the biennium. These savings would be invested back in health care to expand services and improve access to care across the state.

As of January 2023, Wisconsin is one of only 11 states that have not chosen to expand their Medicaid programs. States that have expanded Medicaid have experienced positive outcomes as more people gain access to needed treatment and care, hospitals stay open, and jobs and the economy grow.

Gov. Evers’ budget increases hospital payments by $626 million over the biennium. It also provides $250 million to increase Medicaid reimbursement rates for primary care services, autism treatment services, outpatient mental health and substance use disorder services, and child adolescent day treatment.

Medicaid expansion is also good for Wisconsin’s workforce. Most adults on Medicaid are working in full or part-time jobs that don’t provide insurance – or affordable insurance – or are caregivers or students. Providing access to secure, affordable health coverage increases the number of people who can find and maintain full-time employment.

Building Healthy Communities

Compared to the rest of the nation, Wisconsin has been significantly underfunding its public health efforts for years. The most recent data show Wisconsin invests only $72 per-capita in public health, compared to the national average of $116 per-capita. Recognizing this fact and the importance of a strong public health system to protect and promote the health of all Wisconsinites, the Governor’s budget makes Wisconsin’s largest GPR public health investment to date.

The budget invests in several initiatives to address racial and ethnic disparities in maternal and infant mortality. This includes a proposal to extend postpartum coverage from 60 days after birth of a baby to a full year to help maintain access to coverage and reduce disparities in postpartum follow-up care for chronic conditions associated with mortality rates.

Gov. Evers’ budget invests in the Birth to 3 Program to help kids who have lead poisoning with access to early intervention services by expanding eligibility in the program to include children with elevated lead levels. Additionally, the budget dedicates DHS resources to assessing and responding to PFAS in communities throughout the state.

To improve access and availability of healthy food, Gov. Evers’ budget creates the Double Up Food Bucks Pilot Program, which will significantly reduce the cost of certain food items, allowing FoodShare benefits to be stretched further.

Gov. Evers’ budget makes a one-time investment of $150 million to continue the successful EMS Flex Grant program which provides public and private emergency services providers with funding for reasonable operating expenses. It also makes updates to emergency medical responders licensing and removes barriers for first responders with post-traumatic stress disorder seeking worker’s compensation.

To help prevent cardiac-related health incidents in student athletes, the budget provides $4.1 million for an electrocardiogram screening pilot program in Milwaukee and Waukesha counties. This pilot will be crucial in identifying any best practices and strategies for consideration in developing a future potential statewide expansion of the screening program.

This budget creates a 60-day stockpile of personal protective equipment (PPE) warehouse stockpile. The warehouse remains a critical component of the COVID-19 pandemic response and other emerging infectious diseases response and recovery efforts. Having an ample supply of this equipment is critical to reducing the risk of exposure to disease and ensuring the health and safety of health care responders throughout Wisconsin.

Investing in Mental Health and Crisis Services

The past few years have been tough on all Wisconsinites and behavioral health services providers have been experiencing growing demand. During his 2023 State of the State address, Gov. Evers declared 2023 the Year of Mental Health, calling mental and behavioral health a “burgeoning crisis” affecting the state and Wisconsin’s kids, families, and workforce. In 2021, Wisconsin counties responded to 35,000 crisis calls statewide. Gov. Evers’ biennial budget makes one of the largest budget investments in mental health and substance use disorder treatment in the past 40 years, with more than $500 million to expand access to mental and behavioral health services across Wisconsin. This investment ensures Wisconsinites in all stages of life can access behavioral health services and receive care closer to home.

It includes the development of up to two crisis urgent care and observation centers that would serve as crisis service hubs and offer a range of behavioral health services to everyone from walk-in appointments to first responder emergency drop-off cases. Gov. Evers’ budget also provides $1 million in stable, ongoing state support to continue operations at the three crisis stabilization facilities in Wisconsin specifically designed for the needs of youth experiencing a crisis.

To improve the accessibility of critical mental and behavioral health care, the budget includes developing a statewide behavioral health treatment program directly tailored for those who are deaf, hard of hearing, or deaf-blind where people will receive treatment directly from a behavioral health partner. The budget also provides funding for vouchers for farmers in rural areas to access mental health treatment in person or via telehealth appointment. Additionally, it increases cost transparency to protect people against receiving unreasonably high medical bills for behavioral health services received during a crisis.

A significant package of measures would expand access to mental health services for children in schools. Including increasing the amount of federal Medicaid reimbursement returned to schools through the School-Based Services program and increasing funding to schools by $112.4 million.

Gov. Evers’ budget proposes an additional $3 million over the biennium to expand staffing and resources for Wisconsin’s 988 Suicide & Crisis Lifeline services, which launched statewide in July 2022.

To address the dramatic increase in opioid drug overdose deaths, and the rise in deaths involving the use of stimulants, Gov. Evers’ budget supports the development of two facilities that will provide patients information about harm reduction strategies, connect them with community resources, and aid in transferring them to the level of care they need upon stabilization. It also proposes investing $1.6 million annually to address an immediate need for increased stimulant treatment access in counties of high need.

Investing in Long-Term Care

Wisconsin’s long-term care industry has been severely impacted by the COVID-19 pandemic and is facing numerous challenges, from staffing to financial stability. This budget makes investments to bolster, stabilize, and support long-term care providers across the state.

The budget continues investments made with temporary ARPA federal Medicaid matching funds to strengthen the service system, including to provide a five percent increase and develop a minimum fee schedule for home and community-based services, which help older adults and those who have disabilities live independently in their communities. It also invests nearly $17 million to support Wisconsin’s 47 aging and disability resource centers (ADRCs) and seven Tribal ADRCs and expand caregiver support services to every county.

The budget also invests $15 million GPR into a Complex Patient Pilot which aims to address difficulties and delays experienced in placing individuals with medical challenges in post-acute care settings. The ongoing staffing issues faced by long-term care providers have led to costly delays in discharge from hospital settings and this pilot seeks to find innovative approaches to more timely placements. With the state’s population rapidly aging, investments like this are more critical than ever to ensure Wisconsinites are cared for in the most appropriate setting for their needs.

Long-term care workers provide care to Wisconsin’s most vulnerable residents. Gov. Evers’ budget recommends providing $22.5 million to establish an ongoing Innovation Grant Program for health care employers to engage in improved recruitment and retention of long-term care providers. An additional $8 million is recommended for continuation of the WisCaregiver Careers program, which aims to address the shortage of certified nursing assistants in the state by supporting recruitment, training, and retention of qualified caregivers for nursing home residents across Wisconsin.

Addressing Staffing Needs Across Health Care Sectors

The governor’s budget makes significant investments to addresses workforce shortages experienced by every sector of Wisconsin’s economy. This budget builds upon investments made during the COVID-19 pandemic using federal ARPA funds to support talent development and policy changes to get and keep skilled workers in the Wisconsin economy. Wisconsin’s health care workforce challenges were exacerbated by the pandemic, and Gov. Evers’ budget invests in long-term solutions to promote staffing across all health care sectors.

The budget increases staffing at DHS direct care facilities, including Mendota Juvenile Treatment Center and Northern Wisconsin Center, allowing both facilities to greatly expand treatment and services. In addition, the budget transfers security staff positions at Wisconsin Resource Center (WRC), which had previously been under administration of the Department of Corrections, to DHS, which will streamline and simplify human resource administration in both departments.

To protect the safety of Wisconsinites living in long-term care facilities and to keep pace with the growth in the provider community, Gov. Evers’ budget funds positions in the Office of Caregiver Quality to support misconduct investigations and the background check program.

The governor’s budget continues the successful Workforce Innovation Grants and allocates $100 million to specifically address the state’s health care workforce by providing grants to health care employers and related organizations.

Visit the DHS website for more information about the DHS budget.