MADISON – Gov. Scott Walker announced steps Tuesday to pay mental health professionals and substance abuse counselors more money to work with low-income Wisconsinites.
Advocates hope the higher payment rates, which go into effect next year, will allow providers to offer more therapy appointments, psychiatric evaluations and substance abuse treatment for children and adults without private insurance.
State health officials said the expansion will cost $17 million, with about $7 million coming from state coffers and $10 million from federal dollars. It was not reviewed by legislators since the money will come from funds already approved for health programs.
Prior to the announcement, Walker’s administration has been apathetic of hiking provider rates during state budget talks. But on Tuesday, health officials said the state “is in crisis, particularly related to the opioid epidemic, and we must act now to improve access to treatment.”
Boosting reimbursements for providers is a move mental health advocates have long urged. The idea was also highlighted by USA TODAY NETWORK-Wisconsin’s Kids in Crisis series as a method to improve a statewide shortage of mental health providers.
Currently, mental health providers who help people under Medicaid are often reimbursed by the government for only about half their costs, according to Linda Hall, executive director of the Wisconsin Association of Family and Children’s Agencies. As a result, providers limit how much time they spend with these clients.
The new policy, Hall said, “will allow us to serve more people and hopefully pay people better so they can come into the field.”
Medicaid is a health assistance program for disabled, elderly and low-income residents that receives funding from state and federal taxes. In Wisconsin, Medicaid assistance for low-income families and individuals is called BadgerCare.
About 1 million people in Wisconsin use Medicaid for health insurance. About half of them are children, according to the Kaiser Family Foundation. State health officials said more than a 100,000 people under Medicaid received outpatient mental health or substance abuse services last year.
Wisconsin spends about $1,800 per child enrolled in Medicaid, ranking it second lowest in the nation, according to Kaiser. The state also spends less than most states on adults, at about $3,000 each.
The Wisconsin Council on Mental Health has been pushing the state to bump Medicaid payment rates up to match rates provided by Medicare, the federal insurance program for elderly people. A 2016 state report found that Medicaid paid about 27 percent less than what Medicare paid for behavioral health services.
State health officials declined to provide the new rates, but said they will be “competitive” with Medicare and rates in neighboring states. The new rates will be announced in an upcoming newsletter and published online by January, state health officials said.
State Sen. Jon Erpenbach, D-Middleton, who for years has proposed boosting rates, said he was pleased with the new steps but also puzzled why the rates were hiked now instead of months ago, or as part of the state budget, as some lawmakers proposed. He chalked it up to “playing politics” — Walker seeking GOP credit for the change rather than allowing a bipartisan effort.
In March, Erpenbach repeatedly pressed Walker’s top health official at a state budget hearing to support increasing provider rates for mental health services but got little traction. At that time, Department of Health Services Secretary Linda Seemeyer said more study of rates was needed and expressed doubt that higher rates would expand services. “Perhaps,” she said.
Erpenbach said he didn’t yet know the details of the new rate hikes and whether more could still be needed.
Advocates with Mental Health America and Wisconsin Family Ties said they were hopeful about the investment, but wanted to see details about the new rates.
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