More Medicaid Reimbursement Woes

Providers of services for children with autism are the latest group to describe the harm caused by the state’s low Medicaid reimbursement rate.

Wisconsin Health News (9/22) includes an interview with Jackie Vick and Mike Miller, the president and treasurer of the newly formed Wisconsin Autism Providers Association.  One of the five goals of the WAPA is to “Increase reimbursement rates for Medicaid treatment.  Low reimbursement rates are the primary cause of client demand exceeding the supply of providers…”

Miller and Vick conducted a survey to see if other providers shared the problem of “putting families in a holding pattern” because of an inability to take more Medicaid clients.  The answer was “yes across the board for all of those providers.”

Miller estimated that over 500 children in the state are waiting for treatment under Medicaid funding.  The lists are growing by 15 to 20 children a week and could total 1,000 by the end of the year.

Vick said that providers have responded to the challenges of the reimbursement rate in different ways.  Some limited the number of Medicaid clients in order to maintain fiscal stability.  A related problem, she said, is the difficulty of hiring therapists and technicians because of the low rate of pay.

She pointed out that access to treatment for young children pays off for them and for  taxpayers.  Vick said, “…the research shows that they make great gains and the lifetime costs of care for a child on the autism spectrum go down.”

The low Medicaid rate affects children with other behavioral health problems.  Here is an excerpt from the Kids in Crisis/Legislative Action Tracker article that was part of a series by USA Today-Wisconsin (June 2016)

There is evidence that Wisconsin’s Medicaid reimbursement rates – among the lowest in the country – are shutting children out of accessing outpatient behavioral health care and leading to higher costs associated with emergency psychiatric care.

A report by Milwaukee’s Public Policy Forum found that in Milwaukee County, low reimbursement rates were stopping mental health providers from accepting Medicaid patients. A 2014 survey by the Wisconsin Statewide Medical Home Initiative found that only 20 percent of Wisconsin pediatricians said they could find therapists when needed for their patients on Medicaid, and just 5 percent could find psychiatrists for patients on Medicaid.

Check out “Voices from the Front Lines: NAMI’s Lindsay Wallace” on this blog for a report on how people with mental illness in Dane County are affected by the rate.

Click here to read a study by Pew Trusts that reports experiences of states that supplemented Medicaid rates for primary care doctors.





Support Grants for Community Crisis Response Teams

Last summer, advocates for reform of Dane County’s criminal justice system argued for more community crisis response teams.   Teams help divert persons with mental illness into treatment before arrests that are costly to them and the taxpayers.

The Mental Health Reform Act of 2016 (S 2680 ) would provide grants to support those efforts by strengthening community crisis response systems.  The bill was passed out of the appropriate Senate committee with strong bipartisan support and will be voted upon by the full Senate.  Passage would be a victory for mental health services and bipartisan cooperation.

NAMI-WI posted an excellent analysis of the proposed legislation.  The bill would also strengthen enforcement of parity laws, provide grants for early intervention and suicide prevention, and support an enhanced mental health workforce.

Contact Senator Ron Johnson to urge his support.  He will be listening to voters.



Discouraged about National Politics?

Check out what’s happening with mental health legislation and cheer up.  Republicans and Democrats are working together to address problems that have been simmering on congressional back burners for decades.

Senators Bill Cassidy (R-LA) and Chris Murphy (D-CT) hosted a Senate Summit on Mental Health on May 26, where they were joined by Senators Patty Murray (D-WA) and Lamar Alexander (R-TN) to enlist support for the Mental Health Reform Act of 2016 (S 2680).  That bill represents the joint work of all four senators and was voted out of the appropriate Senate committee on March 16. It has the best chance of passage.

“Mental Health Reform: A Patchwork of Care” reports highlights of the bill.  Among them are: increased access to care for veterans, women and children; efforts to move people from jails and prisons into mental health treatment programs; promotion of evidence-based treatment; and grant money to treat mental illness on colleges and universities.  See also the analysis by NAMI-WI of the bill.  The related House bill (2646) has controversial provisions that are impeding its progress.

“Transforming and Modernizing our Nation’s Mental Health and Addiction System” offers a description of 16 mental health bills introduced in the House and Senate.  The bills are categorized under 10 topics such as integrated care, early intervention, and workforce issues.  You can follow the progress of any bill by clicking on and entering the number of the bill.

Senator Ron Johnson (R) is facing a strong challenge from Russ Feingold (D).   Johnson should be listening to voters about mental health legislation, particularly since it has become a bipartisan issue.  Send him an email.  I did and received a generic response saying that he would keep my views in mind.







WI NAMI Launches Early Intervention Programs

WI NAMI, the state affiliate of the National Alliance on Mental Illness, is coming full circle by honoring the memory of NAMI’s founders with an effort to promote the mental health of young people.  Nearly 40 years ago, a small group of women in Madison met to discuss how to help their children with serious mental illness.  They went on to found NAMI, which today is the country’s leading advocacy and support organization for those concerned with mental illness.

With its 100 Extraordinary Women Celebration, WI NAMI is launching a new youth mental health movement.  The aim is to change the way young people talk about and access mental health supports. Funds will be used to cultivate youth leaders who can encourage open dialogue among their peers about mental health problems and to provide resources for the adults in their lives. More information, including how to donate, is here.

The kickoff dinner will take place on June 17 at the Fluno Center in Madison.




How are You Going to Pay for It?

Push for better mental health services long enough and you will hear that question.

This blog will help explain ways in which the money we have for mental health services could bring about greater returns and explore how to increase those resources.  I will focus on the impact on Dane County residents of decisions made at all levels of government and will include reports of on-the-ground efforts by local advocates to help bring about reform in mental health services.

I know the mental health system at personal and professional levels.  My sister was first hospitalized with a diagnosis of schizophrenia when she was 14.  She is 74, so I have first-hand knowledge of improvements in care and the continuing failures of the system.  I was a reporter for Psychiatric News, the bi-weekly publication of the American Psychiatric Association, specializing in health care economics and community psychiatry. Katie L Mulligan

NOTE:   A disproportionate number of people in the criminal justice system have a mental illness.   People advocating for family members and others with a mental illness are seeing that intersection and urging criminal justice reform.  It is also clear that taxpayer dollars are being wasted because of the current jail and prison systems.  I will be adding news about criminal justice reform to this blog.