The Legislature’s Joint Finance Committee last night voted on disability priorities in the Department of Health Services (DHS) section of the state budget that takes some first steps toward addressing the most pressing needs of the disability community: adequate supports to live in their homes and communities and freedom from abuse and neglect. Another critical issue– mental health supports–were mostly left out of the budget, and it is Survival Coalition’s hope that mental health and other important initiatives can move as stand-alone bills in the months ahead.
“The vote demonstrates recognition of concerns advocates have been expressing for decades and potentially a start to more re-investments that ensure Wisconsinites of all ages and abilities have access to the right care, at the right time and in the place, they most often prefer – in their own home,” said Patti Becker, Survival Coalition co-chair.
Among actions Joint Finance took:
- Continued the 5% increase for Home and Community Based Services providers that were initially part of federal pandemic response legislation. These increases impact providers in Family Care, IRIS, and Children’s Long Term Support Services (CLTS) waivers.
- Increases of 5% for direct care workers in Family Care. However, no increases for IRIS participant-hired workers.
- Increase of 4.3% to the Medical Assistance Personal Care Services
- Requirements that Family Care managed care organizations report publicly amount of care needed (authorized hours) and the amount of care provided by service category and MCO, thus quantifying unmet needs.
“The Legislature’s attention to the direct care crisis through rate increases and better quantifying the state’s needs are important initial investments,” said Beth Swedeen, Survival co-chair. “With average direct care worker wages in the state of $13.53/hr. and fewer than half earning benefits, we have a long way to go in paying the true cost of care.”
Survival Coalition also sees the investments in abuse and neglect prevention and investigation as a starting point to improving safety for people with disabilities. The $7.5 million increase for Adult Protective Services is the first increase since 2016 for county units. The motion also included a modest increase of 2 staff within the Office of Caregiver quality which are desperately needed to increase capacity to investigate complaints that occur in group homes and other settings where people in long-term care live or receive services. Survival’s request was for 15 new positions. Currently the investigation rates for the Office of Caregiver Quality have dropped from 69% to an abysmal 4% in the past 20 years as reports of caregiver misconduct have skyrocked 602% (Source: Legislative Fiscal Bureau budget papers #461 and #462)
Survival Coalition looks forward to working with the legislature to improve strategies to prevent and respond to abuse and neglect of people with disabilities.
Survival Coalition is disappointed that $100,000 for the Guardian Support Center and increased funding to the Lifespan Respite Care grant programs were not included. Respite Care has proven to be a critical public health intervention for family caregivers. The Guardian Support Center provides necessary daily resources and supports to guardians as well as those under guardianship.
Also missing from the budget are key mental health initiatives including:
· Covering the non-federal share of the Medicaid Community Support Program which is currently funded by counties.
· Support to develop two additional peer recovery centers.
· On-going funding to support peer-run respite center for veterans.
· Suicide prevention grant program.
· Behavioral health treatment program for individuals who are deaf, hard of hearing, or deaf-blind.
· Expansion of the Mental Health Consultation Program.
“At a time when the mental health needs in our state are so acute, the Joint Finance Committee missed out on opportunities to invest in community services and prevention,” said Kit Kerschensteiner, Survival Co-Chair.
“Given the longtime bipartisan support for mental health services, we hope these important services will move forward as standalone bills.”
Kerschensteiner said the budget does again include a $10 million appropriation for Crisis Urgent Care and Observation facilities, which would serve people experiencing a mental health crisis closer to home. Disability advocates are hopeful that the funds will be released as soon as possible so development can move forward. These centers provide an alternative to the current practice in which law enforcement transport individuals experiencing a mental health crisis to Winnebago Mental Health Institute, far from their home and support system.
