Issue Summary of the 2007-2009 State Biennial Budget (Updated: 11/04/2007)

1) Affordable Housing

People with disabilities and their families can have trouble finding affordable housing that meets their needs.

What is needed: Increase of $2 million the first year and $4 million the second year

$2 million each year of the budget to support housing grants and loans and creation of an affordable housing trust fund.
Total of $6 million for housing grants and loans; delete Governor’s creation of a $2 million affordable housing trust fund.
Retain Joint Finance actions.
Reduce Joint Finance increase to $4 million for housing grants and loans.
$2 million the first year and $1 million the second year for housing grants and loans and homeless/transitional housing.

1) Autism Spectrum Disorders Insurance Changes

Children with autism and their families need these services, just as children with physical disabilities need access to physicians and therapists.

What is needed: Support Governor’s initiative.

Require every health insurance plan to cover 4 hours of treatment per month by a psychiatrist, psychologist, or social worker certified to practice psychotherapy.
Removed from budget and introduced as SB 178 and AB 417
Put Governor’s proposal back into budget bill.
Retain proposal out of budget.
Removed from budget and introduced as SB 178 and AB 417

2) BadgerCare Plus

BadgerCare provides Medicaid coverage to low-income families with children.

What is needed: Support Governor’s initiative and also support comprehensive health insurance reform.

Expansion of the BadgerCare Program to provide access to health care for all children, youth aging out of foster care, pregnant women, low-income adults without children, low-income farmers, self-employed individuals, and other groups.
Include Governor's initiatives; from funding the Governor recommendedation to increase access to dental services, allocate $200,000 each in 2007-08 to the Peter Christensen Health Center and the Lake Superior Community Health Center to increase access to dental services.
Retain Joint Finance Committee’s proposal.
Delete expansion of BadgerCare Program, but retain combining Medical Assistance and BadgerCare benefits appropriations and retain the estimated cost savings.
Retain Joint Finance Committee’s proposal.

3) Birth to Three

Birth to Three provides early intervention services to infants and young children with disabilities.

What is needed: Maintain current funding.

No increases or cuts.
No increases or cuts.
No increases or cuts.
No increases or cuts.
No increases or cuts.

4) Children’s Long-Term Care Pilots

Children are served by many programs. This planning process would look at consolidating those programs into a managed care model.

What is needed: Support Governor’s position.

$500,000 for technical assistance and planning activities to develop managed long-term care pilot programs for children with disabilities.
Support the Governor’s proposal.
Retain the Governor’s proposal.
Delete pilots from budget.
Pilots removed from budget.

5) Children’s Long-Term Support Waivers

The waivers serve children with developmental or physical disabilities or mental illness and generates federal Medicaid match funding.

What is needed: About $10 million in state funds to eliminate waiting lists.

No increase or cuts.
Increase of $2 million each year of the budget.
Retain Joint Finance increase.
Retain Joint Finance increase.
Retain increase of $2 million in state funds and $4.7 in federal funds each year.

6) Community Aids

A portion of Community Aids is used by counties as match funding for Medicaid waivers that serve people with disabilities.

What is needed: Support Governor’s funding request.

Increase of $206,000 in state funds and $64,800 in federal funds to support basic county services.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Retain Governor’s proposal.
Retain Governor’s funding increase and raise foster care rates by 5%.

7) Community Integration Program 1A (CIP 1A)

CIP 1A is the Medicaid funding source for people moving from the State institutions to the community.

What is needed: Support relocating 36 residents and in addition close Southern Center by the end of the biennium.

Anticipate relocating 36 residents of Southern or Central Wisconsin Center to their home counties.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Retain Governor’s proposal.
Retain Governor’s proposal.

8) Divide the Department of Health and Family Services (DHFS)

Programs serving children with disabilities would not be part of the Department of Children and Families. Those programs would be in the Department of Health.

What is needed: No position at this time.

Create a new Department of Children and Families to manage programs serving families and children currently managed by DHFS and the Department of Workforce Development. The Department of Health would manage the remaining DHFS programs, such as long term support programs.
Retain the Governor’s proposal.
Retain the Governor’s proposal.
Delete the new Department of Children and Families.
Retain the Governor’s proposal.

9) Domestic Abuse Services

Shelters are safe havens for people leaving abusive situations. People with disabilities are at higher risk for abuse than the general population and shelters need to be accessible to people with disabilities.

What is needed: Support increase in funding for shelters.

Increase of $1.9 million for domestic abuse shelters.
Retain the Governor’s increase.
Retain the Governor’s increase.
Reduce increase to $626,300.
Retain the Governor’s increase.

10) Family Care Program

Family Care consolidates all the long term care programs, such as CIP and the Community Options Program (COP), into one program. When fully implemented statewide, Family Care will be an entitlement. People who meet functional eligibility criteria and are eligible for Medicaid will have to be served.

What is needed: Sufficient funding to fully serve people with disabilities and offer self-directed services option.

Increase of $20 million in state funds and $53 million in federal and other funds to expand the number of Aging and Disability Resource Centers (ADRCs) and Care Management Organizations (CMOs) to serve more people under Family Care.
Retain Governor’s proposal and restore legislative oversight of program expansion.
Retain Joint Finance actions.
Delete expansion of Family Care, except provide funding to maintain existing Aging and Disability Resource Centers.
Retain the Governor’s and Joint Finance’s proposals.

11) Family Care Program Independent Advocate

Independent advocates help people with conflicts over their services. The advocate positions will serve people across the state.

What is needed: At least 1 full-time person in each Family Care region.

Fund a full-time and half-time person to be independent advocates for people with disabilities enrolled in the Family Care Program.
Funding for advocates in 4 regions the first year and 6 regions the second year.
Retain Joint Finance actions and add funding for advocacy in Grant County.
Retain Joint Finance actions.
$190,000 the first year and $525,000 the second year for independent advocates for people under age 60.

12) Family Support Program

Family Support provides families with a small allotment of funding to cover some of the extra expenses of a child with disabilities. Currently more people are on a waiting list for Family Support than are receiving help. See above to learn about the Children’s Long-Term Support waivers.

What is needed: At least $10 million in state funds for Family Support or the Children’s Long-Term Support waivers to eliminate waiting lists.

No increases or cuts.
$4 million in state funds over the budget for the Children’s Long-Term Support waiver program which also serves children needing Family Support.
Retain Joint Finance actions.
Retain Joint Finance actions.
Retain Joint Finance actions.

13) Hospital Rate Increase and Assessment

This is a way to get more federal funds for the Medicaid program and encourage more hospitals to serve people on Medicaid.

What is needed: Support the Governor’s proposal to raise federal funds through the rate increase and assessment.

Raises about $400 million in federal funds by imposing a 1% assessment on gross revenues of inpatient and outpatient hospitals. The assessed fee and the federal funds would be returned to the hospitals serving people on Medicaid or BadgerCare and would also be used to raise reimbursement rates for services.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Delete from budget.
Removed from budget.

14) Medicaid Expansion to Adults without Children

This expansion will help individuals with disabilities and low-income workers, such as direct service staff, without health insurance. It does include premiums and cost shares depending on income.

What is needed: Support the Governor’s initiative and also support comprehensive health insurance reform.

Increase of almost $3 million in state funds and $13 million in federal funds to cover about 60,000 uninsured adults with incomes up to twice the federal poverty limit.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Delete from budget.
Require the Department of Health and Family Services to request a federal waiver and develop program for adults without children.

15) Medicaid/BadgerCare/SeniorCare Pharmacy Benefits Management

The Governor anticipates saving money by having one organization managing prescription drug medications instead of the current system of many organizations.

What is needed: Support the benefits management program with the condition that enrolled individuals’ choices of medications are not restricted.

Decrease of $15 million by contracting with a benefits management organization.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Retain Governor’s proposal.
Retain Governor’s proposal.

16) Medicaid Provider Rates

Providers include direct service workers, doctors, dentists, and therapists.

What is needed: At least 5% increase per year of the budget.

Increase of 1% the first year and 2% the second year in the amount paid to community-based Medicaid and BadgerCare providers for their services. Does not include providers of Medicaid waiver services, such as residential or vocational supports.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Delete from budget.
Increase rates for non-institutional providers by 1% the second year.

17) Mental Health Comprehensive Community Services

Comprehensive Community Services help individuals with significant mental illnesses live in the community.

What is needed: At least $2.5 million to expand access to services.

No increases or cuts.
No increases or cuts.
No increases or cuts.
No increases or cuts.
No increases or cuts.

18) Mental Health Outpatient Services

Many people in jail have mental illnesses. When they leave jail, they continue to need treatment or else they may end up in jail again.

What is needed: At least $4 million in state funds.

Increase of $2 million in state funds to help people with mental illness coming out of jail.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Retain Governor’s proposal.
Retain Governor’s proposal.

19) Mental Health Insurance Parity

Current law allows health insurers to limit the amount of coverage they will provide for mental illnesses.

What is needed: Changes in the law to require health insurers to cover mental illnesses as they cover physical illnesses or disabilities.

Increase from $7,000 to $20,250 the minimum dollar amount of coverage by health insurance policies. Increase from $2,000 to $3,450 the minimum dollar amount of coverage by policies that cover only cover outpatient care.
Delete from budget, will be introduced as separate legislation.
Restore the Governor’s proposal.
Delete from budget.
Removed from budget.

20) Mental Health Wraparound Services

Provides comprehensive care that helps children with serious emotional disorders and their families.

What is needed: At least $1.1 million each year of the budget would expand services to 10 new sites.

No increases or cuts.
No increases or cuts.
No increases or cuts.
No increases or cuts.
No increases or cuts.

21) Milwaukee Initiative

Women with children can have a difficult time getting treatment services in Milwaukee. Young people in Milwaukee leaving the foster care system also have trouble getting treatment services.

What is needed: No position at this time.

$600,000 for organizations providing mental health and substance abuse treatment for women with children and for youth transitioning from foster care to independent living.
Delete Governor's proposal and instead provide $100,000 in Milwaukee County for youth transitioning from foster care to independent living.
Retain Joint Finance actions.
Delete Joint Finance actions from budget.
  Removed from budget.

22) Tobacco Tax

Funding for smoking cessation programs will be substantially increased. Reimbursement of Medicaid costs will help keep the Medicaid program solvent.

What is needed: Support the Governor’s initiative.

Increase the tax on tobacco products (cigarettes, chewing tobacco, etc.) by $1.25 a pack for smoking cessation programs and reimbursement of Medicaid costs associated with smoking.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Delete tax from budget.
Increase the tax on cigarettes by $1 a pack and increase tax on other tobacco products; designate funding for smoking cessation and Medicaid programs.

23) Health Savings Accounts

Eligible individuals covered by high-deductible health insurance plans can make pre-tax contributions to accounts and use the savings to pay for medical care expenses.

Not included in budget.
Not included in budget.
Not included in budget.
Created in budget.
  Created in budget.

24) Healthy Wisconsin Plan

Comprehensive, affordable, universal health care system where costs are shared between employers and employees.

What is needed: Comprehensive health care reform.

Not included in budget.
Not included in budget.
Included in budget. See the Senate Democrats website for more information.
Not included in budget.
  Removed from budget.

25) Public Defender

Adults subject to involuntary civil commitment, protective placement, or involuntary administration of psychotropic medications are provided with a public defender.

No changes to current law.
No changes to current law.
No changes to current law.
Public defenders are provided to people only after they are found to be indigent (poor.)
  People are entitled to a public defender prior to being found indigent.

1) Milwaukee Student Achievement Improvement Plan

Many children with and without disabilities drop out before graduation from Milwaukee public schools.

What is needed: No position at this time.

$15 million in state funds to improve student achievement and graduation rates in Milwaukee schools.
Retain Governor’s proposal in budget.
Retain Governor’s proposal.
Retain Governor’s proposal.
  Provide $10 million each year of budget to improve student achievement in Milwaukee schools.

2) School Breakfast Program:

Many public schools provide breakfast for low-income students, including students with disabilities.

What is needed: No position at this time.

Increase of $3.3 million to support an increase in the reimbursement rate to school districts and to fund increase participation in the program.
Retain the Governor’s proposal.
Retain the Governor’s proposal.
Delete from budget.
  Retain Governor’s proposal.

3) Special Education Categorical Aid

State and federal funds help school districts pay for the costs of special education services, such as equipment and aides. The percentage of costs reimbursed continues to drop each biennial budget.

What is needed: Increase of $75 million to maintain and increase the reimbursement rate.

Increase of $53 million in state funds to districts to fund special education services.
Support Governor’s proposal of increase of $53 million.
Retain Governor’s proposal. Add $3.5 million for districts spending a high percentage of their budgets on special education services.
Retain Governor’s proposal.
  Retain Governor’s proposal.

4) Student Achievement Guarantee in Education (SAGE)

Students with disabilities are more likely to be taught in regular classrooms if class sizes are small.

What is needed: Support the Governor’s position.

Increase of $21 million in state funds to increase reimbursement to school districts lowering class sizes in early grades.
Retain Governor’s proposal in budget.
Increase by $27 million over the biennium.
Allow school districts not to participate in the program in grades 2 and 3.
  Retain Senate’s proposal.

5) Transportation Assistance

Transportation is a major portion of the budget for rural school districts and takes resources away from teaching students.

What is needed: Support the Governor’s initiative.

Increase the reimbursement rate to school districts for students traveling 12 miles or more to and from school from $180 to $220 per student.
Support the Governor’s proposal.
Retain the Governor’s proposal.
Increase of $14 million over the biennium to raise reimbursement rates to $17 - $350 per student.
  Retain Governor’s proposal.

6) Autism Scholarship Program

Allows parents of eligible children with autism to apply for scholarships to pay tuition for the children to attend private special education programs.

What is needed: Support the Governor’s initiative.

Not included in budget.
Not included in budget.
Not included in budget.
Created in budget.
  Not included in budget.

7) Aid to High Poverty Districts

Provides additional funding for school districts with at least 50% of students eligible for free or reduced-price lunch.

Not included in budget.
Not included in budget.
Addition of $21 million for poor school districts (approximately 23 districts would be eligible.)
Not included in budget.
  Retain the Senate’s proposal.

8) Aid to Small Rural Districts

Creates a new categorical aid program for school districts that meet certain criteria.

Not included in budget.
Not included in budget.
Addition of $7.3 million over the biennium for rural districts.
Not included in budget.
  Increase of $3.6 million the second year of the budget.

1) Elderly and Disabled Transportation Aids

The funding is distributed to counties to provide specialized transportation to people who are elderly or have disabilities.

What is needed: At least $6 million to improve access to vital transportation services.

Increase funding by 2% each year of the biennium ($265,900 the first year and $537,100 the second year.)
Support the Governor's increase of 2% each year of the biennium.
Increase funding by 2.5% each year of the biennium ($332,400 the first year and $673,100 the second year.)
Retain Governor’s proposal.
  Retain Governor’s proposal.