Mental Health

• About the issue
• Why does this matter to people with disabilities?
• Are there any proposals that would make a change in this issue?
• Who can I contact with my questions?
• Background Information For This Issue

About the issue: (Top of page)

People with mental illness often have problems getting treatment. There are two reasons for this. One is finding the right kind of services the person needs and wants. There are a variety of types of services available, but not every service is available in every county. The other problem involves funding. Treatment is paid for either through a public system or a private insurance system.

Public System:

Those using the public system are usually funded by Medicaid or their county. Each county has a Community Support Program (CSP). CSPs are structured programs that use a more medical model. They are limited to people with more serious mental disorders. Because Medicaid requires counties to pay part of the cost of CSPs, there are people waiting for services in a number of counties.

Comprehensive Community Services (CCS) is a newer approach in treatment. The CCS approach is more flexible, person-centered, and based on the person's strengths. This approach is good for people whose needs aren't as severe as those in CSPs. The first CCS program was started in 2004. In 2006, fourteen counties had CCS programs. This means people in 58 counties cannot get into this program.

For some people with mental illness, peer support programs are very helpful. These programs are usually run by people with mental illness. They might be drop-in centers or places that are vocationally oriented. They emphasize recovery and empowerment. But again, these programs exist only in limited areas.

Private Insurance System:

Wisconsin law requires health insurers to provide at least $7000 per year of coverage. In many cases, that is all private insurance will provide. And insurance companies have the right to refuse to offer a policy to a person with mental illness (or any other "pre-existing" condition). Mental health services can be costly. Weekly visits with a mental health professional could use up that amount before years end. And inpatient treatment costs over $1500/day in Wisconsin. To pay for these services out of pocket is often not possible, so people go without.

Why does this matter to people with disabilities? (Top of page)

Mental illness affects one out of five families. Nearly one million people in Wisconsin have some form of mental illness. This includes those with a primary diagnosis of mental illness, those with a "dual diagnosis" such as cognitive disability and mental illness, and those with less severe illnesses. People with disabilities (unless they have Medicaid) often have limited or no insurance coverage for these disorders.

The cost of mental illness to the individual, the family and society is enormous. Mental illness often prevents a person from being productive at work—or even being able to go to work. Half of all visits to doctors are related to mental illness issues. People with mental illness fill more hospital beds than those with cancer, lung and heart disease combined. Suicide is three times more common than murder.

Are there any bills that would make a change in this issue? (Top of page)

• Assembly Bill 173 - Council on Mental Health
  This bill would change the membership of the Council on Mental Health. It currently has 15 members, but under this bill it would expand to at least 21 members but not more than 25. It also changes the representation of groups and agencies on the Council [More on Assembly Bill 173 ]
  Outcome: Hearings held in both the Assembly and Senate. Passed out of committees in both houses. Passed in both the full Assembly and Senate. Signed into law on 3-18-08 and became Act 113.
• Assembly Bill 279 - Protective Placements
  This is a companion bill to Senate bill 153. It makes minor changes to correct incorrect references, etc. to 2005 Wisconsin Acts 264, 387, and 388. These Acts addressed protective placements and protective services, involuntary administration of psycho [More on Assembly Bill 279 ]
  Outcome: This bill was passed by both houses and signed into law in early January 2008. It became Act 45.
• Assembly Bill 417 - Autism Insurance
  This bill requires health insurance policies and self-insured governmental and school district health plans to cover the cost of treatment for autism, Asperger's syndrome, and pervasive developmental disorder not otherwise specified if the treatment is pr [More on Assembly Bill 417 ]
  Outcome: No action was taken on this bill. This issue was addressed by SB 178. See that bill for a status update.
• Assembly Bill 509 - Inpatient Reimbursement Requirement
  This bill would change the inpatient facility reimbursement requirements of counties for their residents with mental illness, developmental disabilities, alcoholic, and other drug dependencies. Currently, counties must pay for the full cost of care, but [More on Assembly Bill 509 ]
  Outcome: Referred to Assembly committee on Health and Healthcare Reform. Failed to get out of committee.
• Senate Bill 40 - Biennial Budget
  This bill is Gov. Doyle's proposed budget. It covers all state spending and revenue. [More on Senate Bill 40 ]
  Outcome: This bill was signed into law on 10-26-07 and became Act 20.
• Senate Bill 144 - MA Eligibility Changes
  This bill makes a number of changes to assets and divestment rules to conform Wisconsin law to federal law when determining eligibility for Medical Assistance (MA). [More on Senate Bill 144 ]
  Outcome: Failed to get out of the Senate committee on Health and Human Services.
• Senate Bill 153 - Protective Services
  This bill makes minor changes to correct incorrect references, etc. to 2005 Wisconsin Acts 264, 387, and 388. These Acts addressed protective placements and protective services, involuntary administration of psychotropic medication, guardianships, conse [More on Senate Bill 153 ]
  Outcome: This bill passed both houses and was signed into law. It became Act 45 in early January 2008.
• Senate Bill 178 - Autism Insurance
  This bill requires health insurance policies and self-insured governmental and school district health plans to cover the cost of treatment for autism, Asperger's syndrome, and pervasive developmental disorders if the treatment is provided by a qualified [More on Senate Bill 178 ]
  Outcome: Had a Senate hearing, passed out of committee, was amended, and passed the Senate. It was referred to the Assembly, where it never got out of committee.
• Senate Bill 268 - Care Facilities
  This bill would change the process by which care facilities are licensed. An applicant for a community care facility, such as a CBRF, would have to form a community advisory committee. The majority of the people on this committee would be people from th [More on Senate Bill 268 ]
  Outcome: Failed to get out of Senate committee on Economic Development, Job Creation, etc.
• Senate Bill 375 - Mental Health Parity
  This bill requires that insurance policies provide the same coverage for mental health and mental illness as they do for physical, illness or injury. [More on Senate Bill 375 ]
  Outcome: Had a Senate hearing, passed out of committee, was referred to the Joint Finance Committee, and never got out of committee.

Who can I contact with my questions? (Top of page)

John Shaw
Wisconsin Council on Developmental Disabilities
201 W. Washington Avenue
Madison WI 53703-2796
Phone: Voice (608) 266-7707; TDD (608) 266-6660
Email: shawj2@dhfs.state.wi.us
Fax: (608) 267-3906

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Background Information For This Issue (Top of page)

• Mental Illness Waiver
• Making the Case for CCS
• Mental Health Association of Wisconsin
• Mental Health America
• NAMI Wisconsin
• NAMI National
• Wisconsin Family Ties
• Wisconsin Council on Mental Health
• Dual Diagnosis Workgroup
• Parity Fact Sheets
• History of Parity Legislation
• Join the Mental Health Listserv (The mental health community has developed a listserv to help keep the community connected. To become a member of the listserv send an email to Shel Gross at shelgross@tds.net and in the subject line put "Add to Parity Listserve" . Then, in the body of the email indicate whether you are a consumer, a Mental Health provider, or a family member.)