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Cuts to Medicaid and local government spending proposed under Gov. Scott Walker’s 2011-13 budget threaten the state’s publicly-funded mental health system. In Wisconsin, a state once seen as a leader in providing mental health services, the system has already become fragmented and underfunded, according to a new investigation by the Wisconsin Center for Investigative Journalism.

To balance the state budget, the state Department of Health Services plans to cut $500 million over the next two years from the Medicaid program, which pays for much of Wisconsin’s taxpayer-funded mental health care. State Rep. Sandy Pasch (D-Whitefish Bay), a member of the Assembly’s committee on public health, estimates Medicaid cuts could leave 65,000 Wisconsin residents without subsidized health insurance to pay for mental health treatment.

“Services have been underfunded with the current budget, and now we’re going to see a $500 million cut to providing essential services to vulnerable populations,” she says. “When resources start becoming more and more scarce, my experience being a psychiatric nurse for 30 years is that mental health services are one of the first things to get cut.”

Walker’s proposals to cut local government aid and freeze local property taxes, thereby blocking officials from making up lost funding by raising taxes, also threaten the state’s publicly-funded mental health system. According to William Orth, director of the Sauk County Department of Human Services, “This could devastate mental health and substance abuse (services).”

In 2009, 100,238 people received taxpayer-subsidized mental health services through their local county, according to the nonpartisan Legislative Fiscal Bureau. Between counties, there is significant variation in funding for mental health care and the quality of services. County boards decide what to offer and how many people they can afford to help.

Throughout the state, services for children and teenagers are already lacking, and the system is complex and difficult to navigate, making it hard for people to get the right treatment when they need it, many observers say.

Walker’s health secretary, Dennis Smith, says the state will focus its mental health care dollars on models that are centered on people’s needs, community-based and statistically proven to work.

But some advocates are leery about how Smith would manage a $500 million cut to the state’s health services for the poor. While serving as a senior fellow at the Heritage Foundation, a conservative think tank in Washington, D.C., Smith encouraged states to opt out of Medicaid to save money and shed federal control over health care spending.

In one of his first moves as DHS secretary, Smith announced a freeze in enrollment for BadgerCare Basic, which covers adults without dependent children.

Donovan’s story

Donovan Richards first attempted to take his own life at age 4. The Wisconsin boy, who has bipolar disorder and autism, had already been kicked out of three day care programs. His doctors were sure he would be in an institution before he turned 10.

To get the intensive treatment her son needed but she could not afford, Paula Buege, Donovan’s mom, had to win approval from a review board made up of Dane County officials.

“My argument was, ‘If we don’t help him now, you’re going to read about him in the paper one day,’” said Buege, of Middleton, who now helps the parents of mentally ill children with a Madison-based nonprofit, Wisconsin Family Ties.

After years of treatment, Donovan, now 17, plays in a band and wants to be a music teacher. And he has not been hospitalized for mental health problems in 10 years.

Buege says if she loses Medicaid benefits, she could not afford medications and psychiatrists – the tools that keep her son mentally well instead of mentally ill.

Hugh Davis, executive director of Wisconsin Family Ties, says one of the biggest problems he sees is a lack of adequate mental health care for children and teenagers. The Madison-based group helps families with children who suffer from emotional, behavioral and mental disorders.

Buege says she’s glad that when her son needed it the most, the help was there.

“My kid is living proof. He would be costing us all a lot of money right now if we didn’t get those services,” she said. “And instead he’s going to be a taxpaying member of society.”

Center reporter Kate Golden contributed to this report. The nonprofit Wisconsin Center for Investigative Journalism (www.WisconsinWatch.org) collaborates with Wisconsin Public Television, Wisconsin Public Radio and the UW-Madison School of Journalism and Mass Communication and other news media. Lauren Hasler is at lhasler@wisconsinwatch.org.

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