Gov. Tony Evers (D) yesterday signed the 2021-2023 state budget bill into law. Before signing the bill, Evers used his broad veto authority to make 50, mostly minor changes to the state’s two-year spending plan, which was largely reshaped by the Republican-controlled Legislature over the past few months. Click here to review the Governor’s full veto message.

Most importantly to WiAHC members, we are thrilled to report the Governor maintained our home healthcare Medicaid reimbursement rate increase that was added by the Legislature – and the provision is now state law!

This is obviously great news that illustrates the power of effective advocacy. Thank you to all WiAHC members that contacted their legislators on this important issue or helped in other significant ways to achieve this major legislative win.

The final $87.5 billion budget bill contains more than $2 billion in individual income tax cuts, $650 million property tax relief, and provides $129 million in broadband funding. In addition, the budget includes a number of health care-related items that may be of interest to WiAHC members, including:

• Medicaid
• • Home Health Reimbursement Rate: Provide a budgeted sum of $473,300 as the state share of payments, and provide the matching federal share of payments, in 2021-22, and by a budgeted sum of $960,200, as the state share of payments and provide the matching federal share  of payments, in 2022-23, for the Department to increase the Medical Assistance rates paid for nursing care in home health agencies for dates of services beginning January 1, 2022. Specify that funding is to support licensed practical nurses, registered nurses, and nurse practitioners in home health agencies that are licensed under s. 50.49 of the statutes.
  • Medical Assistance Cost-to-Continue Estimate: Provide funding of $1,361,991,300 in 2021-22 and $1,258,573,900 in 2022-23. In addition, adjust the cost-to-continue reestimate to provide $25,900,000  in 2021-22 and $51,400,000 in 2022-23, reflecting the impact of the Department's proposed rate increase to managed care organizations providing services under Family Care, PACE, and Partnership, subject to approval by the federal Centers for Medicare and Medicaid Services.
  • Nursing Home Reimbursement: Provide $82,034,300 in 2021-22 and $170,375,400 in 2022-23 to increase reimbursement rates paid to skilled nursing facilities and intermediate care facilities for individuals with intellectual disabilities.
    
  • Direct Care Workforce Funding: Provide $53,835,800 in 2021-22 and $50,403,200 in 2022-23 to increase funding for the direct care workforce funding supplement. 
    
  • Personal Care Reimbursement: Provide $18,904,300 in 2021-22 and $59,369,300 in 2022-23 to increase hourly rates paid for personal care services to $20.69 on January 1, 2022, and to $22.35 on January 1, 2023.
    
  • Postpartum Eligibility Extension: Provide $2,500,000 in 2022-23 to reflect the estimated cost of extending benefits, for women enrolled in MA as pregnant women, until the last day of the month in which the 90th day after the last day of the month that the end of the pregnancy falls, instead of the 60th day under current law.
  • Outpatient Mental Health and Substance Abuse Services and Child-Adolescent Day Treatment Reimbursement: Provide $6,628,100 in 2021- 22 and $13,256,200 in 2022-23 for a 15% increase to reimbursement rates for outpatient mental health and substance abuse services, effective January 1, 2022; and provide $1,335,600 in 2021-22 and $2,671,200 in 2022-23 for a 20% increase to reimbursement rates for child and adolescent day treatment services, effective January 1, 2022. 
    
  • Medication-Assisted Treatment: Provide $1,224,400 in 2021-22 and $2,448,700 in 2022-23 to increase MA reimbursement rates for opioid treatment providers by 5% and increase rates for opioid-related patient evaluation and management (office visits) provided by primary care providers by $5 per visit.
  • MA Dental Reimbursement: Provide $15,432,800 in 2021-22 and $30,865,800 in 2022-23 to increase MA dental reimbursement rates by 40%, effective January 1, 2022. 

• Public Health
• • Community Health Center Grants: Increase grant funding for federally qualified health centers (FQHCs) by $1,000,000 annually. 
    
  • Grants to Free and Charitable Clinics: Increase grant funding for free and charitable clinics by $1,000,000 annually. 
    
  • Lead Screening and Outreach Grants: Provide $50,000 annually to increase a grant for lead screening and outreach activities provided by a community based human service agency that provides primary health care, health education, and social services to low-income individuals in the City of Milwaukee, from $125,000 to $175,000. 

• Elder and Disability Services
• • Birth to 3: Provide $1,125,000 annually in order for the Department to meet its federal Individuals with Disabilities Education Act (IDEA) maintenance of effort (MOE) requirement for the Birth to 3 program in the 2021-23 biennium.  

• Community Based Behavioral Health
• • Child Psychiatry Consultation Program: Provide $500,000 in 2022-23 to increase from $1,500,000 to $2,000,000 the funding for the child psychiatry consultation program in that year.
  • Medication-Assisted Treatment Expansion: Provide $500,000 in 2021-22 and $1,000,000 in 2022-23 in the Joint Committee on Finance supplemental appropriation for medication-assisted treatment. 
    
  • Methamphetamine Addiction Treatment Grants: Provide $150,000 in 2021-22 and $300,000 in 2022-23 in the Joint Committee on Finance supplemental appropriation for training for substance use disorder treatment providers on treatment models for methamphetamine addiction.  
  • Substance Use Disorder Treatment Platform: Provide $300,000 in 2022-23 in the Joint Committee on Finance supplemental appropriation for development of a substance use disorder treatment platform that allows for the comparison of treatment programs in the state. 
    
  • Behavioral Health Bed Tracker: Provide $50,000 in 2021-22 and $20,000 in 2022-23 to expand the purposes of the current psychiatric bed tracking system to include information on the availability of space for peer run respite beds and crisis stabilization beds. 
    
  • Behavioral Health Trainee Provider Grants: Provide $250,000 GPR in 2022-23 in the appropriation for treatment program grants, to increase total funding for the program in that year to $750,000. Modify the program to: (a) specify that the Department may expend any available federal moneys received for this program; (b) require the Department to distribute a total of $750,000 per year, beginning in 2022-23; and (c) renumber the appropriation so that it is included as an appropriation under mental health and substance abuse services instead of under public health.  

• 
  
• Department of Children and Families:
• • Wisconsin Shares Child Care Subsidies: Increase funding for direct child care subsidies by $11,000,000 FED in 2021-22 and by $18,200,000 in 2022-23 so that the reimbursement rates would fully pay the price of at least 65 percent of the slots for children within the licensed capacity of all child care providers.