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"Hear's" to Life!

News, Information and Ideas on how to deal with hearing loss in a hearing world. Plus a few other topics!

Medicaid/Healthcare Numbers in Wisconsin - How do they look?

First off, I would like to thank all of those that took the time to send me emails and talk with me regarding how Mental Health impacts your life or that of someone that you know. I must admit that I was not expecting the number of communications that I’ve received over the past week. 

Secondly (here’s the disclaimer part!), I want to make sure that everyone reading this realizes that even though I have hearing loss, I have no training or background when it comes to mental health issues. I am on a committee trying to increase access for those with hearing loss/blindness/deafness and I must commend all of the other members of the committee for allowing me to obtain information, statistics and ask many questions that I’m sure were thought of as totally ignorant. But, then again, if you don’t ask, how are you going to learn?

One of the key questions in our meetings was that of trust. How do we get those that are already in a situation of not being looked upon by many in our society as being ‘normal’, take that first big step of actually trusting someone to help them? For those of you that don’t have hearing or vision challenges that actually impact how you live your daily life, I’m sure that this is something that you never think about. In my case, when a stranger learns that I have hearing loss or I don’t understand something they are saying, I usually get put into the category of not being up to par with their expectations. In other words, if I can’t hear very well, I must not be on their intelligence level. While it is frustrating to be looked upon as not an equal in their world, it’s also an opportunity for me to take the time to try and explain how I do things. At least most of the time. For a lot of us, this also adds to our perspective that it is best to not put ourselves ‘out there’ as well as limiting ourselves to who we can actually ‘trust’. I call it my Survivor skill. 

While I hate to put myself in the category of being ‘disabled’, it sometimes feels like others put me there without all of the facts. Evidently, I am not the only one that feels this way based on the reader responses I’ve received this week. I will try and do a synopsis of the email comments regarding mental health in a couple of weeks for those interested. In the meantime, I thought that you might be interested in some data specifically for Wisconsin.

Let’s look at some facts regarding how Medicaid programs are used  just in the State of Wisconsin. All of these were obtained via several sources. I will do my best to add those sources in also should you want to do some further research.

Based on the 1998 DHHS Publication SMA-99-3285, pp. 99-111 from the U.S. Government Printing Office, there were approximately 4,313,555 residents of Wisconsin over the age of 18. Of this number, 232,932 were deemed as having a Serious Mental Illness. This equates to about 5.4% of adults. Children aged 5-18 came out to 106,149 in the State. That equates to about 11%. When you look at the numbers broken down by County, Dane, Milwaukee and Waukesha had the highest numbers. Keeping in mind that all of this data is from 1998, I’m sure that we’ve seen some changes in the numbers. Unfortunately, it takes a while before our Government resources are updated.

Why is the number/percentages higher for Children in our state? When you look at the resources available for children via their educational institutions, requirements for doctor visits to obtain things like vaccinations, ect., it becomes quite obvious that they are seen by medical professionals more than adults are. 

Out of these numbers, an estimated 90,000 children and adults in our state with severe mental illness use Medicaid Services. Medicaid pays for approximately 28% of mental health services for persons served in the public mental health system.

In 2009, only 3.2% of children with severe emotional disturbance (SED) received public mental health services in Wisconsin. Over the past 2 years, the number of children served by the public mental health system in Wisconsin decreased by 499.

Of the seven states in the upper Midwest (Illinois, Indiana, Iowa, Michigan, Minnesota & Ohio), Wisconsin has the lowest rate of children (ages 0-17) served by the public mental health system. The data above came from the CMHS Uniform Reporting System, FY 2009, p. 8.

There were 9800 children and young adults (ages 0-21) with severe disabilities utilizing the Wisconsin Medicaid Community based supports and medical coverage.

An additional 3,000 children are on waiting lists for community support. In other words, their insurance either doesn’t cover this type of treatment or they have no insurance at all. 

According to the latest U.S. Census, approximately 790,917 Wisconsinites over age 5, or 16% have some form of disability. Three percent of these individuals identity as having some form of self-care disability (for example – trouble dressing or bathing). Of those 16 and older with disabilities, 6.4% have difficulty going outside the home.

The Wisconsin programs affiliated with Family Care, Partnership and Pace help over 12,000 people with developmental disabilities and 5,509 people with physical disabilities stay independent at home and in their communities. In addition, nearly 3,000 people with disabilities are enrolled in IRIS (Include, Respect, I Self-Direct). This is the statewide self-directed supports waiver program.

COP and CIA Waiver funds provide community based services and supports up to 5,934 adults with disabilities.

Family Care, Partnership, Pace and IRIS help over 18,000 Seniors stay independent at home and in their communities. By 2035, 22.3% of Wisconsinites will be over the age of 65. Some counties here in Wisconsin will have over 30% of their population at age 65+. To keep the costs of long-term care manageable with a rapidly aging population, we must manage resources wisely. Family Care has shown that it can be a cost-effective community investment.

Ninety Thousand Wisconsin seniors rely on SeniorCare for affordable prescription drugs, 84% of the funding for SeniorCare goes to Seniors who are under the 200% poverty level (as of now). SeniorCare is the only option for many seniors in rural areas where few pharmacists accept Part D coverage (Medicare).

BadgerCare Plus was enacted in 2007 to merge the state’s 3 Medicaid programs for children, parents and pregnant women into one health coverage program. It was implemented to make sure that 98% of Wisconsin residents have access to quality, affordable health care.

BadgerCare provides health insurance for over 750,000 women, men and children, including families with children under age 19 and household incomes of less than 200 percent of the federal poverty level (approx. $36,600/yr. for a family of three) without access to employer-provided insurance. 

More than 60% of total expenses incurred under BadgerCare are covered by Federal Medicaid dollars. Through this partnership, Wisconsin draws down billions in federal funding enabling our limited state funds to go farther and serve more people. According to the Kaiser Family Foundation, Wisconsin’s total Medicaid spending for FY2009 was $5,926,000,000 - $1,082,000,000 from General Funds and $3,914,000,000 from Federal Funds. 

Medicaid is the single largest source of long-term care coverage and financing. Long-Term care services, including nursing home care and Family Care now comprise approximately 45% of total Wisconsin Medicaid expenses.

Traditionally Medicaid had an institutional bias. The 2009 AARP ‘Across the States’ study found that 72% of Medicaid spending went towards nursing home care. The report also noted that, on average, Medicaid dollars can support nearly 3 older adults or persons with disabilities in home and community based settings for every 1 person in a nursing home facility. Home and community-based care (Family Care, IRIS, Personal Care, Waiver Programs) is generally more cost effective and preferred by consumers. In other words, if you are thinking about trying to stay in your home or that of a family member vs. going into a nursing home, it’s more cost efficient. But, the report also did not look at the cost to mental health for the family members or caregivers involved in this scenario.

As of the end of January 2011, there were about 1.16 million Wisconsinites on Medicaid-related programs, including 775,000 on BadgerCare, 193,000 Seniors and people with disabilities, more than 90,000 on SeniorCare, and about 57,000 receiving family planning services.

During the same month, 36,947 Wisconsin residents were eligible under a Community Medicaid Waiver program and 20,581 Medicaid recipients were institutionalized in facilities of some kind. 

Older adults and people with disabilities accounted for 20% of Medicaid enrollment and 67% of spending, while BadgerCare Plus (including Core), the Well Woman program and MA for foster care kids accounting for 80% of enrollment and 33% of spending.

Despite the rapid growth of BadgerCare and Medicaid in Wisconsin, 2009 Census Bureau figures show that the percentage of people who get their primary insurance coverage through Medicaid was lower in Wisconsin than the National average. (WCCF Analysis of 2009 data from the American Community Survey)

Medicaid supports salaries of thousands of working people in community programs, treatment centers, nursing homes, doctors’ offices, health clinics, daycare centers, transportation programs, school and public health programs, as well as employment services for people with disabilities. Needless to say, with the budget cuts being looked at, we will have to figure out how to keep all of this going. If anyone has any ideas, please feel free to send them to me.

Here’s a chart/wrap-up on the Overall Wisconsin Medicaid Enrollment – By Category – as of December 2010 in Wisconsin.

Children under age 19           408,878

Parents/Caretakers of Children   218,897

Pregnant Women          18,344

Youths exiting out of homecare    259

Income Ext – Child Support and Earned Income Extensions     81,614

Exp Enroll – PW (Express enrollment for pregnant women)   474

Exp Enroll – Children (Express enrollment for Children)    208

Core Plan (Adults without dependent children)    46,984

BadgerCare Plus – Subtotals (excludes Family Planning Waiver)     775,658

SSI (Receiving or deemed to be receiving an SSI payment)      100,910

SSI-related (Meet SSI income and asset req’s, but not recv. SSI)    16,536

Institutionalized (nursing home or long term care institution)    20,581

Waiver (eligible under a community waiver program)   36,947

MAPP (Medicaid Purchase Plan)    17,659

Family Care Non-MA (Eligible for Family Care (non-MA)     14

Senior Care 3 (prescription drug coverage for low income elderly)   88,949

Elderly and Disabled Coverage – Subtotals        281,596

Other Coverage Subtotal (Medicare Beneficiaries, Foster Care, Subsidized Adoption,

FPW & BC + Basic  101,899

Source: www.forwardhealth.wi.gov

So, as you can see, we’ve got a lot of people needing a lot of help just in Wisconsin. I thought that you might like to see what the numbers look like. In our everyday lives, you don’t see many articles on what exactly is happening in Wisconsin when it comes to things like the State/Federal Health Care Programs. 

Many thanks to the many people that helped me to obtain the information. I know that when I look at these huge numbers, it’s mentally exhausting. 

Have a great week!

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