While the debate around the fate of the Affordable Care Act has dominated the news over the past few months, other threats to health care have been brewing. In Wisconsin, advocates, providers, lawmakers, and individuals and families affected by mental health challenges know that every dollar is crucial when it comes to ensuring that the families in our communities can access mental health services. However, this coming September, the state will submit its application for the FY 2018 federal Mental Health Block Grant (MHBG) with $2.35 million less in funding to work with ($6.39 million in funding for FY 2018 vs $8.44 million in FY 2017).
The federal budget bill for FY 2018 proposed by President Trump would make deep cuts in many federal programs, especially block grants. The risks to programs and services seem particularly clear and imminent for the MHBG, which would be slashed 26% by the Trump budget. That’s because states across the country have been instructed by the federal government to develop their plans for allocating their FFY2018 mental health block grant funds based on the President’s proposed budget.
The MHBG provides funding for states to provide community mental health services especially targeted for adults and children with serious mental health conditions. Wisconsin will be forced to reduce and eliminate funding for a number of programs that provide important mental health services to some of the most vulnerable adults and children throughout Wisconsin.
The cuts Wisconsin would be forced to make include reductions to:
- Family, consumer, and peer support programs
- Early Intervention for First Episode Psychosis
- State operations around program development and administration
In addition, the proposed Wisconsin plan would eliminate MHBG funding for:
- Infant Mental Health Consultation
- Suicide Prevention programming
- County Quality Improvement around reducing inpatient readmissions
- Homeless Access to Mental Health services
- Training for providers of mental health services
- Tribal Best Practices in Co-Occurring Disorders
- Supported Employment Individual Placement and Support (IPS) Model
- Program evaluation
Major program cuts like these, at a time when access to mental health services is already insufficient, would move Wisconsin backwards in terms of its goals to improve and expand mental health services. For example, some of these programs provide support to families and individuals impacted by mental health challenges, allow communities to implement effective suicide prevention initiatives, and provide quality supported employment services that help people work while receiving mental health treatment.
These cuts also illustrate the dangers of the block grant approach in federal funding to states. Many of the mental health programs are being cut to the minimum amount required under state or federal regulations, and may very well have been cut deeper without those protections. Governor Walker and other Republicans continue to tout block grants as an approach to financing Medicaid and health care in general.
The National Alliance on Mental Illness estimates that serious mental illness costs America $193 billion in lost earnings per year. We need to do more to support children, adults, and families affected by mental illness; not cut programs that support access to care and support.
Please stand up for essential mental health programs and let your legislators know that you don’t support cuts to health services, including mental health and Medicaid. Don’t be fooled by promises of increased flexibility, and remember: block grants lead to cuts.
Sashi Gregory and William Parke-Sutherland
