Health Care and Milwaukee County

Health Care and
Milwaukee County
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County Budget Expenditures
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County Budget Revenues
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Health and Human Services
Director
DHHS
Behaviorial
Health
Management
Services
Economic
Support
Disablities
Services
Housing
Deliquency
& Courts
County
Health
Programs
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Milwaukee County Budget
Total budget for DHHS: $330 m
Largest of any department in county
State and Federal Revenue: $128 m
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Behavioral Health Division
Day Hospital operations consolidated
into Psychiatric Hospital
EMS under BHD
Outsource housekeeping ($1.2 m)
Increase support for Hilltop ($1.1 m)
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Economic Support Division
State takeover of IM and child care
IM tax levy up 10.5% per state
Space rental at Coggs Center
GA burials continue as in 2009
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Disabilities Services
Expansion of Family Care ($4.5 m)

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Eliminate waiting list for services
Operate Disabilities Resource Center
CMO (least restrictive; most integrated)
Reduce costs of “non-waiver” service
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Housing Division
Supportive Housing Programs
Housing Trust Fund
Supportive Housing Dev Comm

Special Needs Housing Action Team & COC
Homeless Shelters
Domestic Abuse Counseling Services
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Juvenile Corrections
Continue Wraparound, firearms,
chronic re-offense behavior & FOCUS
Enhance siblings of chronic offenders
Alternatives to Corrections (ACE)
Collaborate w/Div of Juv Corrections
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Department on Aging
Continue Family Care
Funding for Senior Meal Program
Operate Senior Centers
Programs
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Uninsured in Milwaukee Co.
GAMP: 1990s to 2008
BadgerCare Plus – Childless Adults
State mandates $6.8 m IGT
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Medicaid Population – Milw Co
251,168 (26% of pop)
BadgerCare Plus: 171,648
BadgerCare Plus Core: 16,079
Other programs: 10,689
SSI eligible: 52,752
*9/30/09
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Hospitals in Heart of City
Community Hospitals Systems, Co.,
PPF, fdns & state to fund consultant
from Human Services Research Institute
of Boston
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Respective roles of current partners
How to fund system & by whom
Should state operate system
How many psychiatric beds are needed
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Mental Health Services
Chapter 51 commitments
Un-reimbursable – uninsured/Medicaid
BHD = IMD (Inst for Mental Disease)
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Police Diversions at BHD
Total Hours Police Diversion Status
Average Event Duration (hours)
349.1
350
300
Hours
250
200
150
100
50
23.3
28.5
9.5
0
0
0
2007
2007- 21 events (6 missing data)
2008
2008- 3 events
2009 (Sept)
2009 - 0 events
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Hospital ER Backlog for BHD
Percent tim e on w ait list status
100
90
80
70
60
50
40
30
20
10
0
Jan
Apr
Total 2007 = 48%
Jul
Oct
Jan
Apr
Total 2008 = 27%
Jul
Oct
Jan
Apr
Jul
Jan-Sep 2009 = 6.0%
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Decisions by the State
Delayed payments from the state

Booked $195.4 m in Medicaid savings
Shifting burden of uncompensated care

State re-bid Medicaid contracts for Badger Care
Plus = lower reimbursement
Adjusting “acuity status” of nursing
home patients quarterly
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Homes closing due to reimbursement rates while
pop grows sicker
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Future Goals
Complete expansion of Family Care
Consolidate mental health services
Find stable support mix for BHD
Expand correctional alternatives
Work with state on public assistance
Grow supportive housing partnerships
Maintain strong EMS system
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