MADISON— In his 2023 State of the State address, Gov. Tony Evers declared 2023 the Year of Mental Health, and today, as the nation recognizes Mental Health Awareness Month, the governor highlighted his 2023-25 biennial budget initiatives to invest $500 million in mental and behavioral health services for kids, workers, farmers, veterans, Wisconsinites working to overcome substance use disorders, and to support the state’s mental and behavioral health workforce.

“With our state’s historic surplus, we have a historic opportunity and responsibility to make critical investments to address the pressing challenges facing our state. These past few years have been especially difficult for our kids, families, and folks across Wisconsin, and the mental and behavioral health challenges facing our state today will have disastrous consequences for generations,” said Gov. Evers.

“As budget deliberations are set to begin this week, I urge the Legislature to support these important investments, including expanding access to school-based mental health services, providing more options for substance use disorders, and bolstering our mental and behavioral health workforce. We cannot afford to look back months or years from now and regret that more wasn’t done sooner—I call on the Legislature to join me in giving this crisis the urgent attention, action, and investment it deserves.”

Tomorrow, Tues., May 2, the Joint Committee on Finance is expected to meet in the first executive session of the budget process, where they will begin debating and voting on provisions in the governor’s budget. According to a meeting notice sent on Friday, Republican committee members are expected to remove more than 540 provisions from the governor’s budget, including several aimed at supporting and expanding mental and behavioral health across the state. Among provisions expected to be removed tomorrow include measures to provide $270 million to continue school-based mental health services through “Get Kids Ahead,” $4 million to support the purchase of opioid antagonists, such as Narcan, used to reverse opioid overdoses, more than $3.2 million to support stimulant prevention and treatment efforts, and $1 million for a statewide suicide prevention program.

In February, the Centers for Disease Control and Prevention released the Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021, reporting that in 2021, more than 40 percent of high school students felt so sad or hopeless nearly every day for at least two weeks in a row that they stopped doing their usual activities, one in 10 students attempted suicide, and nearly one in five students seriously considered attempting suicide. Further, nearly 60 percent of teen girls felt persistently sad or hopeless—nearly double the rate for teen boys, nearly a third of teen girls seriously considered attempting suicide, about 70 percent of LGBTQ students experienced persistent feelings of sadness or hopelessness, and more than 20 percent of LGBTQ students attempted suicide.

In addition to troubling statistics regarding youth and student mental health, adults have similarly struggled in recent years. Since launching last July, callers to Wisconsin’s new 988 Suicide & Crisis Lifeline have reported struggling with suicidal thoughts and intent, as well as challenges with mental health, substance use, and interpersonal or relationship issues and abuse. The state has also seen record-high rates of substance use and overdose deaths, with more than 1,500 Wisconsinites having lost their lives to an overdose in 2020 alone. Compounded with findings from a 2022 report by the University of Wisconsin Population Health Institute that indicated there are 440 people for each mental health provider in Wisconsin, the need to take urgent action to address the state’s mental health needs has never been more important.   

Of the more than $500 million in Gov. Evers’ 2023-25 biennial budget to expand mental and behavioral health services, the governor is proposing more than $270 million to make his “Get Kids Ahead” initiative a permanent, ongoing program to ensure kids across Wisconsin have access to school-based mental health services and can bring their best, full selves to the classroom. More information about the governor’s “Get Kids Ahead” proposal is available here.

Additionally, the governor’s 2023-25 executive budget proposal will propose significant investments in developing robust prevention strategies to reduce suicide, self-harm, and other mental and behavioral health-related injuries, including providing more than $3 million for the 988 Suicide & Crisis Lifeline call center, creating a suicide prevention program to coordinate suicide prevention activities, develop educational materials, and conduct suicide prevention training, and increasing support for peer-run and community-based services across the state. 

A full list of Gov. Evers’ $500 million in mental and behavioral investments by state agency is provided below.  

Department of Health Services  

    Crisis Urgent Care & Observation Center Grant Program  
        Provide $64,700 general purpose revenue (GPR) in fiscal year (FY) 2024 and $10,038,500 GPR in FY25 for grants to establish up to two crisis urgent care and observation centers to offer a variety of behavioral health services, accept emergency detention cases, conduct medical clearances, and support up to 15 crisis stabilization beds.  
    Psychiatric Residential Treatment Facility Grant Program  
        Provide $1,790,000 GPR in FY25 for grants to establish a 25-bed psychiatric residential treatment facility to serve children and youths with intensive behavioral health needs. Create a new Medicaid benefit for psychiatric residential treatment facilities.  
    Youth Crisis Stabilization Facilities Funding  
        Provide $996,400 GPR in annual, ongoing state support for the three Youth Crisis Stabilization Facilities.  
    Deaf, Hard of Hearing, and Deaf-Blind Behavioral Health Treatment Program  
        Provide $1,936,000 GPR in FY25 for a grant to establish a state-wide behavioral health treatment program for individuals who are Deaf, Hard of Hearing, or Deaf-Blind.  
    Peer-Run Respite for Veterans Support  
        Provide $450,000 GPR in annual, ongoing state support for the Peer-Run Respite Center for Veterans.  
    Peer Recovery Centers Support  
        Provide $260,000 GPR annually to supplement existing Peer Recovery Centers and provide funding to support two new Peer Recovery Centers in areas not yet served.  
    988 Suicide & Crisis Lifeline Support  
        Provide $898,700 GPR in FY24 and $2,105,700 GPR in FY25 to cover operating costs of the state’s 988 Suicide & Crisis Lifeline call center.  
Stimulant Prevention & Treatment Programs Support  

        Provide $1,644,000 GPR annually for high-need counties to support stimulant treatment services and for individual trainings at stimulant use prevention programs.  
    Qualified Treatment Trainee Grants Program Expansion  
        Provide $1,576,600 GPR in FY25 to replace current American Rescue Plan Act Treasury dollar investments into the Qualified Treatment Trainee Grant Program, which facilitates the licensure and certification of those obtaining or with a graduate degree in psychology, counseling, marriage and family therapy, social work, nursing, or a closely related field.
    Medicaid Community Support Program Funding  
        Provide $19,733,400 GPR in FY24 and $21,516,500 GPR in FY25 to fund the nonfederal share of the Medicaid Community Support Program with GPR.  This item’s funding amount will be reestimated in the future.  
    Medicaid School Telehealth Origination Cost Reimbursement
        Provide $3,644,900 AF in FY24 and $7,322,000 AF in FY25 for Medicaid to reimburse schools for telehealth origination costs.  
    Medicaid Psychosocial Rehabilitation Benefit  
        Provide $2,027,200 AF in FY25 to create a new Medicaid psychosocial rehabilitation benefit.  
    Medicaid Withdrawal Management and Intoxication Monitoring Benefit  
        Create a new Medicaid benefit for residential intoxication monitoring services, residential withdrawal management programs, and adult residential integrated behavioral health stabilization services (alcohol and other drugs detoxification services).  
    Medicaid Certified Peer Specialists Expansion  
        Provide $3,715,500 AF in FY25 to expand the use of certified peer specialists in the Medicaid program.   
    Medicaid Residential Substance Use Disorder Treatment Room and Board Coverage  
        Provide $8,309,500 GPR in FY24 and $8,309,500 GPR in FY25 for Medicaid to begin covering room and board costs for individuals receiving residential substance use disorder treatment.  
    Injury & Violence Prevention Program Position  
        Provide 1.0 FTE GPR position, $66,800 GPR in FY24, and $87,300 GPR in FY25 to the DHS Injury and Violence Prevention Program to act as the program’s suicide/self-harm prevention coordinator.   
    First Responders Worker’s Compensation Improvements  
        Create statutory language that removes the barriers first responders with Post Traumatic Stress Disorder face when seeking worker’s compensation.   
    Medicaid Autism Treatment Services Rate Increase  
        Provide $4,075,200 all funds (AF) in FY24 and $8,150,400 AF in FY25 for a Medicaid rate increase for certain autism treatment services.   

Additional Medicaid Behavioral Health Services Rate Increases  

        Provide $17,000,000 AF over the biennium for a Medicaid rate increase for various outpatient mental health and substance use services and child/adolescent day treatment.    
    Mendota Juvenile Treatment Center  
        Provide 114.5 FTE program revenue-service (PR-S) positions in FY24 and 174.0 FTE PR-S positions and $24,691,800 PR-S over the biennium to fully staff the expansion of the Mendota Juvenile Treatment Center.    
    Service Animal Training Grants  
        Provide $250,000 GPR to make grants to help providers achieve accreditation from Assistance Dog International for providing PTSD training to service dogs who serve veterans.  
    Office of Children’s Mental Health Support  
        Provide 1.0 FTE position, $63,800 GPR in FY24, and $78,500 GPR in FY25 to the Office of Children’s Mental Health to support carrying out the duties of the office.  
    Suicide Prevention Program  
        Provide $500,000 GPR annually for grants for suicide prevention efforts. Create a suicide prevention program to coordinate suicide prevention activities, develop educational materials, provide public awareness campaigns, conduct suicide prevention trainings for those interacting with at-risk individuals, and centralize suicide prevention resources online.  
    Addiction Treatment Platform Funding  
        Provide $30,000 GPR annually to support an online substance use disorder treatment program aggregator which locates, compares, and reviews available substance use disorder treatment programs in the state.  
    Marijuana Excise Tax Revenue Payments to Counties for Behavioral Health Services  
        Direct DHS to distribute marijuana excise tax revenue to the counties to support mental health and substance use disorder services.  
    Mental Health Consultation Program  
        Provide $2,000,000 GPR in FY24 and $2,000,000 GPR in FY25 to expand the existing Child Psychiatry Consultation Program into a broader Mental Health Consultation Program.    
    Maternal and Infant Mortality Prevention Grief and Bereavement Support  
        Provide $200,000 GPR in FY24 and $200,000 GPR in FY25 to expand an initiative that provides grief and bereavement support for families that have lost a fetus or infant.    
    Resilient Wisconsin   
        Provide $1,000,000 GPR over the biennium to convert funding for the Resilient Wisconsin program from FED to GPR.       

Office of the Commissioner of Insurance  

    Balance Billing Regulation  
        Codify the federal No Surprises Act into state law, which protects insured individuals against surprise/balance billing when receiving services outside of their control at either out-of-network facilities or by out-of-network ancillary providers at in-network facilities. Additionally, expand protections to include services provided during a mental health emergency.  
    Qualified Treatment Trainee Coverage Requirement  
        Mandate all health insurance plans cover services provided by a Qualified Treatment Trainee.  
    Substance Use Disorder Counselor Coverage Requirement  
        Mandate all health insurance plans cover services provided by a substance use disorder counselor.   

Department of Public Instruction  

    Comprehensive School Mental Health Aid  
        Provide $117,900,000 AF annually for comprehensive school mental health aid, such as navigators, parent training, and the implementation of best practices.  
    School Mental Health Staff Reimbursement  
        Provide $18,000,000 AF annually to reimburse schools for certain school staff who assist students with mental health issues, such as counselors, school nurses, and social workers.  
    Mental Health Staff Training Funding  
        Provide $580,000 AF annually for staff training in mental health areas.   

Department of Children and Families  

    Wisconsin After 3 Program  
        Increase funding to the Boys and Girls Clubs by $500,000 Temporary Assistance for Needy Families (TANF) funding in each year for the Wisconsin After 3 program to improve the literacy skills and math proficiency for low-income children. Additionally, provide $1,300,000 GPR annually to support youth mental health and substance use prevention.  
    Support for Child Care Setting Behavioral Issues  
        Provide $1,327,200 TANF in FY24 and $1,963,900 in FY25 for social-emotional training and technical assistance in child care settings with the goal of reducing instances of children being removed from daycare for behavioral issues.  
    Continuum of Care – Milwaukee Child Welfare System  
        Provide $1,820,000 GPR in FY24 and $3,640,000 GPR in FY25 for behavioral and mental health services for youth as part of a larger initiative to provide a continuum of care for families in Milwaukee involved with the child welfare system.   
    Tribal Healing to Wellness Court   
        Provide $259,100 Tribal gaming revenues annually to the Oneida Nation for staff and service costs in their Healing to Wellness Court to support a coordinated, post-conviction substance use program that will reduce recidivism and break the cycle of substance use.   

Department of Veterans Affairs  

    Veterans Outreach and Recovery Program  
        Provide $272,300 segregated funds (SEG) in FY24 and $684,900 SEG in FY25, and 7.0 FTE SEG positions to expand the Veterans Outreach and Recovery Program.  The program would expand by 5.0 FTE additional outreach and recovery specialists to work with local partners to provide appropriate recovery supports to aid veterans and 2.0 FTE additional clinical coordinators to conduct mental health diagnosis.   

Department of Military Affairs  

    Comprehensive Wellness Office  
        Provide $821,400 GPR and 11.0 FTE positions to maintain an expansion of the Comprehensive Wellness Office, which is an initiative that takes a comprehensive approach to help Wisconsin citizen Soldiers and Airmen improve not only their mental health but financial, social, spiritual, and physical well-being.   

Medical College of Wisconsin  

    Wisconsin Community Safety Fund  
        Provide $7,500,000 GPR annually to the Medical College of Wisconsin for their Wisconsin Community Safety Fund, which supports local, evidence-informed activities that enhance the safety and well-being of children, youth, and families throughout Wisconsin and aim to prevent violence.