Resolution to Request the State of Wisconsin, in its 2025-27 State Biennial Budget, Provide State General Purpose Revenue (GPR) Funding to Cover the Full Non-Federal Share of MA CSP and Crisis Services

Sauk County (“County”) is concerned that the public mental health

system in Wisconsin is in need of additional resources to respond appropriately to the needs of individuals with persistent mental illness and those experiencing a mental health crisis. 

State law designates counties with the responsibility for the well-being, treatment, and care of individuals with mental illness, and serving those without private insurance coverage. 

The Medical Assistance program (MA) covers an array of mental health services, ranging from office-based therapy to inpatient hospitalization, and many of these services are delivered by counties. 

Community Support Programs (CSP) offer intensive community-based care for adults whose mental illness and functional limitations might otherwise require them to need institutionalized care.  Counties use CSP services to keep people out of extended hospitalizations and support people in the community following emergency detentions. 

Counties are required to provide Crisis intervention services including an emergency mental health services program to serve persons in crisis situations; at a minimum, 24-hour crisis telephone service and 24-hour in-person response on an on-call basis. 

While the state pays the full cost of most MA services, when it comes to county-based CSP and Crisis mental health services, the county finances the cost of the services up front, and receives MA reimbursement for only the federal share for that service. 

Community Aids funding has not kept pace over the years with increased county costs for services, resulting in counties bearing a disproportionate share of CSP and Crisis service costs from county tax levy. 

Counties are limited in their capacity to use tax levy revenue due to state levy limits, so the lack of Community Aids increases combined with strict property tax controls makes it difficult for counties to maintain Crisis and CSP services. 

In addition to the costs to county human service departments, counties and municipalities also incur law enforcement costs to transport and provide security for persons in a crisis. 

The awareness of the 988 National Suicide & Crisis Lifeline has made mental health assessment and referral more readily available, resulting in more demand on the mental health crisis systems. 

Stagnant state funding results in variations in the extent of services available across counties, wait lists for services, and eligible people receiving limited services. 

The limited state funding for Crisis services makes it difficult for counties to implement new evidence-based services, such as mobile crisis workers that could meet law enforcement officers in the field for crisis calls, that would reduce the need for law enforcement involvement and provide a more trauma-informed response to crisis situations. 

Wisconsin’s counties continue to cover the costs of mental health services for individuals who are not Medicaid eligible.