A health care system which is financially and geographically accessible to the residents of the state. Where problems exist, the state should work in concert with individuals, and public and private organizations at local, state and national levels to rectify those conditions which make services inaccessible to some residents.
Selective state involvement in activities to increase the availability of basic health care services in underserved areas. For example, the state should work with local community groups to attract health care providers to underserved areas.
State government involvement in a coordinated information/referral service dealing with available health care services. State involvement should be tied into existing county or agency networks and should not duplicate systems already in place.
A public health system with responsibility shared by both state and local governments. State government should identify a limited number of basic public health services which must be provided by local units of government; localities could augment these services to suit community needs. The state should assist in financing public health services; at a minimum state financial support should be made available for mandated services.
A continued state role in the health insurance field to include consumer education and some regulation of benefit offerings. State government has a major role to play in educating the public about the advantages and disadvantages of different forms of health insurance. It should take action to encourage employers to offer both traditional and alternative forms of health insurance (such as health maintenance organizations) so that individuals may select the health insurance best suited to their needs. The state should continue to require that health insurance sold in the state offer a limited number of essential benefits to ensure that basic health services are covered no matter what plan is selected.
State government involvement in the development of a program of health insurance for the uninsured. State government should develop ways to provide coverage for uninsured residents. Any state program of health insurance should be designed to meet the needs of a broad segment of residents, including individuals who are unable to purchase health insurance at a reasonable percentage of family income.
State regulation of health care in Wisconsin to protect citizens and to contain costs.
Selective state regulation of hospitals and hospital use. The state should continue its Capital Expenditure Review Program for hospitals. It should continue to inform citizens about hospital rates in Wisconsin. State government health care programs should permit non-hospital treatment where other settings are more cost-effective as long as quality of care is maintained.
State regulation of licensure of health care professionals. The state should continue to insure public health, safety, and welfare through licensure of health care professionals. State government should investigate setting standards for currently unlicensed professionals when licensure might enhance safety and reduce costs to consumers.
State government oversight in payment systems to assure availability of cost-effective choices to consumers. In state-mandated health care programs, payment systems should define covered health care services without reference to type of licensed provider. The state should require private insurance contracts to include coverage for some licensed non-physicians' services to reduce costs and to improve accessibility and availability of health care services.
A state role in aiding individuals to make cost-effective and humane choices in health care. Legislation on living wills should be expanded to include nutrition and hydration as medical treatment which can be refused in advance. Legislation on living wills should be extended to allow for withdrawal/withholding life sustaining treatment in the event of permanent vegetative state. The state should serve as a resource agency for individuals and organizations by providing information about extraordinary treatments available; it should assist in the maintenance of organ networks and registries. The state should promote the use of hospital ethics committees to help patients, families, and staff in difficult decisions and to reduce use of the courts.
Active state government involvement in programs which emphasize prevention. The state should allocate monies to programs that promote health and prevent disease.
Adequate funding for community support programs in order to provide adequate mental health care services for persons with mental illness in Wisconsin.
Community-based care when it meets the treatment needs of the client as a cost-effective alternative to institutional care. We believe treatment should be eligible for federal funding in addition to current state and local funding. The need to expand existent community based services—especially in the area of case management service to meet consumer needs and with an emphasis on specialized housing.
State-mandated benefits requiring private insurance companies to provide funding for community-based programs for the mentally ill. We believe that insurance companies should provide payments for participation in these programs, equally as they do for other types of inpatient and outpatient treatment.
Coordinated community based mental health services for children and adolescents with emphasis on early treatment and prevention. In a well-coordinated delivery system, professional information would be shared, ensuring that duplication of services does not occur while client confidentiality is protected.
A civil commitment law which provides that in order to be civilly committed an individual must be: Mentally ill, drug or alcohol dependent, or developmentally disabled, and a “proper subject for treatment” and dangerous as defined by paragraph 51.20(1)(a) Wis. Stats. The four criteria for dangerousness are:
- Probability of harm to self shown by recent threats or attempts at suicide or serious bodily harm.
- Probability of physical harm to others as shown by recent violent behavior or threats placing others in reasonable fear of harm.
- Probability of physical impairment or injury due to impaired judgment shown by a recent pattern of behavior.
- Probability of serious physical harm because mental illness impairs the ability to satisfy basic needs. [See 51.20 (1) (a) 2.a,b,c,d,. Wis. Stats.]
We believe the enforcement of the “dangerousness standard” allows early intervention when judges and attorneys are educated and trained to uniformly and consistently apply mental health law.
Measures to assure prompt identification of incarcerated persons with mental illness, including comprehensive training of jail personnel in recognition and care of persons with mental illness, assessment and jail diversion decisions by qualified staff, and appropriate treatment whether in jail or another facility.