Department of Health Services: Funding awarded to cover room and board costs for residential treatment of opioid use disorder for Medicaid members

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An estimated 1,100 Wisconsin Medicaid members with a opioid use disorder will access residential treatment this year, thanks to $2.5 million in Department of Health Services (DHS) grants to agencies serving 54 counties and four tribes. Funding from Opioid Settlement Dollars will be used to cover room and board costs for this benefit. Federal law prohibits Medicaid from reimbursing residential substance use disorder treatment providers for a client’s room and board costs. Lack of funds to cover room and board costs is the primary reason Medicaid members do not enroll in this level of treatment.

Funding for room and board was included in Governor Evers’ 2021-23 biennial budget, but was not approved by the legislature. These grants awarded today are funded by Wisconsin’s share of a multi-state settlement with McKinsey & Company, a global consulting firm that for years fueled the nationwide opioid epidemic through his work with opioid drug manufacturers. DHS is receiving $10.4 million over five years from this settlement. Funds must be invested in strategies to address Wisconsin’s opioid epidemic.

“Room and board costs for residential treatment for substance use disorders can be prohibitively expensive for Medicaid members, meaning many people can’t get the care they need,” said DHS Secretary-designate Karen Timberlake. “Currently, some counties and tribes cover these costs, but not all are able to do so, resulting in unequal and inequitable access to residential treatment services. The flexibilities offered by opioid settlement funds allow us to remove a significant barrier to this critical benefit designed to help Medicaid members move forward on their recovery journey.

Residential Treatment for Substance Use Disorders may include assessment and treatment planning, case management, individual and group counselling, medication therapy, nursing services, peer support and recovery coaching. The services provided are tailored to the client’s needs.

View the list of county and tribal agencies that have received grants.(link is external) Grant amounts are based on the estimated number of people to be served by each county or tribe through the end of 2022, room and board rate for contracted residential substance use disorder treatment provider and the average length of stay of a guest. county or tribe.

All counties and tribes were invited to apply for funding. Requests exceeded available funds. The scholarships have been distributed on a pro-rata basis to ensure that all applicants receive funding.

Medicaid members with an opioid use disorder who require financial assistance with room and board costs for residential treatment should contact their county health and human services agency or tribal.

The DHS plan for the McKinsey & Company settlement also includes:

  • Prevention programs for Black and Native American communities, which have been disproportionately impacted by the opioid epidemic. This project will address the root causes of harmful opioid use, including stress caused by systemic marginalization, oppression, exclusion, and trauma, through partnerships with groups that work directly with these populations . This funding will be awarded to community organizations through an application process that is expected to open later this year.
  • Mobile harm reduction teams to reduce the negative consequences of harmful opioid use. This project will create teams of public health and human services personnel who can be sent to areas of the state experiencing a spike in opioid overdoses. These harm reduction teams will focus on strategies to reduce deaths from opioid abuse. They will also work to reduce the spread and damage caused by diseases like hepatitis C and HIV. The coordinator for this effort has been hired. The process of hiring staff for each team is underway.
  • Short-term and long-term housing for people in recovery. This project will add an option for people in recovery from substance use disorders to use the existing housing voucher program run by the Wisconsin Department of Administration in partnership with continuum of care agencies across the country. to better support people’s access to affordable, stable and secure housing. . It will also create a housing option that provides additional services such as classes to help people with activities of daily living, employment training and support for people who have successfully recovered. This funding will be made available to interested continuum of care agencies and recovery residences through an application process expected to open by this fall.
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