Wisconsin Governor Tony Evers has vetoed Assembly Bill 541, which would have allowed mental telehealth services offered by out-of-state providers to continue within the state–echoing similar rulings across the US in recent years. The bill, which received bipartisan support in the Assembly when it was passed in January, aimed to refine and extend an executive order originally put in place by Evers during the height of the COVID-19 pandemic. Both supporters and opponents of the bill released statements indicating that they would continue debating the policy and the broader scope of online mental health care in sessions to come.
Analysis
Originally brought to the Wisconsin State Legislature in October of 2023, Bill 541 was co-sponsored by a bipartisan group of ten representatives and five state senators. Passing with a vote of 25-7 in January of 2024, Governor Evers elected to veto the bill in late March after the legislative session had ended.
The Governor expressed his concern that making the policy permanent would undercut state licensing laws for healthcare practitioners and leave patients vulnerable if they received substandard care or were the victim of unethical practice. “I cannot support legislation that is likely to ultimately reduce healthcare quality and patient protections for Wisconsinites across our state,” said Evers in his veto statement.
Key Points
The Institute for Reforming Government (IRG), a Wisconsin public policy analysis group that supported the bill, offered the following counterpoints to the veto:
- Wisconsin currently lacks the infrastructure to manage the mental health crisis within the state. The bill would have provided vital access for patients unable to find a provider in their local community.
- There is currently limited evidence to suggest that Wisconsin patients received substandard care from out-of-state providers while the governor’s executive order was in place.
- The bill itself did include provisions regulating out of state providers such that as a requirement the provider be in good standing within their home state, and the provider notifies the Department of Safety and Professional Services of their intent to practice within the state of Wisconsin.
Those opposed, including the Wisconsin Association of Family and Children’s Agencies, the National Alliance on Mental Health Wisconsin, and the state chapter of the National Association of Social Workers, are backing the veto based on the following:
- Due to the rapid growth of telehealth offerings, patients may find themselves working with providers who lack useful knowledge of the region where their patients reside, impacting the quality of care.
- Rather than opening Wisconsin markets to an unlimited number of out-of-state providers, the state should invest in the growth of state-based care and services.
- Other options, such as the recently established interstate compact, allow professional counselors in partner states to practice within Wisconsin, provided a more organized pathway to increasing telehealth services that included more robust oversight by state-specific oversight committees.
“Online therapy is a little bit of the wild, wild west. You don’t know who’s where, or who’s certified or licensed where,” said Mary Kay Battaglia, Executive Director of the National Alliance on Mental Illness Wisconsin. “We just want to make sure it’s good quality care and that the people they’re talking to also understand how they would access crisis services if they were in a mental health crisis.”
Conclusion
Although Bill 541 is no longer active, supporters intend to revive it during the next legislative session. The IRG noted that while they support the growth of the local care system, extending the allowance for out-of-state providers would help manage the state-wide mental health crisis while the necessary training and licensing barriers are developed to fully support the state from within. In the meantime, Wisconsinites will join the growing list of people to receive mental healthcare exclusively from in-state providers.