Molly Beck and Lee Bergquist

Milwaukee Journal Sentinel

MADISON – Gov. Tony Evers is proposing more than $100 million in his first state budget to replace lead pipes, reduce water pollution and increase access to dental care for low-income Wisconsin residents.

The proposals come at a time when the Democratic governor also is seeking to expand Medicaid, increase funding for public schools by $1.4 billion and provide middle-class families a 10 percent tax cut.

The plans were first reported by the Associated Press and the Eau Claire Leader-Telegram.

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Under Evers' plan, state officials would be directed to borrow nearly $70 million more over the next two years to create a forgivable loan program for local governments to help pay for the replacement of lead water pipes.

The borrowing also would create a separate grant program that would allow farmers to build infrastructure aimed at reducing pollution and help rid contaminants in the Milwaukee River and St. Louis River in northwest Wisconsin.

Evers' plan comes as the City of Milwaukee continues to address widespread deficiencies in preventing lead poisoning in children.

In September, Milwaukee Mayor Tom Barrett proposed $20 million in the 2019 city budget to address the issue — including replacing lead water pipes.

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Evers' proposal would pay for up to 50 percent of the cost of replacing a lead water service line in Milwaukee if the city qualified for the state program.

The proposed $40 million in bonding could lead to the replacement of 9 percent of the state's 170,000 lead service lines still in use, Evers' officials estimated.

Evers' plans also call for increases in spending and bonding to address runoff pollution in rural areas where soil, manure or fertilizer have contaminated wells and polluted streams, rivers and lakes.

“Increasingly, we have a large number of Wisconsinites, whether you are in rural or urban areas, thanks to a variety of contaminants, are concerned about turning on the tap and drinking the water,” said Todd Ambs, deputy assistant secretary of the Department of Natural Resources.

In Milwaukee and near Superior, Evers is seeking $25 million over two years in additional bonding authority to pay for the state’s share to clean up toxic hot spots in the Milwaukee River and St. Louis River basin.

In Milwaukee, this includes the estuary near Lake Michigan, Ambs said.

The toxic contaminants are so-called “legacy pollutants” where the polluter has never been identified.

The federal government would pay a share of the funding. Ambs said the stumbling block in recent years has been finding the state money to match the federal dollars.

The push to improve water quality is part of Evers' yearlong focus on the issue, having dubbed 2019 the Year of Clean Drinking Water in his recent State of the State address.

Between 2007 and 2010 health departments in Wisconsin tested about 4,000 private wells and found that 47 percent did not meet one or more health-based standards for measures like bacteria, nitrates and heavy metals, according to a study published in the Journal of Environmental Health.

Lead can be found in paint in older homes as well as dust and can enter drinking water when service pipes corrode. Lead is harmful to everyone, but there is no known safe level of lead for a child's blood, according to federal authorities.

To help jump-start upgrades in the state, the Wisconsin Department of Natural Resources under former Gov. Scott Walker provided $26 million in forgivable loans in 2016 and 2017 to communities.

In 2017 and 2018, Walker also allocated about $7 million in state funding for Milwaukee to help cover the costs of removing lead water pipes.

$43M for dental care access

Expanding access to dental care for low-income Wisconsin residents covered by Medicaid also will be included in Evers' 2019-2021 state budget proposal.

The $43 million increase in funding provides more than four times what current funding levels are for programs aimed at providing dental services for low-income residents.

"We are very excited about this package. It’s comprehensive. It’s coming at this problem from many directions," said Matt Crespin, associate director of the Children's Health Alliance of Wisconsin.

The proposal would provide more funding for grants to provide dental care for individuals in low-income households and increase the reimbursement rate for non-profit dental service providers by 50 percent if "they serve a (low-income) patient base of at least 50 percent" according to the Leader-Telegram.

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For-profit providers would receive a 30 percent reimbursement increase if they serve a patient base of at least five percent, the newspaper reported.

More funding also would be included in the state budget for a program that provides dental care to students in public schools. In the last state survey, 18 percent of third-graders have untreated cavities.

Crespin said the state still ranks "near the bottom in access to dental care for kids.”

Current funding levels for the affected programs is $12.2 million. Evers' plan increases funding by $43.3 million.

Evers also is proposing to create a state license for dental therapists in Wisconsin — drawing objections from the Wisconsin Dental Association.

The therapists, who are not licensed dentists, could perform procedures usually reserved for dentists such as filling cavities. Five states including Minnesota and Michigan allow therapists.

Patrick Tepe, a Verona dentist and president of the Wisconsin Dental Association, said the move would take away funding that should go toward reimbursing dentists for performing services for patients on Medicaid, a rate which lags most states.

"Despite consistent claims by advocates for dental therapy that this proposal is revenue-neutral and comes at no cost to taxpayers, the Governor is now proposing directly subsidizing the creation of a dental therapy program," Tepe said in a statement. "Any new money directed toward providers should first go to reimbursing the hard-working dental professionals who already spend time and energy seeing many high-need patients at a significant loss."

Evers in a statement said, "increasing dental access across our state requires a comprehensive approach."

“These are critically important initiatives and I’m proud to invest in these programs that will improve the health and wellness of folks all over Wisconsin," he said.

Crespin said he has not seen an increase or comprehensive package addressing barriers to obtaining dental care in the 15 years he's been working as an advocate for such care.

"It’s huge. The state is prioritizing oral health," he said.

Access to dental care for low-income Wisconsin residents has improved only slightly in recent years.

In 2013, emergency departments at Wisconsin hospitals saw 27,741 patients who were in pain because of dental problems, such as abscesses — an average of 533 a week.

The total was an improvement, but not by much. In 2009, emergency departments in the state saw 29,592 patients for dental problems — an average of 569 a week.

Most of the visits stem from the limited access to dental care for people who are covered by BadgerCare Plus, the state's largest Medicaid program, or for people who are uninsured.

The fees paid to dentists by BadgerCare Plus are among the lowest in the country and typically don't cover dentists' costs. As a result, most dentists do not accept — or strictly limit — the number of patients covered by the program.

It's unclear whether Republicans who control the state Legislature would approve of the proposals. Aides to Assembly Speaker Robin Vos of Rochester and Senate Majority Leader Scott Fitzgerald of Juneau did not say whether the plans would have support.

Guy Boulton and Patrick Marley of the Milwaukee Journal Sentinel contributed to this report.