The Milwaukee County Department of Health and Human Services presented its recommended 2026 budget to the Committee on Finance, detailing program successes, funding sources and proposed service changes that officials said respond to shifting state and federal revenue.

Department Executive Director Shaquille Grama McLean introduced the presentation and said the department is “Together Creating Healthy Communities” across aging, disability, behavioral health, housing, child support and youth services. The department said it serves roughly 1,000 employees and partners with about 4,000 providers.

The nut graf: department finance staff said the 2026 plan relies on three main funding sources — about 26% tax levy, 30% direct revenue (largely Medicaid billing) and 44% federal grants — and warned that reductions in federal and Medicaid reimbursements, plus state rate changes, are forcing difficult trade-offs between mandated services and community programs.

Matt Fortman, chief financial officer for DHHS, told the committee the department aims to limit tax-levy exposure by shifting costs to state and federal sources where possible. “Were about 26% tax levy, 30% direct revenue…and 44% federal grants,” Fortman said. He said tax levy pays for nonmandated programs (senior centers, housing outreach), mandated services not otherwise funded, and the countys share of matched programs.

Fortman described two large budget drivers: an accounting guidance change for the Childrens Long-Term Support (CLTS) program that removed roughly $39 million of expense and revenue from DHHS books but did not reduce services, and a set of roughly $7 million of service cuts concentrated in behavioral health. The presentation said continuation of some behavioral health funding is threatened by lower Medicaid enrollment after pandemic-era flexibilities ended.

On detox services, Fortman said the budget discontinues county funding for the First Step detox program, a longtime local program. When asked what alternatives clients will have, administrators said they have been connecting people to other levels of care, bridge housing and community providers but acknowledged limited options for some individuals.

Behavioral health administrators described expanded crisis-response partnerships and outreach this year, including CART teams pairing clinicians with police and expanded youth mental-health outreach. Mike Lappin, administrator for behavioral health services, said those teams aim to provide “a mental health intervention versus a law enforcement intervention.”

Juvenile corrections funding was a focal point. Fortman said the department had planned for a sharp state rate increase for juvenile corrections placements that would have required deep local cuts; he credited the governors veto of a proposed rate spike for averting an immediate crisis. Fortman warned, however, that the veto holds for two state budget cycles and that further rate increases could again pressure county budgets in 2027.

Other highlights and changes in the recommended budget:
- Housing: completion or rehabilitation of tax-foreclosed homes for affordable sale; opening of supportive housing projects, and a $7.5 million HUD lead remediation grant to be targeted to suburban residents in the county's CDBG jurisdiction.
- Aging and disability: the ADRC logged more than 24,000 calls in the first six months of the year and opened a benefits enrollment center; blood-pressure monitors were added to five senior centers.
- Child welfare and youth: DHHS reported reducing the statewide CLTS wait list from about 700 to roughly 50 children and raised CLTS audit compliance from 44% two years ago to 92.3% this year.
- Veterans: local veteran services processed more than 1,100 federal benefits claims and nearly 1,500 state applications with a staff of four FTEs.

Fortman outlined position changes funded by state grants in several program areas and said behavioral health services will reduce eight FTEs, including two unfilled positions, due to funding declines. He said the department will consolidate some administrative functions to share resources across agencies.

Why it matters: DHHS leaders told the finance committee that continued reductions in federal and Medicaid revenues would push the county to cut nonmandated programs that local officials and community partners view as prevention and supports. Grama McLean urged collaborative, cross-sector planning to sustain services.

Looking ahead: Fortman said the department will return with more detailed financial reports and that staff are preparing for policy recommendations, additional grant pursuits and public reporting to mitigate future funding gaps.

Speakers quoted in this article spoke during the DHHS presentations and question period that began with the department's opening remarks and continued through the committee's discussion.