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1
HOUSE RESOLUTION

 
2    WHEREAS, The Department of Children and Family Services is
3required by the Children and Family Services Act [20 ILCS
4505/7] to place children in its care in safe and adequate
5placements consistent with each child's health, safety, and
6best interests; and
 
7    WHEREAS, The Department of Children and Family Services has
8adopted rules, entitled "Placement Selection Criteria", [89
9Ill. Adm. Code Part 301.60] that provide that "all placement
10decisions will be made consistent with the safety, best
11interests and special needs of the child" and that
12consideration shall be given to, "the least restrictive setting
13appropriate for the child which most closely approximates a
14family"; and
 
15    WHEREAS, The Department of Children and Family Services has
16adopted procedures, entitled "Psychiatric Hospitalization,
17Basic Premises Regarding Psychiatric Hospitalization" [DCFS
18Procedures 301.110(b)], that provide that "a psychiatric
19hospitalization is not a placement" and that "discharge and
20placement planning shall begin from the moment of admission";
21and
 
22    WHEREAS, The Department of Children and Family Services is

 

 

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1the party to a federal court consent decree [B.H. et al., 88 C
25599, N.D. ILL] that provides that emergency shelter placements
3"shall be limited to 30 days"; and
 
4    WHEREAS, Children in the custody of the Department of
5Children and Family Services are being left in psychiatric
6hospitals after their treatment is complete because there is
7insufficient in-state capacity in the types of the programs the
8children need, including residential treatment centers and
9specialized and therapeutic foster homes; and
 
10    WHEREAS, The cost of leaving children in psychiatric
11hospitals is significantly higher than providing the care the
12children actually need and is not subject to federal
13reimbursement pursuant to Title IV-E; therefore, be it
 
14    RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE
15HUNDRED FIRST GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that
16the Auditor General is directed to conduct a performance audit
17of the Department of Children and Family Services to review and
18assess the Department's ability to meet the placement needs of
19the children in its custody and its compliance with its
20obligations to place children in its care in placements
21consistent with their best interests and to make
22recommendations regarding how the Department can develop a
23responsive behavioral health continuum of care process that

 

 

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1produces good outcomes for children and families in Illinois;
2and be it further
 
3    RESOLVED, That the audit include, but not be limited to,
4the following:
5        (1) A review and analysis of systems issues impacting
6    the timely and appropriate placement of children in the
7    custody of the Department of Children and Family Services,
8    including, but not limited to:
9            (a) The current referral and admission process for
10    children and youth requiring placement in a residential
11    treatment center;
12            (b) The role of residential treatment centers in
13    the continuum of care;
14            (c) The evidence-based models currently utilized
15    in residential treatment settings;
16            (d) Identification of any gaps in the continuum of
17    care from psychiatric hospitalization to traditional
18    foster care/home settings;
19            (e) The status of the Department's progress toward
20    achieving appropriate and timely step-down placements for
21    children at any stage in the continuum of care; and
22            (f) How priorities should be changed to ensure
23    timely access to appropriate residential and foster care
24    resources;
25        (2) A review and analysis of how youth enter and exit

 

 

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1    residential treatment programs, including, but not limited
2    to, the following:
3            (a) The number of youth who entered a residential
4    placement in the last 10 fiscal years;
5            (b) The number of youth who entered residential
6    settings outside of Illinois;
7            (c) The number of planned and unplanned exits from
8    residential treatment by type (for example, child was
9    psychiatrically hospitalized, placed in a foster home,
10    returned to parent, etc.);
11            (d) A description of the current step-down process
12    from residential treatment;
13            (e) A description of how the Department determines
14    appropriate clinical placements for youth needing
15    residential care; and
16            (f) Recommendations regarding changes that should
17    be made to the process of matching children to the
18    appropriate clinical setting, including timeframes;
19        (3) A review and analysis of date tracking of outcomes
20    for children in psychiatric hospitals longer than
21    necessary, including, but not limited to:
22            (a) How demographic and clinical data regarding
23    children in psychiatric hospitals longer than necessary is
24    collected, made available, and utilized; and
25            (b) The current demographic of children in the
26    residential care service continuum, including youth who

 

 

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1    are in psychiatric hospitals longer than necessary, on
2    waiting lists for residential placements, and in
3    residential placements ready for step-down, including:
4                1. Ethnicity
5                2. Gender
6                3. Age
7                4. Geographic origin
8                5. Permanency goal
9                6. Current residential placement if applicable
10                7. Case management responsibilities
11                8. Diagnosis
12                9. Length of stay
13                10. Length of stay beyond targeted discharge
14    date;
15        (4) A review and analysis of the following contracting
16    and monitoring issues impacting the timely and appropriate
17    placement of children in the custody of the Department of
18    Children and Family Services, including, but not limited
19    to:
20            (a) An assessment of current residential bed
21    capacity and utilization; what capacity and utilization
22    are needed to meet the demand? Are there facilities with
23    unused physical capacity that could be utilized if need was
24    determined?;
25            (b) Analysis of the effectiveness of the current
26    funding structure, including analysis of the no-decline

 

 

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1    and bed hold component in contracts;
2            (c) How residential specialty population providers
3    are identified in the matching process;
4            (d) How community-based behavioral health
5    resources are identified, quantified, and evaluated; and
6            (e) Whether community-based behavioral health
7    organizations have adequate resources (funding, staff,
8    equipment, facilities, training, etc.) to achieve
9    appropriate service delivery and timely placements for
10    youth;
11        (5) A review and analysis of the following contracting
12    and monitoring issues impacting the timely and appropriate
13    placement of children in the Department's custody,
14    including, but not limited to:
15            (a) How residential programs are monitored. What
16    dashboards are utilized? Are the outcome measures
17    quantitative or qualitative? Are the measures effective?
18    What outcome measures should be utilized?;
19            (b) The current performance of Illinois'
20    residential continuum of care and how it compares to
21    generally accepted national practice standards and outcome
22    measures; and
23            (c) Residential continuum of care systems in other
24    comparable jurisdictions in terms of costs of staff by
25    type, overall costs and other cost centers; and be it
26    further
 

 

 

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1    RESOLVED, That the Department of Children and Family
2Services shall cooperate fully and promptly with the Auditor
3General's Office in conducting this audit; and be it further
 
4    RESOLVED, That the Auditor General commence this audit as
5soon as possible and distribute the report upon completion in
6accordance with Section 3-14 of the Illinois State Auditing
7Act; and be it further
 
8    RESOLVED, That a copy of this resolution be delivered to
9the Auditor General and the Illinois Department of Children and
10Family Services.