SB0347 EngrossedLRB102 13799 KTG 19149 b

1    AN ACT concerning mental health.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. Short title. This Act may be cited as the
5Alternatives to Crisis Escalation (ACE) Act.
6    Section 5. Purpose. This Act is intended to strengthen and
7bring community awareness to underutilized Medicaid mental
8health and substance use crisis response services, called
9adult mobile crisis response services, to enable timely
10community-based stabilization, symptom management, and
11connection to treatment before crisis symptoms escalate to an
12emergent level, and to enable similar crisis response services
13for anyone regardless of insurance status.
14    Section 10. Public awareness campaign. The Department of
15Public Health, or a third-party contractor with experience in
16successful public education and awareness campaigns selected
17by the Department of Public Health, shall develop and lead a
182-year educational campaign within each of Illinois' 11 health
19regions on the availability of adult mobile crisis response
20services within each region and how to access such services.
21The Department of Public Health shall develop and implement
22this public awareness and educational campaign in



SB0347 Engrossed- 2 -LRB102 13799 KTG 19149 b

1collaboration with community stakeholders, including the types
2of organizations and individuals listed in paragraph (5), the
3Department of Healthcare and Family Services, and the
4Department of Human Services. This campaign shall align with
5and be coordinated with any rollout of a centralized 988
6crisis line in Illinois for the development of a coordinated
7mental health and substance use crisis response system of care
8and to ensure aligned messaging around such services. Such a
9campaign shall also take into account crisis services, if any,
10offered under Section 15, and shall begin by no later than
11January 1, 2022.
12        (1) The public awareness campaign shall be culturally
13    competent and locally tailored to ensure local buy-in and
14    community understanding and use of adult mobile crisis
15    response services.
16        (2) Any written public or community awareness
17    materials must be written in plain, easy-to-understand
18    language, and shall be available in multiple languages
19    that are representative of the communities in a particular
20    health region.
21        (3) All written or visual materials, videos, webinars,
22    presentations, social media, or other methods of
23    communication or marketing used for increasing community
24    awareness and public support and use of adult mobile
25    crisis response services shall be specifically tailored
26    for different types of community stakeholders or



SB0347 Engrossed- 3 -LRB102 13799 KTG 19149 b

1    audiences, including, but not limited to, healthcare
2    providers, law enforcement, and community groups, for
3    purposes of increasing support for and use of such
4    services.
5        (4) The public awareness and educational campaign
6    shall be directed toward community entities and actors,
7    including, but not limited to, those listed in paragraph
8    (5), that are likely to come into contact with individuals
9    in crisis or that have broad community involvement and
10    support, as well as to individuals who might seek mental
11    health or substance use crisis support services.
12        (5) The following types of stakeholders shall be
13    included as partner-stakeholders in the development of the
14    campaign:
15            (A) Individuals who have or might use adult mobile
16        crisis response services.
17            (B) Mental health and substance use disorder
18        organizations representing individuals and family
19        members, including peer support networks.
20            (C) Hospitals and primary care clinics.
21            (D) Local law enforcement, including units trained
22        in crisis intervention team training.
23            (E) Law enforcement associations.
24            (F) The Illinois Law Enforcement Training
25        Standards Board.
26            (G) The Illinois State Police.



SB0347 Engrossed- 4 -LRB102 13799 KTG 19149 b

1            (H) Local fire departments.
2            (I) Municipalities.
3            (J) Faith-based organizations.
4            (K) Food pantries.
5            (L) Homeless shelters.
6            (M) Local public officials.
7            (N) Nursing homes, specialized mental health
8        rehabilitation facilities, and facilities that qualify
9        as an institution for mental diseases as defined in 42
10        U.S.C. 1369(d)(i).
11            (N) Other community organizations or providers
12        that may come into frequent contact with individuals
13        in a mental health or substance use crisis, or that
14        have broad community support and involvement.
15    Section 15. Enabling universal access to adult mobile
16crisis response services. Subject to appropriation, the
17Department of Human Services shall establish a grant program
18for purposes of providing adult mobile crisis response
19services to any adult age 18 or older experiencing a mental
20health or substance use crisis regardless of insurance status.
21The adult mobile crisis response services covered by this
22grant shall mirror the adult mobile crisis services covered by
23Illinois' Medicaid program at a minimum. Such grant shall also
24cover linkage, case management, and any wrap around treatment
25and support services that are medically necessary for up to 90



SB0347 Engrossed- 5 -LRB102 13799 KTG 19149 b

1days following a mental health or substance use crisis. Such
2grant shall also support the service provider's work on
3enrolling the individual in Medicaid if they are eligible for
4enrollment. The grant services covered in accordance with this
5Section shall not be used to pay for adult mobile crisis
6response services or other services for individuals enrolled
7in Illinois' Medicaid program, or for individuals whose
8private insurance plan covers similar mobile crisis response
9or wrap around services. The Department of Human Services'
10Division of Mental Health and Division of Substance Use
11Prevention and Recovery shall convene a working group of
12providers and other stakeholders for purposes of receiving
13meaningful input on development of the grant program covered
14by this Section to ensure that there is no duplication of
15services, and to avoid placing any unnecessary barriers that
16impede access to crisis response services. This grant program
17for adult mobile crisis response services shall not replace or
18diminish existing Department of Human Services grants for
19crisis services, and are intended to fill the gap in mobile
20crisis response services for individuals not covered by
22    Section 20. Strengthening CARES line capacity and
23implementing best practices.
24    (a) By no later than one year after the effective date of
25this Act, the Department of Healthcare and Family Services,



SB0347 Engrossed- 6 -LRB102 13799 KTG 19149 b

1with meaningful stakeholder input and input from states and
2localities across the country that have implemented nationally
3recognized or emerging best practices in crisis response
4systems of care, shall do all of the following:
5        (1) Develop and implement training and protocols for
6    individuals answering crisis calls to the Crisis and
7    Referral Entry Services (CARES) line that support and
8    enable providing triage and de-escalation to CARES line
9    callers when appropriate and safe. The Department of
10    Healthcare and Family Services shall ensure that CARES
11    line call takers are trained mental health professionals,
12    which may also include peers who are individuals with a
13    lived experience of a mental health or substance use
14    condition.
15        (2) Develop and implement protocols and training for
16    CARES line staff to conduct quality control and caller
17    satisfaction follow up.
18        (3) Ensure coordination of adult mobile crisis
19    response services and CARES line services with other
20    existing and future crisis response services and hotlines,
21    such as any future 988 centralized crisis line that may be
22    established.
23    (b) By no later than one year after the effective date of
24this Act, the Department of Healthcare and Family Services,
25with meaningful input from adult mobile crisis response and
26CARES line providers and organizations representing



SB0347 Engrossed- 7 -LRB102 13799 KTG 19149 b

1individuals and families with lived experience of mental
2health and substance use conditions, shall identify crisis
3response policies and practices that must be standardized
4across providers to ensure quality and consistency of crisis
5response care, and shall identify strategies to expand
6staffing for CARES line call takers to reduce wait times. Any
7standardization of policies and practices must also allow for
8variability to ensure the ability to effectively provide these
9services in a manner that reflects the unique needs of the
10communities served in each health region.
11    (c) The Department of Healthcare and Family Services shall
12convene a workgroup that includes the appropriate stakeholders
13to help inform the development and implementation of this
15    Section 25. Use of data to strengthen CARES line responses
16and adult mobile crisis response services.
17    (a) The Department of Healthcare and Family Services shall
18annually track the following data related to CARES line calls
19for purposes of developing a crisis response system of care in
20each of Illinois' 11 health regions.
21        (1) The number and percentage of calls to the CARES
22    line by adults in a mental health crisis by health region.
23        (2) The number and percentage of calls to the CARES
24    line by adults in a substance use crisis by health region.
25        (3) The number and percentage of CARES line calls for



SB0347 Engrossed- 8 -LRB102 13799 KTG 19149 b

1    which adult mobile crisis response services were rejected
2    or not provided and why.
3        (4) The annual percentage increase or decrease from
4    the previous year in CARES line calls for mental health
5    crises and for substance use crises following the first
6    year of data collection.
7        (5) The number of callers to the CARES line who needed
8    to be referred to a second provider due to a wait list or
9    the inability to access timely services.
10    (b) The Department of Healthcare and Family Services shall
11track the following data annually related to adult mobile
12crisis response services by using the data reported by adult
13mobile crisis response providers of such services on the
14Illinois Medicaid Crisis Assessment Tool.
15        (1) Demographics (race, gender expression, and
16    Illinois health region of residence) for individuals who
17    received adult mobile crisis response services.
18        (2) The number of providers delivering adult mobile
19    crisis response services in each of Illinois' 11 health
20    regions, and the zip codes in which they operate.
21        (3) The number and percentage of adult mobile crisis
22    response services calls that involved law enforcement,
23    including transportation services and safety risks.
24        (4) The types of mental health or substance use
25    services to which individuals are linked and the
26    percentage of that type of linkage through the year



SB0347 Engrossed- 9 -LRB102 13799 KTG 19149 b

1    following receiving adult mobile crisis response services,
2    including:
3            (A) Hospital emergency rooms.
4            (B) Inpatient hospitalization.
5            (C) Crisis stabilization or triage units.
6            (D) Detoxification services.
7            (E) Substance use disorder residential treatment.
8            (F) Outpatient substance use disorder treatment.
9            (G) Living room services.
10            (H) Assertive community treatment.
11            (I) Community support treatment.
12            (J) Case management.
13            (K) Individual or group mental health or substance
14        use services.
15            (L) Placement in a nursing home, an institution
16        for mental diseases, or a specialized mental health
17        rehabilitation facility.
18    (c) The data collected under this Section shall be
19reported annually on the official website of the Department of
20Healthcare and Family Services by July 1st of each year
21beginning in calendar year 2022.
22    Section 30. Rulemaking Authority. The Departments of
23Public Health, Human Services, and Healthcare and Family
24Services shall adopt, within one year after the effective date
25of this Act, any rules necessary to implement the provisions



SB0347 Engrossed- 10 -LRB102 13799 KTG 19149 b

1of this Act.
2    Section 99. Effective date. This Act takes effect upon
3becoming law.