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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
5Strengthening and Transforming Behavioral Health Crisis Care
6in Illinois Act.
 
7    Section 5. Findings. The General Assembly finds that:
8    (1) 1,440 Illinois residents died from suicide in 2021, up
9from 1,358 in 2020 or a 6% increase.
10    (2) An estimated 110,000 Illinois adults struggle with
11schizophrenia, and 220,000 with bipolar disorder.
12    (3) 3,013 Illinois residents died due to opioid overdose
13in 2021, a 2.3% increase from 2020 and a 35.8% increase from
142019.
15    (4) Too many people are experiencing suicidal crises, and
16mental health or substance use-related distress without the
17support and care they need, and the pandemic has amplified
18these challenges for children and adults.
19    (5) On July 16, 2022, the U.S. transitioned the 10-digit
20National Suicide Prevention Lifeline to 9-8-8, an
21easy-to-remember 3-digit number for 24/7 behavioral health
22crisis care.
23    (6) The ultimate goal of the 9-8-8 crisis response system

 

 

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1is to reduce the over-reliance on 9-1-1 and law enforcement
2response to suicide, mental health, or substance use crises,
3so that every Illinoisan is ensured appropriate and supportive
4assistance from trained mental health professionals during his
5or her time of need.
6    (7) The 3 interdependent pillars of the 9-8-8 crisis
7response system include someone to call (Lifeline Call
8Centers), someone to respond (Mobile Crisis Response Teams),
9and somewhere to go (Crisis Receiving and Stabilization
10Centers).
11    (8) The transition to 9-8-8 provides a historic
12opportunity to strengthen and transform the way behavioral
13health crises are treated in Illinois and moves us away from
14criminalizing mental health and substance use disorders and
15treating them as health issues.
16    (9) Having a range of mobile crisis response options has
17the potential to save lives.
18    (10) Individuals who interact with the 9-8-8 crisis
19response system should receive follow-up and be connected to
20local mental health and substance use resources and other
21community supports.
22    (11) Transforming the Illinois behavioral health crisis
23response system will require long-term structural changes and
24investments. These include strengthening core behavioral
25health crisis care services, ensuring rapid post-crisis
26access, increasing coordination across systems and State

 

 

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1agencies, enhancing the behavioral health crisis care
2workforce, and establishing sustainable funding from various
3streams for all dimensions of the crisis response system.
 
4    Section 10. Purpose. The purpose of this Act is to improve
5the quality and access to behavioral health crisis services;
6reduce stigma surrounding suicide, mental health, and
7substance use conditions; provide a behavioral health crisis
8response that is equivalent to the response already provided
9to individuals who require emergency physical health care in
10the State; improve equity in addressing mental health and
11substance use conditions; ensure a culturally and
12linguistically competent response to behavioral health crises
13and saving lives; build a new system of equitable and
14linguistically appropriate behavioral crisis services in which
15all individuals are treated with respect, dignity, cultural
16competence, and humility; and comply with the National Suicide
17Hotline Designation Act of 2020 and the Federal Communication
18Commission's rules adopted July 16, 2020 to ensure that all
19citizens and visitors of the State of Illinois receive a
20consistent level of 9-8-8 and crisis behavioral health
21services no matter where they live, work, or travel in the
22State.
 
23    Section 15. Cost analysis and sources of funding.
24    (a)(1) Subject to appropriation, the Department of Human

 

 

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1Services, Division of Mental Health, shall use an independent
2third-party expert to conduct a cost analysis and determine
3actuarially sound costs associated with developing and
4maintaining a statewide initiative for the coordination and
5delivery of the continuum of behavioral health crisis response
6services in the State, including all of the following:
7            (A) Crisis call centers.
8            (B) Mobile crisis response team services.
9            (C) Crisis receiving and stabilization centers.
10            (D) Follow-up and other acute behavioral health
11        services.
12    (2) The analysis shall include costs that are or can be
13reasonably attributed to, but not limited to:
14        (A) staffing and technological infrastructure
15    enhancements necessary to achieve operational and clinical
16    standards and best practices set forth by the 9-8-8
17    Suicide and Crisis Lifeline;
18        (B) the recruitment of personnel that reflect the
19    demographics of the community served; specialized training
20    of staff to assess and serve people experiencing mental
21    health, substance use, and suicidal crises, including
22    specialized training to serve at-risk communities,
23    including culturally and linguistically competent services
24    for LGBTQ+, racially, ethnically, and linguistically
25    diverse communities;
26        (C) the need to develop staffing that is consistent

 

 

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1    with federal guidelines for mobile crisis response times,
2    based on call volume and the geography served;
3        (D) the provision of call, text, and chat response;
4    mobile crisis response; and follow-up and crisis
5    stabilization services that are in response to the 9-8-8
6    Suicide and Crisis Lifeline;
7        (E) the costs related to developing and maintaining
8    the physical plant, operations, and staffing of crisis
9    receiving and stabilization centers;
10        (F) the provision of data, reporting, participation in
11    evaluations, and related quality improvement activities as
12    may be required;
13        (G) the administration, oversight, and evaluation of
14    the Statewide 9-8-8 Trust Fund;
15        (H) the coordination with 9-1-1, emergency service
16    providers, crisis co-responders, and other system
17    partners, including service providers; and
18        (I) the development of service enhancements or
19    targeted responses to improve outcomes and address gaps
20    and needs.
21    (3) The Department of Human Services, Division of Mental
22Health, and independent third-party experts shall obtain
23meaningful stakeholder engagement on the cost analysis
24conducted in accordance with paragraphs (1) and (2).
25    (b) The Department of Human Services, Division of Mental
26Health, and independent third-party experts, with meaningful

 

 

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1stakeholder engagement, shall provide a set of recommendations
2on multiple sources of funding that could potentially be
3utilized to support a sustainable and comprehensive continuum
4of behavioral health crisis response services.
5    (c) The Department of Human Services, Division of Mental
6Health, may hire an independent third-party expert, amend an
7existing Department of Human Services contract with an
8independent third-party expert, or coordinate with the
9Department of Healthcare and Family Services to amend and
10utilize an independent third-party expert contracted with the
11Department of Healthcare and Family Services.
 
12    Section 20. Behavioral health crisis workforce.
13    (a) The Department of Human Services, Division of Mental
14Health, with meaningful stakeholder engagement shall do all of
15the following:
16        (1) Examine eligibility for participation as an
17    Engagement Specialist under the Division of Mental
18    Health's Crisis Care Continuum Program. As used in this
19    paragraph, "Engagement Specialist" means an individual
20    with the lived experience of recovery from a mental health
21    condition, substance use disorder, or both.
22        (2) Consider many additional experiences, including
23    but not limited to, being a parent or family member of a
24    person with a mental health or substance use disorder,
25    being from a disadvantaged or marginalized population that

 

 

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1    would be valuable to this role and can help provide a more
2    culturally competent crisis response. This includes the
3    need for crisis responders who are African American,
4    Latinx, have been incarcerated, experienced homelessness,
5    identify as LGBTQ+, or are veterans.
6        (3) Consider how that expansion impacts the unique
7    training and support needs of Engagement Specialists from
8    different populations.
9        (4) Allow providers to use their clinical discretion
10    to determine responses by one individual or by a
11    two-person team depending on the nature of the call with
12    access to an Engagement Specialist.
13        (5) Collect feedback on other policies to address the
14    behavioral health workforce issues.
15    (b) The Department of Human Services, Division of Mental
16Health, shall implement a process to obtain meaningful
17stakeholder engagement not later than 6 months after the
18effective date of this Act.
 
19    Section 25. Action plan. Not later than 12 months after
20the effective date of this Act, the Department of Human
21Services, Division of Mental Health, shall submit an action
22plan to the General Assembly on the activities under Sections
2315 and 20 of this Act. The action plan shall be filed
24electronically with the General Assembly, as provided under
25Section 3.1 of the General Assembly Organization Act, and

 

 

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1shall be provided electronically to any member of the General
2Assembly upon request. The action plan shall be published on
3the Department of Human Services' website for the public.
 
4    Section 30. Coordination across State agencies.
5    (a) The Department of Human Services, Division of Mental
6Health, and the Department of Healthcare and Family Services
7shall convene a stakeholder working group immediately after
8the effective date of this Act to develop recommendations to
9coordinate programming and strategies to support a cohesive
10behavioral health crisis response system.
11    (b) The stakeholder working group shall:
12        (1) Identify logistical challenges and solutions and
13    define a process to ensure the Illinois crisis response
14    system established by the Division of Mental Health's
15    Crisis Care Continuum Program and the Department of
16    Healthcare and Family Services' Medicaid Mobile Crisis
17    Response is coordinated across the lifespan.
18        (2) Consider cross-program identification and
19    alignment of providers within geographic regions,
20    messaging regarding the 9-8-8 Suicide and Crisis Lifeline
21    and the Illinois Crisis and Referral Entry Services
22    (CARES) lines, and coordination between disparate program
23    plan goals to ensure that crisis response services are
24    delivered efficiently and without duplication.
25    (c) The stakeholder working group shall at least include

 

 

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1Division of Mental Health Crisis Care Continuum Program
2providers, Pathways to Success providers, parent, and family
3advocates, and associations that represent behavioral health
4providers and shall meet no less than once per month.
5    (d) Not later than 6 months after the effective date of
6this Act, the Department of Human Services, Division of Mental
7Health, in collaboration with the Department of Healthcare and
8Family Services, shall submit an action plan to the General
9Assembly on the activities under Section 30 of this Act. The
10action plan shall be filed electronically with the General
11Assembly, as provided under Section 3.1 of the General
12Assembly Organization Act, and shall be provided
13electronically to any member of the General Assembly upon
14request. The action plan shall be published on the Department
15of Human Services' website for the public.
 
16    Section 99. Effective date. This Act takes effect upon
17becoming law.