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1 | AN ACT concerning mental health.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 1. Short title. This Act may be cited as the | ||||||
5 | Strengthening and Transforming Behavioral Health Crisis Care | ||||||
6 | in Illinois Act. | ||||||
7 | Section 5. Findings. The General Assembly finds that: | ||||||
8 | (1) 1,440 Illinois residents died from suicide in 2021, up | ||||||
9 | from 1,358 in 2020 or a 6% increase. | ||||||
10 | (2) An estimated 110,000 Illinois adults struggle with | ||||||
11 | schizophrenia, and 220,000 with bipolar disorder. | ||||||
12 | (3) 3,013 Illinois residents died due to opioid overdose | ||||||
13 | in 2021, a 2.3% increase from 2020 and a 35.8% increase from | ||||||
14 | 2019. | ||||||
15 | (4) Too many people are experiencing suicidal crises, and | ||||||
16 | mental health or substance use-related distress without the | ||||||
17 | support and care they need, and the pandemic has amplified | ||||||
18 | these challenges for children and adults. | ||||||
19 | (5) On July 16, 2022, the U.S. transitioned the 10-digit | ||||||
20 | National Suicide Prevention Lifeline to 9-8-8, an | ||||||
21 | easy-to-remember 3-digit number for 24/7 behavioral health | ||||||
22 | crisis care. | ||||||
23 | (6) The ultimate goal of the 9-8-8 crisis response system |
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1 | is to reduce the over-reliance on 9-1-1 and law enforcement | ||||||
2 | response to suicide, mental health, or substance use crises, | ||||||
3 | so that every Illinoisan is ensured appropriate and supportive | ||||||
4 | assistance from trained mental health professionals during his | ||||||
5 | or her time of need. | ||||||
6 | (7) The 3 interdependent pillars of the 9-8-8 crisis | ||||||
7 | response system include someone to call (Lifeline Call | ||||||
8 | Centers), someone to respond (Mobile Crisis Response Teams), | ||||||
9 | and somewhere to go (Crisis Receiving and Stabilization | ||||||
10 | Centers). | ||||||
11 | (8) The transition to 9-8-8 provides a historic | ||||||
12 | opportunity to strengthen and transform the way behavioral | ||||||
13 | health crises are treated in Illinois and moves us away from | ||||||
14 | criminalizing mental health and substance use disorders and | ||||||
15 | treating them as health issues. | ||||||
16 | (9) Having a range of mobile crisis response options has | ||||||
17 | the potential to save lives. | ||||||
18 | (10) Individuals who interact with the 9-8-8 crisis | ||||||
19 | response system should receive follow-up and be connected to | ||||||
20 | local mental health and substance use resources and other | ||||||
21 | community supports. | ||||||
22 | (11) Transforming the Illinois behavioral health crisis | ||||||
23 | response system will require long-term structural changes and | ||||||
24 | investments. These include strengthening core behavioral | ||||||
25 | health crisis care services, ensuring rapid post-crisis | ||||||
26 | access, increasing coordination across systems and State |
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1 | agencies, enhancing the behavioral health crisis care | ||||||
2 | workforce, and establishing sustainable funding from various | ||||||
3 | streams for all dimensions of the crisis response system. | ||||||
4 | Section 10. Purpose. The purpose of this Act is to improve | ||||||
5 | the quality and access to behavioral health crisis services; | ||||||
6 | reduce stigma surrounding suicide, mental health, and | ||||||
7 | substance use conditions; provide a behavioral health crisis | ||||||
8 | response that is equivalent to the response already provided | ||||||
9 | to individuals who require emergency physical health care in | ||||||
10 | the State; improve equity in addressing mental health and | ||||||
11 | substance use conditions; ensure a culturally and | ||||||
12 | linguistically competent response to behavioral health crises | ||||||
13 | and saving lives; build a new system of equitable and | ||||||
14 | linguistically appropriate behavioral crisis services in which | ||||||
15 | all individuals are treated with respect, dignity, cultural | ||||||
16 | competence, and humility; and comply with the National Suicide | ||||||
17 | Hotline Designation Act of 2020 and the Federal Communication | ||||||
18 | Commission's rules adopted July 16, 2020 to ensure that all | ||||||
19 | citizens and visitors of the State of Illinois receive a | ||||||
20 | consistent level of 9-8-8 and crisis behavioral health | ||||||
21 | services no matter where they live, work, or travel in the | ||||||
22 | State. | ||||||
23 | Section 15. Cost analysis and sources of funding. | ||||||
24 | (a)(1) Subject to appropriation, the Department of Human |
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1 | Services, Division of Mental Health, shall use an independent | ||||||
2 | third-party expert to conduct a cost analysis and determine | ||||||
3 | actuarially sound costs associated with developing and | ||||||
4 | maintaining a statewide initiative for the coordination and | ||||||
5 | delivery of the continuum of behavioral health crisis response | ||||||
6 | services 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 | ||||||
13 | reasonably 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 | ||||||
22 | Health, and independent third-party experts shall obtain | ||||||
23 | meaningful stakeholder engagement on the cost analysis | ||||||
24 | conducted in accordance with paragraphs (1) and (2). | ||||||
25 | (b) The Department of Human Services, Division of Mental | ||||||
26 | Health, and independent third-party experts, with meaningful |
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1 | stakeholder engagement, shall provide a set of recommendations | ||||||
2 | on multiple sources of funding that could potentially be | ||||||
3 | utilized to support a sustainable and comprehensive continuum | ||||||
4 | of behavioral health crisis response services. | ||||||
5 | (c) The Department of Human Services, Division of Mental | ||||||
6 | Health, may hire an independent third-party expert, amend an | ||||||
7 | existing Department of Human Services contract with an | ||||||
8 | independent third-party expert, or coordinate with the | ||||||
9 | Department of Healthcare and Family Services to amend and | ||||||
10 | utilize an independent third-party expert contracted with the | ||||||
11 | Department of Healthcare and Family Services. | ||||||
12 | Section 20. Behavioral health crisis workforce. | ||||||
13 | (a) The Department of Human Services, Division of Mental | ||||||
14 | Health, with meaningful stakeholder engagement shall do all of | ||||||
15 | the 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 | ||||||
16 | Health, shall implement a process to obtain meaningful | ||||||
17 | stakeholder engagement not later than 6 months after the | ||||||
18 | effective date of this Act. | ||||||
19 | Section 25. Action plan. Not later than 12 months after | ||||||
20 | the effective date of this Act, the Department of Human | ||||||
21 | Services, Division of Mental Health, shall submit an action | ||||||
22 | plan to the General Assembly on the activities under Sections | ||||||
23 | 15 and 20 of this Act. The action plan shall be filed | ||||||
24 | electronically with the General Assembly, as provided under | ||||||
25 | Section 3.1 of the General Assembly Organization Act, and |
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1 | shall be provided electronically to any member of the General | ||||||
2 | Assembly upon request. The action plan shall be published on | ||||||
3 | the 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 | ||||||
6 | Health, and the Department of Healthcare and Family Services | ||||||
7 | shall convene a stakeholder working group immediately after | ||||||
8 | the effective date of this Act to develop recommendations to | ||||||
9 | coordinate programming and strategies to support a cohesive | ||||||
10 | behavioral 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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1 | Division of Mental Health Crisis Care Continuum Program | ||||||
2 | providers, Pathways to Success providers, parent, and family | ||||||
3 | advocates, and associations that represent behavioral health | ||||||
4 | providers and shall meet no less than once per month. | ||||||
5 | (d) Not later than 6 months after the effective date of | ||||||
6 | this Act, the Department of Human Services, Division of Mental | ||||||
7 | Health, in collaboration with the Department of Healthcare and | ||||||
8 | Family Services, shall submit an action plan to the General | ||||||
9 | Assembly on the activities under Section 30 of this Act. The | ||||||
10 | action plan shall be filed electronically with the General | ||||||
11 | Assembly, as provided under Section 3.1 of the General | ||||||
12 | Assembly Organization Act, and shall be provided | ||||||
13 | electronically to any member of the General Assembly upon | ||||||
14 | request. The action plan shall be published on the Department | ||||||
15 | of Human Services' website for the public.
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16 | Section 99. Effective date. This Act takes effect upon | ||||||
17 | becoming law.
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