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Public Act 103-0337 | ||||
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AN ACT concerning mental health.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 1. Short title. This Act may be cited as the | ||||
Strengthening and Transforming Behavioral Health Crisis Care | ||||
in Illinois Act. | ||||
Section 5. Findings. The General Assembly finds that: | ||||
(1) 1,440 Illinois residents died from suicide in 2021, up | ||||
from 1,358 in 2020 or a 6% increase. | ||||
(2) An estimated 110,000 Illinois adults struggle with | ||||
schizophrenia, and 220,000 with bipolar disorder. | ||||
(3) 3,013 Illinois residents died due to opioid overdose | ||||
in 2021, a 2.3% increase from 2020 and a 35.8% increase from | ||||
2019. | ||||
(4) Too many people are experiencing suicidal crises, and | ||||
mental health or substance use-related distress without the | ||||
support and care they need, and the pandemic has amplified | ||||
these challenges for children and adults. | ||||
(5) On July 16, 2022, the U.S. transitioned the 10-digit | ||||
National Suicide Prevention Lifeline to 9-8-8, an | ||||
easy-to-remember 3-digit number for 24/7 behavioral health | ||||
crisis care. | ||||
(6) The ultimate goal of the 9-8-8 crisis response system |
is to reduce the over-reliance on 9-1-1 and law enforcement | ||
response to suicide, mental health, or substance use crises, | ||
so that every Illinoisan is ensured appropriate and supportive | ||
assistance from trained mental health professionals during his | ||
or her time of need. | ||
(7) The 3 interdependent pillars of the 9-8-8 crisis | ||
response system include someone to call (Lifeline Call | ||
Centers), someone to respond (Mobile Crisis Response Teams), | ||
and somewhere to go (Crisis Receiving and Stabilization | ||
Centers). | ||
(8) The transition to 9-8-8 provides a historic | ||
opportunity to strengthen and transform the way behavioral | ||
health crises are treated in Illinois and moves us away from | ||
criminalizing mental health and substance use disorders and | ||
treating them as health issues. | ||
(9) Having a range of mobile crisis response options has | ||
the potential to save lives. | ||
(10) Individuals who interact with the 9-8-8 crisis | ||
response system should receive follow-up and be connected to | ||
local mental health and substance use resources and other | ||
community supports. | ||
(11) Transforming the Illinois behavioral health crisis | ||
response system will require long-term structural changes and | ||
investments. These include strengthening core behavioral | ||
health crisis care services, ensuring rapid post-crisis | ||
access, increasing coordination across systems and State |
agencies, enhancing the behavioral health crisis care | ||
workforce, and establishing sustainable funding from various | ||
streams for all dimensions of the crisis response system. | ||
Section 10. Purpose. The purpose of this Act is to improve | ||
the quality and access to behavioral health crisis services; | ||
reduce stigma surrounding suicide, mental health, and | ||
substance use conditions; provide a behavioral health crisis | ||
response that is equivalent to the response already provided | ||
to individuals who require emergency physical health care in | ||
the State; improve equity in addressing mental health and | ||
substance use conditions; ensure a culturally and | ||
linguistically competent response to behavioral health crises | ||
and saving lives; build a new system of equitable and | ||
linguistically appropriate behavioral crisis services in which | ||
all individuals are treated with respect, dignity, cultural | ||
competence, and humility; and comply with the National Suicide | ||
Hotline Designation Act of 2020 and the Federal Communication | ||
Commission's rules adopted July 16, 2020 to ensure that all | ||
citizens and visitors of the State of Illinois receive a | ||
consistent level of 9-8-8 and crisis behavioral health | ||
services no matter where they live, work, or travel in the | ||
State. | ||
Section 15. Cost analysis and sources of funding. | ||
(a)(1) Subject to appropriation, the Department of Human |
Services, Division of Mental Health, shall use an independent | ||
third-party expert to conduct a cost analysis and determine | ||
sound costs associated with developing and maintaining a | ||
statewide initiative for the coordination and delivery of the | ||
continuum of behavioral health crisis response services in the | ||
State, including all of the following: | ||
(A) Crisis call centers. | ||
(B) Mobile crisis response team services. | ||
(C) Crisis receiving and stabilization centers. | ||
(D) Follow-up and other acute behavioral health | ||
services. | ||
(2) The analysis shall include costs that are or can be | ||
reasonably attributed to, but not limited to: | ||
(A) staffing and technological infrastructure | ||
enhancements necessary to achieve operational and clinical | ||
standards and best practices set forth by the 9-8-8 | ||
Suicide and Crisis Lifeline; | ||
(B) the recruitment of personnel that reflect the | ||
demographics of the community served; specialized training | ||
of staff to assess and serve people experiencing mental | ||
health, substance use, and suicidal crises, including | ||
specialized training to serve at-risk communities, | ||
including culturally and linguistically competent services | ||
for LGBTQ+, racially, ethnically, and linguistically | ||
diverse communities; | ||
(C) the need to develop staffing that is consistent |
with federal guidelines for mobile crisis response times, | ||
based on call volume and the geography served; | ||
(D) the provision of call, text, and chat response; | ||
mobile crisis response; and follow-up and crisis | ||
stabilization services that are in response to the 9-8-8 | ||
Suicide and Crisis Lifeline; | ||
(E) the costs related to developing and maintaining | ||
the physical plant, operations, and staffing of crisis | ||
receiving and stabilization centers; | ||
(F) the provision of data, reporting, participation in | ||
evaluations, and related quality improvement activities as | ||
may be required; | ||
(G) the administration, oversight, and evaluation of | ||
the Statewide 9-8-8 Trust Fund; | ||
(H) the coordination with 9-1-1, emergency service | ||
providers, crisis co-responders, and other system | ||
partners, including service providers; and | ||
(I) the development of service enhancements or | ||
targeted responses to improve outcomes and address gaps | ||
and needs. | ||
(3) The Department of Human Services, Division of Mental | ||
Health, and independent third-party experts shall obtain | ||
meaningful stakeholder engagement on the cost analysis | ||
conducted in accordance with paragraphs (1) and (2). | ||
(b) The Department of Human Services, Division of Mental | ||
Health, and independent third-party experts, with meaningful |
stakeholder engagement, shall provide a set of recommendations | ||
on multiple sources of funding that could potentially be | ||
utilized to support a sustainable and comprehensive continuum | ||
of behavioral health crisis response services. | ||
(c) The Department of Human Services, Division of Mental | ||
Health, may hire an independent third-party expert, amend an | ||
existing Department of Human Services contract with an | ||
independent third-party expert, or coordinate with the | ||
Department of Healthcare and Family Services to amend and | ||
utilize an independent third-party expert contracted with the | ||
Department of Healthcare and Family Services to conduct a cost | ||
analysis and determine sound costs as
outlined in this | ||
Section. | ||
Section 20. Behavioral health crisis workforce. | ||
(a) The Department of Human Services, Division of Mental | ||
Health, with meaningful stakeholder engagement shall do all of | ||
the following: | ||
(1) Examine eligibility for participation as an | ||
Engagement Specialist under the Division of Mental | ||
Health's Crisis Care Continuum Program. As used in this | ||
paragraph, "Engagement Specialist" means an individual | ||
with the lived experience of recovery from a mental health | ||
condition, substance use disorder, or both. | ||
(2) Consider many additional experiences, including | ||
but not limited to, being a parent or family member of a |
person with a mental health or substance use disorder, | ||
being from a disadvantaged or marginalized population that | ||
would be valuable to this role and can help provide a more | ||
culturally competent crisis response. This includes the | ||
need for crisis responders who are African American, | ||
Latinx, have been incarcerated, experienced homelessness, | ||
identify as LGBTQ+, or are veterans. | ||
(3) Consider how that expansion impacts the unique | ||
training and support needs of Engagement Specialists from | ||
different populations. | ||
(4) Allow providers to use their clinical discretion | ||
to determine responses by one individual or by a | ||
two-person team depending on the nature of the call with | ||
access to an Engagement Specialist. | ||
(5) Collect feedback on other policies to address the | ||
behavioral health workforce issues. | ||
(b) The Department of Human Services, Division of Mental | ||
Health, shall implement a process to obtain meaningful | ||
stakeholder engagement not later than 6 months after the | ||
effective date of this Act. | ||
Section 25. Action plan. Not later than 12 months after | ||
the effective date of this Act, the Department of Human | ||
Services, Division of Mental Health, shall submit an action | ||
plan to the General Assembly on the activities under Sections | ||
15 and 20 of this Act. The action plan shall be filed |
electronically with the General Assembly, as provided under | ||
Section 3.1 of the General Assembly Organization Act, and | ||
shall be provided electronically to any member of the General | ||
Assembly upon request. The action plan shall be published on | ||
the Department of Human Services' website for the public. | ||
Section 30. Coordination across State agencies. | ||
(a) The Department of Human Services, Division of Mental | ||
Health, and the Department of Healthcare and Family Services | ||
shall convene a stakeholder working group immediately after | ||
the effective date of this Act to develop recommendations to | ||
coordinate programming and strategies to support a cohesive | ||
behavioral health crisis response system. | ||
(b) The stakeholder working group shall: | ||
(1) Identify logistical challenges and solutions and | ||
define a process to ensure the Illinois crisis response | ||
system established by the Division of Mental Health's | ||
Crisis Care Continuum Program and the Department of | ||
Healthcare and Family Services' Medicaid Mobile Crisis | ||
Response is coordinated across the lifespan. | ||
(2) Consider cross-program identification and | ||
alignment of providers within geographic regions, | ||
messaging regarding the 9-8-8 Suicide and Crisis Lifeline | ||
and the Illinois Crisis and Referral Entry Services | ||
(CARES) lines, and coordination between disparate program | ||
plan goals to ensure that crisis response services are |
delivered efficiently and without duplication. | ||
(c) The stakeholder working group shall at least include | ||
Division of Mental Health Crisis Care Continuum Program | ||
providers, Pathways to Success providers, parents, family | ||
advocates, associations that represent behavioral health | ||
providers, and labor unions that represent workers in the | ||
behavioral health workforce and shall meet no less than once | ||
per month. | ||
(d) Not later than 6 months after the effective date of | ||
this Act, the Department of Human Services, Division of Mental | ||
Health, in collaboration with the Department of Healthcare and | ||
Family Services, shall submit an action plan to the General | ||
Assembly on the activities under Section 30 of this Act. The | ||
action plan shall be filed electronically with the General | ||
Assembly, as provided under Section 3.1 of the General | ||
Assembly Organization Act, and shall be provided | ||
electronically to any member of the General Assembly upon | ||
request. The action plan shall be published on the Department | ||
of Human Services' website for the public.
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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