Illinois DHS Division of Mental Health Block Grant Application - FY2012 - FY 2013

The Illinois DHS Division of Mental Health is pleased to post the draft of the FY 2012 - FY 2013 Mental Health Block Grant Application. The DMH welcomes public comment on the application. Contact:

Dr. Mary E. Smith
Associate Director

Decision Support, Research and Evaluation

Division of Mental Health
160 North LaSalle Street, 10th Floor
Chicago, Illinois 60601

Table of Contents

  1. SECTION I
  2. SECTION II-A, STATE PLAN- ADULT SERVICES
  3. SECTION II-B, STATE PLAN- CHILD & ADOLESCENT SERVICES
  4. SECTION III-C, Use of Block Grant Dollars for Block Grant Activities
  5. SECTION III (PARTS D THROUGH P), NARRATIVE PLAN

COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT

FY 2012-FY2013

STATE NAME: ILLINOIS

DUNS #: 067919071

I.State Agency to be the Grantee for the Block Grant

  • AGENCY: Illinois Department of Human Services
  • ORGANIZATIONAL UNIT: Division of Mental Health
  • STREET ADDRESS: 160 North LaSalle Street, 10th Floor
  • CITY: Chicago STATE: Illinois  ZIP:  60601
  • TELEPHONE: 312-814-4948 FAX: 312-814-2964

II. Contact Person for the Grantee of the Block Grant

  • NAME: Mary E. Smith, Ph.D
  • TITLE: Associate Director, Decision Support, Research, and Evaluation
  • AGENCY: Illinois Department of Human Services
  • ORGANIZATIONAL UNIT: Division of Mental Health
  • STREET ADDRESS:  160 North LaSalle Street, 10th Floor
  • CITY: Chicago STATE: Illinois ZIP: 60601
  • TELEPHONE: 312-814-4948 FAX: (312) 814-2964
  • EMAIL: MaryE.Smith@illinois.gov 

III. State Expenditure Period ( Most recent State expenditure period that is closed out)

FROM: July,1st 2009 TO: June 30, 2010

SECTION I

FY 2012-13 MENTAL HEALTH BLOCK GRANT APPLICATION EXECUTIVE SUMMARY

The Illinois Department of Human Services-Division of Mental Health (DMH) is responsible for managing and purchasing a comprehensive array of services that provide effective treatments to people most in need of publicly funded mental health care. The policies and practices of the DMH focus on fostering coordination and integration of services provided by DMH funded community agencies, private hospitals, and state hospitals across Illinois. A variety of collaborative initiatives serve to increase coordination with other state agencies whose services are accessed by individuals receiving mental health services. The FY2012-FY2013 Mental Health Block Grant Plan reflects these coordination efforts as well as an emphasis on developing and directing care which is consumer and family driven. DMH is actively transforming the mental health service delivery system in Illinois to one that is recovery-oriented. These efforts include increasing consumer and family involvement in planning and implementation activities and expanding the focus on planning and implementation of evidenced-based practices. A wide array of stakeholders representing consumers, family members of individuals with mental illnesses, advocates and public service agencies purchasing or providing treatment to individuals with mental illnesses participate in these efforts. The anticipated outcome is the continued enhancement of activities that support the recovery-orientation of the mental health system and address the needs of consumers and their families.

Serious fiscal challenges are confronting the mental health service system in FY 2012 as in FY 2011. The DMH Fiscal Year 2012 community mental health services budget has again been reduced, however, as in FY 2011, key services including the community residential services line has been preserved. The overall impact of this year's budget reductions is described at various points in the plan narrative. The Division continues to work diligently to increase revenue from Medicaid and to seek grant funding to support programmatic efforts. In FY 2012, the emphasis again will be on maintaining essential services to individuals with serious mental illnesses.

During FY 2012, the priorities of the DMH include: (1) Assurance of an effective array of clinical and support services for persons enrolled in Medicaid and services which are essential for ongoing clinical care and support of individuals with serious mental illnesses who are not enrolled in Medicaid during this period of fiscal constraint. (2) Bi-directional Integration of Primary Health Care and Behavioral Health Care. (3) The provision of services in the least restrictive manner including screening and crisis services for individuals at risk of hospitalization that contribute to reducing the use of hospitalization and identification of individuals who are experiencing psychosis for the first time as a priority population for community-based services.(4) Advancement of the recovery vision including Wellness Recovery Action Planning, expansion of the scope and quality of consumer and family participation, and promotion of the utilization of the Certified Recovery Support Specialist (CRSS) credential. (5) Carrying out the responsibilities stipulated in Implementation Plan of the Williams vs. Quinn Consent Decree with diligence and efficiency. (6) Partnership with state agencies and statewide organizations in initiatives which respond to ongoing consumer needs such as the criminal justice system, alcoholism and substance abuse services, vocational and employment services, housing opportunity, and services for military personnel. (7) Expansion of System of Care in Illinois. (8) Continuing consultation and partnering with the state Medicaid agency, DHFS, the IDHS Community Health and Prevention Division (CHP) and the Illinois Children's Mental Health Partnership to address the behavioral health needs of women in pregnancy, single mothers with young children, and early childhood interventions. (9) Enhancement of collaborative efforts with state and local partners to address the mental health needs of adults involved with the criminal justice system and youth in the juvenile justice system. (10) Advancements in the use of data to inform and guide decision-making in C&A Services. The FY 2012 Plan has been reorganized to comply with the priorities and format established by the SAMHSA.

Mental Health System Performance Indicators

The FY 2012 plan contains Illinois-specific performance indicators, as well as indicators relating to the SAMHSA CMHS National Outcome Measures (NOMS). The system performance indicators are described and referenced in the plan narrative. The Illinois specific indicators are used to monitor the impact of the mental health services that are purchased on behalf of mental health consumers. These indicators include information that is collected and reported as part of the CMHS Uniform Reporting System. The ability to track values of indicators across time has assisted in identifying issues that need to be addressed within the public mental health service system and have served as a basis for planning. Additional indicators are added as required to meet the priorities of mental health system development.

ASSURANCES NON-CONSTRUCTION PROGRAMS (PAGE 1)

Signed Copies on File


ASSURANCES NON-CONSTRUCTION PROGRAMS (PAGE 2)

CERTIFICATIONS

  • 1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
  • 2. CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS

Signed Copies On File

CERTIFICATION REGARDING LOBBYING

3. CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA)

5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE

Signed Copies on File

COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT FUNDING AGREEMENTS

FISCAL YEAR 2012

I hereby certify that Illinois Dept of Human Services agrees to comply with the following sections of Title V of the Public Health Service Act [42 U.S.C. 300x-1 et seq.]

Section 1911:

Subject to Section 1916, the State will expend the grant only for the purpose of:

  1. Carrying out the plan under Section 1912(a) [State Plan for Comprehensive Community Mental Health Services] by the State for the fiscal year involved:
  2. Evaluating programs and services carried out under the plan; and
  3. Planning, administration, and educational activities related to providing services under the plan.

Section 1912

(c)(1)& (2) [As a funding agreement for a grant under Section 1911 of this title] The Secretary establishes and disseminates definitions for the terms "adults with a serious mental illness" and "children with a severe emotional disturbance" and the States will utilize such methods [standardized methods, established by the Secretary] in making estimates [of the incidence and prevalence in the State of serious mental illness among adults and serious emotional disturbance among children].

Section 1913:

  • (a)(1)(C) In the case for a grant for fiscal year 2009, the State will expend for such system [of integrated services described in section 1912(b)(3)] not less than an amount equal to the amount expended by the State for the fiscal year 1994.

  • [A system of integrated social services, educational services, juvenile services and substance abuse services that, together with health and mental health services, will be provided in order for such children to receive care appropriate for their multiple needs (which includes services provided under the Individuals with Disabilities Education Act)].
    (b)(1) The State will provide services under the plan only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs).
  • (b)(2) The State agrees that services under the plan will be provided through community mental health centers only if the centers meet the criteria specified in subsection (c).

  • (C)(1) With respect to mental health services, the centers provide services as follows:

21. The term State shall hereafter be understood to include Territories.


  1. Services principally to individuals residing in a defined geographic area (referred to as a "service area")
  2. Outpatient services, including specialized outpatient services for children, the elderly, individuals with a serious mental illness, and residents of the service areas of the centers who have been discharged from inpatient treatment at a mental health facility.
  3. 24-hour-a-day emergency care services.
  4. Day treatment or other partial hospitalization services, or psychosocial rehabilitation services.
  5. Screening for patients being considered for admissions to State mental health facilities to determine the appropriateness of such admission.
  1. The mental health services of the centers are provided, within the limits of the capacities of the centers, to any individual residing or employed in the service area of the center regardless of ability to pay for such services.
  2. The mental health services of the centers are available and accessible promptly, as appropriate and in a manner which preserves human dignity and assures continuity and high quality care.

Section 1914:

  • The State will establish and maintain a State mental health planning council in accordance with the conditions described in this section. 
  • (b) The duties of the Council are:
  1. to review plans provided to the Council pursuant to section 1915(a) by the State involved and to submit to the State any recommendations of the Council for modifications to the plans;
  2. to serve as an advocate for adults with a serious mental illness, children with a severe emotional disturbance, and other individuals with mental illness or emotional problems; and
  3. to monitor, review, and evaluate, not less than once each year, the allocation and adequacy of mental health services within the State.

(c)(1) A condition under subsection (a) for a Council is that the Council is to be composed of residents of the State, including representatives of:

  1. the principle State agencies with respect to:
    1. mental health, education, vocational rehabilitation, criminal justice, housing, and social services; and
    2. the development of the plan submitted pursuant to Title XIX of the Social Security Act;
  2. public and private entities concerned with the need, planning, operation, funding, and use of mental health services and related support services;
  3. adults with serious mental illnesses who are receiving (or have received) mental health services; and
  4. the families of such adults or families of children with emotional disturbance.
     
  • (2) A condition under subsection (a) for a Council is that:
    1. with respect to the membership of the Council, the ratio of parents of children with a serious emotional disturbance to other members of the Council is sufficient to provide adequate representation of such children in the deliberations of the Council; and
    2. not less than 50 percent of the members of the Council are individuals who are not State employees or providers of mental health services.

Section 1915:

  • (a)(1) State will make available to the State mental health planning council for its review under section 1914 the State plan submitted under section 1912(a) with respect to the grant and the report of the State under section 1942(a) concerning the preceding fiscal year.
  • (2) The State will submit to the Secretary any recommendations received by the State from the Council for modifications to the State plan submitted under section 1912(a) (without regard to whether the State has made the recommended modifications) and comments on the State plan implementation report on the preceding fiscal year under section 1942(a).
  • (b)(1) The State will maintain State expenditures for community mental health services at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant.

Section 1916:

  1. The State agrees that it will not expend the grant:
    1. to provide inpatient services;
    2. to make cash payments to intended recipients of health services;
    3. to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;
    4. to satisfy any requirement for the expenditure of non-Federal funds as a condition of the receipt of Federal funds; or
    5. to provide financial assistance to any entity other than a public or nonprofit entity.
      1. The State agrees to expend not more than 5 percent of the grant for administrative expenses with respect to the grant.

Section 1941:

The State will make the plan required in section 1912 as well as the State plan implementation report for the preceding fiscal year required under Section 1942(a) public within the State in such manner as to facilitate comment from any person (including any Federal or other public agency) during the development of the plan (including any revisions) and after the submission of the plan to the Secretary.

Section 1942:


  • (a) The State agrees that it will submit to the Secretary a report in such form and containing such information as the Secretary determines (after consultation with the States) to be necessary for securing a record and description of:
    1. the purposes for which the grant received by the State for the preceding fiscal year under the program involved were expended and a description of the activities of the State under the program; and
    2. the recipients of amounts provided in the grant. 
      (b) The State will, with respect to the grant, comply with Chapter 75 of Title 31, United Stated Code. [Audit Provision]
      (c) The State will:
      1. make copies of the reports and audits described in this section available for public inspection within the State; and
      2. provide copies of the report under subsection (a), upon request, to any interested person (including any public agency).

Section 1943:

  1. The State will:
    • (1)(A) for the fiscal year for which the grant involved is provided, provide for independent peer review to assess the quality, appropriateness, and efficacy of treatment services provided in the State to individuals under the program involved; and
    • (B) ensure that, in the conduct of such peer review, not fewer than 5 percent of the entities providing services in the State under such program are reviewed (which 5 percent is representative of the total population of such entities);
    • (2) permit and cooperate with Federal investigations undertaken in accordance with section 1945 [Failure to Comply with Agreements]; and
    • (3) provide to the Secretary any data required by the Secretary pursuant to section 505 and will cooperate with the Secretary in the development of uniform criteria for the collection of data pursuant to such section
  2. The State has in effect a system to protect from inappropriate disclosure patient records maintained by the State in connection with an activity funded under the program involved or by any entity, which is receiving amounts from the grant.

Governor Date

Governor's Designee: Michelle R.B. Saddler Secretary, Illinois Department of Human Services

Signed Copy on File

SECTION II-A, STATE PLAN- ADULT SERVICES

I. Assessment of Strengths and Needs

Description/Overview of the State's Mental Health System

The Illinois Department of Human Services Division of Mental Health (DMH) has a statutory mandate to plan, fund, and monitor community-based mental health services. Through collaborative and interdependent relationships with service system partners, the DMH is responsible for maintaining and improving an evidence-based, community-focused, and outcome-validated mental health service system that builds resilience and facilitates the recovery of individuals with mental illnesses. The DMH accomplishes this responsibility through the coordination of a comprehensive array of public/private mental health services for adults with serious mental illnesses and children/adolescents with serious emotional disturbances.

It is the vision of the Division of Mental Health that all persons with mental illnesses can recover and participate fully in life in the community. Within available fiscal resources, the priority for DMH is to provide access to clinically appropriate, effective and efficient mental health care and treatment for individuals who have serious mental illnesses and who have limited social and economic resources. Planning and budgeting decisions are guided by the basic principle that individuals will receive services in the least restrictive, most clinically appropriate environment, with the best quality of recovery-oriented and evidence-based treatment and care possible.

Statewide efforts to maintain and improve the system of care are coordinated through the Division of Mental Health Central Office based in both Springfield and Chicago. Planning and program implementation are accomplished in conjunction with five regional administrators. The Central Office is responsible for oversight of the system, policy formulation and review, the operation of nine state hospitals, planning, services evaluation, and allocation of funds. Interagency collaborative efforts and leadership in initiatives such as activities related to transformation, consumer participation and involvement, the promotion of evidence-based practices, planning for clinical services, forensic services, and child and adolescent services are carried out by statewide administrative staff. As of July 2011, the DMH Central Office had 72 FTE positions.

The Community-Based Mental Health Service System

Community services are considered the cornerstone of the mental health delivery system. Services provided and purchased by the DMH are geographically based. The DMH is organized into five Comprehensive Community Service Regions (CCSRs). Through these Regions, the DMH operates nine state hospitals, contracts with 174 community-based outpatient/rehabilitation agencies across the state. Comprehensive Community Service Regions are charged with the responsibility for managing care, developing the capacity and expertise of providers, monitoring service provision and increasing the quality and the quantity of participation from persons who receive mental health services. Two Regions are located in the Chicago Metropolitan area and surrounding suburbs, and three Regions cover the central, southern and metro-east southern (East St. Louis region) areas of the State. Administratively, each Region has an Executive Director, a lead Clinical Director, a lead Recovery Services Development Specialist, and a Coordinator of Forensic Services.

The DMH continually seeks input from consumers, family members, advocates, and representatives of public and private organizations through the framework of the Illinois Mental Health Planning and Advisory Council (IMHPAC) to aid in planning efforts. The DMH uses emerging developments at the local, state and national levels as a basis for strategically setting statewide parameters and goals, with the CCSRs carrying the responsibility for the development of congruent local systems of care. CCSR Strategic Plans reflect the overall goal of the development of a recovery-oriented service system. Ongoing strategic thinking and planning efforts with Regional stakeholders are designed to uniquely meet local area needs within each Region. The DMH is able to improve linkage and insure that treatment occurs in the least restrictive and most cost-effective settings by integrating hospital-based services into a network of community outpatient services and supports that are coordinated across service providers and consumers. By building on the strengths of communities in which consumers live, the CCSRs are able to manage DMH funds, and coordinate the most effective use of the local tax dollars and private resources budgeted for public mental health services.

The CCSRs are also responsible for integration of a comprehensive care system that includes mental health, rehabilitation, substance abuse, social services, criminal justice, and education. Each CCSR has assigned staff specially designated to address child and adolescent and Forensic services. Being part of IDHS has provided an opportunity for the DMH to address a number of challenges within the shared mission of one Department, including: disability determination for persons with serious mental illnesses (SMI), integration of vocational and psychiatric rehabilitation services, coordination and development of Mental Illness and Substance Abuse (MISA) services and, through the coordinated intake process, an opportunity to enhance case finding, early identification, and outreach efforts.

The Growth of Community-Based Services

Within Illinois there are numerous private practitioners, community mental health agencies, community hospitals providing inpatient psychiatric care, and community long-term care facilities providing services to individuals with serious mental illnesses. Over the past 30 years the locus of treatment for persons with mental illness has shifted from institutions to community-based settings. In FY1973, 8% of the DMH's budget was allocated for community services. Until recently, approximately 70% of DMH expenditures have been allocated for community-based services. However, due to continuing budget reductions, the balance between community based and state hospital expenditures has begun to shift. In FY2010, the DMH purchased community based services for 124,253 adults and 36,219 children and provided state hospital services for approximately 10,200 individuals.

The Illinois Mental Health Collaborative for Access and Choice

In Fall 2007 a national behavioral health company was selected to assist DHS/DMH in implementing a number of contractual objectives. This Administrative Services Organization, called the Illinois Mental Health Collaborative for Access and Choice (Collaborative), began operations in FY2008. The role and function of the Collaborative in the management of the public mental health system in Illinois encompasses a broad spectrum of administrative activity.

The prominent activity of the Collaborative is assistance to DMH in continued efforts to transition the mental health system to a consumer/ family-centered recovery and resilience-oriented service system. Some of the accomplishments of the Collaborative have included: (1) Assisting DMH in post-payment review of services. (2) Authorization of intensive services such as Assertive Community Treatment (ACT), Community Support Teams (CST), and Individual Care Grants (ICG) for children with serious emotional disturbance. (3) Working with DMH to convene and plan annual conferences on Evidence Based and Evidence Informed Practices. (4) Collaborating with DMH on the development and maintenance of an integrated Management Information System (MIS). (5) Assisting DMH Recovery staff in convening regional consumer conferences. (6) Development and implementation of a Consumer Warm Line and a Consumer Family Care Line. (7) Completion, dissemination, and posting of a variety of mental health reports, manuals, and handbooks including a provider manual, consumer and family handbook, and a study guide for the CRSS credential. Clearly, the work of the Collaborative has been very valuable in advancing the goals of DMH with regard to the mental health service delivery system.

Consumer Supports

The Collaborative has established a statewide "warm line" as a cutting edge source of peer and family support. Staffed by five Peer and Family Support specialists, the toll-free number is operational Monday through Friday, 8 a.m to 5 p.m except holidays and receives 60 to 120 calls per week. These professionals are persons in recovery, or family members of persons in recovery, who are trained to effectively support recovery in other individuals' lives. They reaffirm, reconnect, and renew hope, and provide practical assistance for overcoming mental illnesses to persons who are striving to live, learn, work, and participate fully in their communities. The warm line has been a successful DHS/DMH investment by assuring the accessibility of a human connection at a time when it is needed now more than ever. Although warm lines are found throughout the U.S., Illinois is among the very few states known to operate statewide Warm Lines. In addition to the Warm Line, consumers and family members may contact the Consumer and Family Care Line with compliments and complaints about the mental health services they receive. Each complaint is reviewed by the staff, referred to the appropriate agency or authority for investigation or resolution, and followed up. Written feedback is provided to consumers and family members on the progress or resolution of their complaints and assistance is offered to obtain further review or to appeal a decision. In FY2011, the Collaborative received and responded to a total of 53 complaints, investigated eight (8) complaints related to adults, and two complaints as well as one appeal which were related to children and adolescents.

Impact of the Current Economic Recession

Beginning in FY2009, economic conditions in Illinois significantly deteriorated. The Illinois Department of Revenue (IDOR) reports that the Total Revenue Collected (not including taxes collected for local governments) dropped from $29,150,982,929 for SFY2008 to $26,831,571,515 in SFY2009 resulting in a deficit to the state in excess of $2.3 billion due to a 7.9% drop in revenue. Concurrently, the Illinois Department of Employment Security (IDES) reported that the state's Unemployment Rate (Seasonally Adjusted) steadily increased from 6.6 in July 2008, at the beginning of the state fiscal year to 8.1 in January, 2009 and reached 11.1 by the end of December, 2009. The number of persons employed dropped from 6,237,500 to 5,863,200 during the same period. The Annual Average of Unemployment rose dramatically from 6.4 in CY2008 to 10.0 in CY2009 reflecting an increase in the average number of Unemployed persons from 425,500 in CY2008 to 659,900 in CY2009.

The vast majority of individuals served in the Illinois public mental health system are unable to pay for their behavioral health care. They are either Medicaid-eligible or their services have been supported through DMH capacity grants. Beginning in FY2011, economic hardship has necessitated a demarcation of those consumers who are enrolled in Medicaid and those who are not. Medicaid recipients continue to receive the normal array of services while those who are not Medicaid eligible will receive limited service packages to be paid for with the minimal funding DMH has available. Service provision and coverage for them is now based on clinical criteria and financial eligibility. Those individuals and families below 200% of federal poverty level (FPL) are fully covered for the cost of the service packages, partially covered from 200 - 400%, and not covered at all when over 400%. Providers now need to obtain definitive information from clients regarding their household income and family size. As the data system integrates the updated financial information, DMH will be able identify the size of the currently uninsured consumer group and address capacity needs in a focused manner. As additional funding becomes available due to the ACA, mental health providers anticipate being able to enhance their clinical programs and increase their capacity to provide the necessary quantity and quality in services to more consumers. Every effort is currently being undertaken to support consumers who qualify to apply for Medicaid eligibility.

Illinois is on an annual budget cycle. Budget reductions are occurring in FY2012 and are expected to continue into FY2013. This year, a 20% to 25% statewide reduction in community services is anticipated unless the General Assembly restores some or all of the $40 million taken from this year's budget. The outlook for any new funding for mental health services remains extremely bleak. In this constricted environment, DMH is making every effort to maintain essential mental health services for persons with the most serious mental illnesses through reallocation existing funds and has developed a very limited set of service packages to carry individuals who are not enrolled in Medicaid through this fiscal year.

Current Initiatives-Adult Services

Community Support Teams

Since FY2008, Community Support Teams (CST) has been operational as a core service to support recovery/resilience. Community Support Team services consist of therapeutic interventions delivered by a team that facilitate illness self-management, skill building, use of natural supports, and community resources to decrease crisis episodes and hospitalizations, and assist the client to achieve rehabilitative, resiliency and recovery goals. Interventions and activities are delivered in natural settings and are targeted toward the management and reduction of symptoms as well as the promotion of stability and independence. The aim of Community Support is to build capacity by assisting the individual to do for self. Reimbursement is based on medical necessity requiring documentation of psychiatric disability (diagnosis), currently assessed need, an existing service plan with allowable interventions, and continuing assessment of progress toward achieving recovery and resilience goals. Due to budget shortfalls, CST is limited to those consumers who are enrolled in Medicaid and are clinically suitable for this intensive service. Currently, fourteen community mental health centers are providing CST in Illinois.

Permanent Supportive Housing

Permanent Supportive Housing (PSH) refers to integrated permanent housing (typically rental apartments) linked with flexible community-based mental health services that are available to tenants/consumers when they need them, but are not mandated as a condition of occupancy. The PSH model is based on a philosophy that supports consumer choice and empowerment, rights and responsibilities of tenancy, and appropriate, flexible, accessible, and available support services that meet each consumer's changing needs. A growing body of knowledge has documented the effectiveness of PSH and helped generate the systems changes needed to create it. The Division of Mental Health is committed to develop an array of Permanent Supportive Housing consistent with the flexible needs of consumers and associated with other new initiatives, i.e., Money Follows the Person (MFP) demonstration project, the Williams vs. Quinn legal settlement, and supportive employment. A concerted redirection of energy and resources has been necessary to ensure that consumers have choice on housing alternatives and that this choice has a foundation based on principles of recovery thereby expanding options for consumers to live independently.

Supportive Employment

Supported Employment (EBSE) is an evidence-based practice that has been shown to improve employment rates of persons with serious mental illness by as much as 60%. EBSE services in Illinois are based on integration of the DHS Division of Rehabilitation Services (DRS) funded vocational services and resources with DMH funded mental health treatment and supportive services. DMH and DRS have collaborated closely in this joint effort to increase access to Individual Placement and Support (IPS) supportive employment for persons with serious mental illnesses and to improve the coordination of psychiatric and vocational services. Locally, services are obtained through joint planning and service efforts by community mental health centers (CMHCs) and local offices of DRS. This evidence-based practice initiative has been supported by two grants: a NIH/SAMHSA Planning grant to address state infrastructure issues (which ended in September, 2007) and a Johnson & Johnson/Dartmouth Community Mental Health Program Grant to support implementation at four pilot sites ended in June 2009. The number of mental health agencies working to implement EBSE and reaching fidelity to standards of EBSE based upon the Individual Placement and Support (IPS) model has steadily increased to 23 locations in the State meeting fidelity standards at the end of FY2011.

Transitions to Community from Long Term Care

There are a substantial number of individuals with serious mental illnesses who require long-term care services. Some require this level of care because of functional limitations associated with their mental illness, and others require it for functional limitations associated with both mental illness and medical needs. In either case, the lack of viable community alternatives for persons in this situation frequently necessitates their admission and continued care in longer term care facilities. The Illinois Department of Public Health (DPH) is responsible for monitoring the licensing requirements of nursing facilities, and the Department of Healthcare and Family Services (DHFS) oversees Medicaid funding. The DMH has made a concerted effort to assist community providers and these two state agencies to understand the service needs of persons with serious and disabling mental illnesses and the long term care service options that are available. DMH is currently working extensively through the initiatives described below to develop community-based alternatives to accommodate the needs of this population.

The "Money Follows the Person" Federal Demonstration

Illinois is receiving $55.7 million dollars in federal Medicaid reimbursement to assist individuals who have serious mental illnesses and who are living in non-IMD nursing facilities with seamless transition to community residential alternatives (non-group home settings) and necessary support services. The "Money Follows the Person"(MFP) demonstration will facilitate the transition of approximately 3500 persons, between the involved state Departments, into their home communities over the course of several years. Over 500 individuals falling within the DMH identified priority population are to be transitioned. The Department of Healthcare and Family Services, the lead agency for the initiative, is working closely with the IDHS divisions of Developmental Disabilities (DDD), Rehabilitation Services (DORS) and DMH, the Department on Aging, and the Illinois Housing Development Authority (IHDA) on the project. IDHS is committed to maximizing reimbursement in support of the goals of consumer self-direction, independence and community reintegration. Programs under the MFP are designed to: (1) Eliminate barriers or mechanisms that prevent Medicaid-eligible individuals from receiving support for appropriate and necessary long-term services in the setting of their choice; (2) Increase the ability of the state Medicaid program to assure continued provision of home and community-based long term care services to eligible individuals who choose to move from an institutional to a community setting; and (3) Ensure that procedures are in place to provide for continuous quality improvement in these services for individuals receiving Medicaid home and community-based long-term care. DMH participates in the identification of appropriate candidates for transition to the community and contracts with provider agencies for the provision of services.

During Calendar Year 2010, the number of persons originally targeted to be transitioned by DMH (72) was exceeded and 99 persons were actually transitioned. By the end of CY2010, 126 persons had been transitioned since the demonstration project began at a total expenditure of over $4.2 million. The current goal is to transition a total of 108 by the end of December 2011. It is anticipated that at least 60% of this group will have been transitioned by the end of this fiscal year (June 30, 2011)

Rapid Reintegration Pilot Project

Through the use of Hospital Tax dollars, DMH initiated and has maintained a small scale pilot project in central and northern Illinois. While the MFP demonstration targets persons who have been in long term care for 90 days or longer, DMH's Rapid Reintegration Pilot Project targets persons who have been in nursing homes for a year or less. Two CMHCs, one in Rockford, and one in Springfield, have been working to transition persons into community-based options since October 2008. As of July 2010, 42 persons had been transitioned.

Williams vs. Quinn Consent Decree

During FY2010 there was a Class Action Court Settlement to be finalized in FY2011 that may require additional financial resources available to the Department for mental health services. The Williams' Suit targets individuals who are residents of Institutes for Mental Disease (IMD), Nursing Facilities in which more than 50% of the population is diagnosed with Serious Mental Illness. As such, an IMD cannot bill for federal Medicaid reimbursement and are 100% funded out of State General Revenue Funds. The premise of the Williams' suit is that individuals with serious mental illness have not been afforded due process to move out of these facilities when they no longer require or desire this level of nursing care. There are 4,500 class members involved in this suit.

Key terms in the Consent Decree include the following:

  • Development of community capacity. This requires the State to ensure the availability of services, supports, and other resources to meet its obligations under the Decree.
  • Development of a service plan. For individuals currently residing in IMDs who do not oppose moving to a community-based setting and who are otherwise appropriate for community placement, the State will develop a service plan specific to each person.

The settlement, approved in September 2010 requires that all class members will be assessed and given the choice to transition to the most appropriate integrated community based options with support services over the course of 5 years. The ultimate goal is to transition them into independent living/permanent supportive housing. A Draft Implementation Plan detailing the steps to be taken by the State and the timelines towards reaching this goal was completed in February, 2011. Additional financial resources are anticipated by the Department to meet these mental health service needs. As all the class members may not be ready for independent living at the initial stage of transitioning, the service system is required to develop an array of housing options and clinical support services to best accommodate members' immediate transition needs. Concurrently, the state will have to ensure that transitioning consumers, who do qualify, based on clinical and functional criteria, for independent living can afford to live in community based housing. Expanding funding resources to ensure the availability of Bridge Subsidies (until permanent rental subsidies or Section 8 housing choice vouchers can be secured) for those who do qualify for Permanent Supportive Housing will be paramount.

However, to assure success, Illinois further recognizes that an array of available Community Services, including some non-Medicaid services, will be critical in achieving and sustaining the successful community placement of Williams Class Members. The existing infrastructure of services in the Illinois Medicaid State Plan is inclusive of mental health rehabilitation services, substance abuse and co-occurring services, services for persons with developmental disabilities and physical healthcare services that will be beneficial for Class Members. Twenty-five to 50% of Class Members seeking community placement are likely to have a co-occurring substance use disorder. Thus, coordination with DHS/Division of Alcohol and Substance Abuse Services (DASA) is critical for these individuals. DHS/DASA and DHS/DMH have a foundation in collaborating in the development and implementation of services for individuals with these co-occurring disorders.

A parallel Class Action Suit, Colbert, is currently being developed and targets nursing facilities that are not IMDs in the City of Chicago boundaries, only, and across disability populations. The total class for Colbert is 10,000. Potentially, there are an additional 5,000 individuals with mental illness in this Class. Like Williams, mental health services (including residential supports) and affordable housing will be necessary to ensure seamless and safe transitioning for this population. Accommodating the residential and support service needs of these legal settlements will necessitate extensive enhancement to the existing public mental health service delivery system.

Framework for Continuing Collaborative Planning- Mental Health and Substance Abuse Prevention and Treatment (DMH-DASA Combined Plan)

DMH is in constant cross-divisional conversations with our sister agency, the DHS Division of Alcohol and Substance Abuse (DASA). Most recently, the divisions worked together in planning and convening a policy summit on bi-directional integration of behavioral health and primary health care. DMH and DASA have worked diligently together over the years to collaborate, develop and implement initiatives focusing on consumers with co-occurring disorders. These collaborations included co-location projects that continued through FY2009 at four state hospitals; Elgin, Chicago Read, Madden, and McFarland. Sharing service delivery site resources allowed DASA funded providers to perform screening and assessment for consumers on-site, and to provide consultation to DMH staff regarding the substance abuse treatment needs of consumers when these services were warranted. Sharing facilities has resulted in the development of more hospital staff training and expanded the role of the DASA providers to perform linkage and engagement activities. In the past year, funding for these efforts has not been available. However, both divisions continue to highlight the clinical importance of integrated treatment for individuals who are dually diagnosed. Several sessions at the DMH EBP Conference held in April 2010 were focused on IDDT as an EBP sorely requiring further development in Illinois. Treatment funded by DHS/DASA in Illinois emphasizes services that are consumer-oriented, geographically accessible, comprehensive, bridging continuing care responsibilities between all levels of an integrated system of care. Specialized training, technical assistance and case consultation are available from the Illinois Co-Occurring Center for Excellence (ICOCE) formerly, the MISA Institute, to assist providers in acquiring skills to assure the highest quality of integrated care is provided. The concepts, practices, and skills developed from IDDT and ICOCE, continue to be useful in addressing the treatment needs of individuals with co-occurring disorders.

Bi-Directional Integration of Behavioral health and Primary Care Services

In collaboration with the DHS Division of Alcohol and Substance Abuse (DASA), the Illinois Department of Healthcare and Family Services, and the Illinois Department of Public Health (IDPH), DMH planned and convened ""Beginning the Conversation: A Statewide Policy Summit on Advancing Bidirectional Behavioral Health and Primary Care Integration" in Chicago, IL on June 22, 2011 - which focused on bi-directional service delivery models and convened key partners across State, County, providers and consumers from behavioral health and primary care to hear from national and local expert faculty about:

  • Emerging evidence-based and best practice models and outcomes in integrated health care;
  • Concepts of person-centered healthcare homes and accountable care organizations;
  • Financing and payment reforms;
  • Existing integrated models of care in Illinois;
  • Involving consumers and family members in wellness and prevention services;
  • Workforce implications for integrated care;
  • Using health information technology to promote integrated care; and sharing information on existing integrated models of care within Illinois.

The goals of the Summit were achieved by bringing together a diverse group of healthcare providers, all of whom share the DHS mission to assume bidirectional integrated care delivery within local communities. Throughout the one day event, formally and informally, the Summit jump-started discussion and strategic planning among primary care and behavioral health providers and policymakers. The participants issued a resounding call to continue the discussions needed to further activate collaboration across the State.

DMH is maintaining a Summit Website as a means of continuing to share information and developments and build participation into the process. Since the Summit itself, several new items have been added to the "Related Links" website section including a link to videos of the entire day at "Summit Speaker Presentations - Web Links"; A "Final Summit Agenda and Workbook" ; and a list of all in-person "Summit Participants". A "Summary of Small Group / Technical Assistance Recommendations" plus a "Summary of Summit Evaluations" will be added to the website shortly. The Summit Website may be accessed at: http://www.dhs.state.il.us/page.aspx?item=55312

DMH is currently considering the development of a series of focused follow-up meetings and anticipates assuming an active role in a working partnership with DASA, DPH, and DHFS in accomplishing the tasks required to move forward in bi-directional integration of primary health care and behavioral health. These tasks include: assisting in needs assessments, formulating recommendations on reforming the delivery system for chronic disease prevention and health promotion, ensuring adequate funding for infrastructure and delivery of programs, addressing health disparities, and considering the role of health promotion and chronic disease prevention in support of state spending on health care.

Issues related to primary health care in other venues continue to be addressed with a special emphasis on the relationship between primary health care and mental illness. These include the following activities.

DMH is a charter member of the Illinois Department of Public Health's Chronic Disease Prevention Task Force and is actively collaborating with other member agencies in developing management strategies to address issues relevant to individuals with behavioral health needs who also suffer with chronic diseases.

DMH continues to emphasize the importance of assisting adult consumers in the completion of applications for Medicaid benefits as one means of assuring that access to health services are available. Individuals with serious mental illnesses who are Medicaid recipients are entitled to the range of health services covered in the Illinois Medicaid plan.

Programs implemented by the Department of Health Care and Family Services (DHFS) follow a Disease Management model. Illinois Health Connect is a statewide Primary Care Case Management (PCCM) Program for most persons covered by DHFS medical programs. DMH is collaborating with DHFS on two distinct projects that impact Medicaid recipients. Under the Primary Care Case Management (PCCM) - Disease management (DM) program (Health Care Connect), DMH facilitates an active team process that links mental health providers with PCCM/DM case managers in order to (1) assure the most active linkage of the enrollee and the Primary Care Provider, and (2) facilitate an exchange of information and a combined work effort from both PCCM and MHC providers in identifying, assessing, treating, tracking, monitoring and engaging all enrollees with mental illnesses. The most recent focus has been on those persons assessed by the PCMM/DM team as high and medium risk. People who are enrolled in Illinois Health Connect have a "medical home" through a Primary Care Provider (PCP) who coordinates and manages their care.

In FY2011, DMH is working with DHFS, to pilot an integrated managed care system in Suburban Cook County and adjacent counties in the Chicago Metropolitan Area (not including the City of Chicago)which will include behavioral health with primary health care. This project is currently in the enrollment phase and has not yet been fully implemented. Medicaid AABD (aged, blind and disabled) recipients are being placed into a managed care arrangement with vendors who will be implementing a fully integrated service delivery system. DMH is acting as the subject matter expert and facilitator for mental health matters.

The establishment of relationships between Federally Qualified Health Centers (FQHCs) and DMH funded community mental health agencies is also being emphasized.

DMH continues to explore options for more extensive collaboration with Health Resources and Services Administration (HRSA) funded Federally Qualified Health Centers (FQHCs) in Illinois. CMHC'S in rural areas have been interested in this collaboration as a means of integrating services in order to provide greater access for rural residents. Several have participated in joint piloting efforts.

Provision of Recovery Support Services

The provision of mental health care that is consumer and family driven is an important priority of the Illinois Division of Mental Health. This priority is consistent with the current emphasis on involving consumers and families in orienting the mental health system towards recovery, and to improving access to, and accountability for mental health services. Consumer participation block grant objectives for FY 2012/2013 support the DMH priority for furthering work on the recovery vision in Illinois, by encouraging consumers and family members to participate in decision-making and service planning efforts. Some of these objectives are continuations of efforts initiated in prior fiscal years.

Recovery oriented training sessions were held in a variety of venues for all interested stakeholders in FY2011. Audiences for these sessions included diverse stakeholder groups and focused on educating consumers of mental health services, family members of consumers, mental health and addiction professionals, advocates, college students, occupational therapy professionals, and many others. Topics for these sessions included the foundational principles of mental health recovery, Wellness Recovery Action Planning (WRAP), mentoring, advocacy, crisis planning, recovery support, spirituality, and others.

Certified Recovery Support Specialist (CRSS)

In collaboration with the Illinois Certification Board (ICB), the Divisions of Mental Health, Rehabilitation, and Alcoholism and Substance Abuse have developed the Illinois Model for Certified Recovery Support Specialist (CRSS). Access to this credential became available through the ICB beginning in July of 2007. Individuals are certified as having met specific predetermined criteria for essential competencies and skills. The purpose of certification is to assure that individuals who meet the criteria for CRSS will provide quality services. Individuals attending consumer conferences, statewide consumer education and support teleconferences, and regional WRAP Refresher trainings, receive CEU's toward achieving or maintaining their credential through the ICB. As of May 1, 2011, 132 individuals had achieved their CRSS certification, and all were in good standing with the Illinois Certification Board (ICB).

In FY2011, the DMH Office of Recovery Support Services continued to work with other system partners, including the ICB and the Mental Health Collaborative for Access and Choice (MHCAC), to develop training and study materials for those seeking to obtain their CRSS credential. Webinars for provider agencies are planned in FY2012 to help increase agencies' understanding of the role, value, function, and advantages of hiring CRSS professionals. The aim is to increase the number of agencies hiring CRSS professionals in FY2013.

Moving toward a recovery-oriented system of care requires the utilization of evidence-based and promising practices related to locus of service delivery and the use of technology in the delivery of mental health and substance abuse services. The Wellness Recovery Action Plan (WRAP) model has been established and is fully operational in Illinois. Through provision of WRAP classes in community agencies and the introduction of the principles of WRAP at consumer forums and conferences, thousands of consumers throughout the state have benefited from receiving orientation and education in the principles and components of this evidence-based practice in recovery-oriented services.

The principles of Recovery overlap both mental health and substance abuse. A clear statement of these principles is provided in the CSAT White Paper: Guiding Principles and Elements of Recovery-Oriented Systems of Care

Briefly stated they are:

  • There are many pathways to recovery.
  • Recovery is self-directed and empowering.
  • Recovery involves a personal recognition of the need for change and transformation.
  • Recovery is holistic.
  • Recovery has cultural dimensions.
  • Recovery exists on a continuum of improved health and wellness.
  • Recovery is supported by peers and allies.
  • Recovery emerges from hope and gratitude.
  • Recovery involves a process of healing and self-redefinition.
  • Recovery involves addressing discrimination and transcending shame and stigma.
  • Recovery involves (re)joining and (re)building a life in the community.
  • Recovery is a reality. It can, will, and does happen.

For DMH and DASA, cross training of key leadership staff has been a prominent activity related to Recovery. DMH has provided WRAP Training for DASA at the management level, and also at DASA's annual AATI conference. DASA has very recently (within the past year) been rolling out the new ROSC (Recovery Oriented Systems of Care) training and DMH executive staff were among the initial group that received the training. This has resulted in a cross-fertilization of staff and a development of an understanding of recovery principles.

DASA is currently intending to develop a five year state plan organized around a recovery-oriented system of care (ROSC) to ensure that an appropriate mix of substance abuse services and recovery supports for both youth and adults is available and accessible throughout the state. As part of this effort, DASA has actively been moving forward in redefining a new business model that reorients away from compliance and oversight related activities toward a focus on quality of services, program performance and outcomes.

To develop a statewide infrastructure to effectively and efficiently integrate ROSC principles, practices, and services into the existing prevention and treatment service system in Illinois, DASA is providing training for DASA staff, stakeholders and providers on ROSC principles and practices and is planning to use therapeutic and clinical interventions and non-clinical community-based resources that support recovery, early identification, engagement, and sustenance of the recovery process for individuals and families. Recovery Support services included in the planning process are funded and provided through Access to Recovery (ATR), a Presidential initiative to provide client choice among substance abuse clinical treatment and recovery support service providers, as well as to expand access to a comprehensive array of clinical treatment and recovery support options, including faith-based programmatic options. ATR offers a wide array of services to clients in need, including:

  • Outpatient and Intensive Outpatient treatment for methamphetamine and National Guard clients
  • Continuing Care
  • Employment Coaching
  • Pastoral Counseling
  • Peer Coaching
  • Recovery Coaching
  • Recovery Home for National Guard Clients
  • Recovery Skills
  • Spiritual Support
  • Transportation Assistance
  • Vocational Training

Collaborative Focus on Military Personnel and Veterans

Military personnel returning from the wars in Iraq and Afghanistan are at increased risk of traumatic brain injury, post-traumatic stress disorder, depression, anxiety and other mental health symptoms as well as new-onset heavy drinking, binge drinking and other alcohol-related problems. Anxiety, depression and engagement in high risk behaviors, such as substance abuse, are more likely among adolescents in families with a deployed parent than among similar adolescents in non-deployed families (Chandra et al., 2009) Given the increasing recovery needs among returning military personnel and their families, both DMH and DASA are working to improve partnerships with the Illinois National Guard and Illinois Department of Veterans Affairs in order to improve access to mental health services, alcohol and other drug treatment, and recovery support services among military personnel returning from deployment and their families. Through proposed grants, DASA is seeking to provide substance abuse treatment and/or recovery support services to at least 200 returning Illinois National Guard members and to increase treatment outreach efforts to engage teens with substance abuse problems and who either currently have or have had a deployed parent. Through a SAMHSA grant of approximately $2 million over 5 years, DMH has established the Illinois Veterans Reintegration Initiative (VRI) to increase diversion for criminal justice-involved veterans with trauma histories in Cook and Rock Island counties. The VRI is expected to result in the delivery of trauma-informed, evidence-based treatment to 120 consumers per year over a 5-year program period, as well as specialized training for 1,000 police officers in street-level responses to veterans demonstrating mental illness.

Expenditures and Services for Co Occurring Mental Health Disorder and Substance Abuse Disorders

Budgetary constraints in Illinois have impeded funding for any special initiatives to address the needs of consumers with co-occurring disorders. However, DMH and DASA have collaborated to address services for individuals with co-occurring disorders for many years. Initiatives have included the establishment of consortiums comprised of mental health and substance abuse providers to collaborate on treatment provision, cross-training of providers from both service systems focusing on integrated treatment, and the funding of an institute to provide training to service providers across the state. DMH and DASA have jointly participated in the SAMHSA National Policy Academy on co-occurring disorders. Staff of both Divisions have been actively working together to implement integrated treatment. The DMH and DASA collaborated to apply for a SAMHSA grant to train providers and evaluate the implementation of Integrated Dual Diagnosis Treatment (IDDT) in 2003 which resulted in an award. The grant ended in FY2007 with fairly successful results. Since then, DMH has continually assessed the feasibility of realigning those activities with new funding which has not become available.

DASA contracts with Heartland Alliance to fund the Illinois Co-Occurring Center for Excellence (ICOCE) to provide training, technical assistance, and consultation to agencies that provide dual diagnosis treatment. ICOCE defines its central role as fostering the use of evidence-based practice models for the treatment of co-occurring substance use and mental health disorders. Consultation is also provided in related areas such as recovery-oriented systems of care, supported employment, illness management, motivation to change and organizational change issues, cultural competence, HIV-AIDS, and trauma. Consultation and training are offered to DASA providers as requested and needed due to limited resources.

In reference to children and youth, DASA has been a leading participant in the DMH Family Driven Care initiative and has collaborated with DMH in providing training on trauma informed prevention, treatment and recovery as well as adolescent and family co-occurring disorders and their treatment. The DMH C & A Services unit in collaboration with DASA continues to explore the need for staff training and current program capacity issues to address the clinical needs of this population.

Currently, DMH continues to implement WRAP which is seen as bridging the gap between traditional mental health treatment and traditional substance abuse treatment for individuals with co-occurring disorders. The use of Wellness Recovery Action Planning principles of self-determination, personal responsibility, and empowering support are a means of addressing an individual's divergent needs.

Providers who are funded by both DMH and DASA are positioned to work with clients with co-occurring disorders (COD). That value and vision is clearly espoused by both divisions. However, while some DASA and DMH providers are considered Capable of providing COD services, very few mental health programs in Illinois are fully enhanced to the point of following the IDDT model with adherence to most of its fidelity standards. The table below depicts the Integrated Treatment Continuum for COD which was extrapolated and condensed from the DDCAT by Mark McGovern and the SAMHSA IDDT Fidelity Scale and was used as a training tool during the course of the SAMHSA grant, to help conceptualize the continuum of care resulting in co-occurring enhanced substance abuse and mental health service delivery. It was based on seven criteria and differentiates the characteristics of being COD capable and being COD enhanced from the polar Substance Abuse and Mental Health perspectives. (See Table 1 below)

The ongoing efforts of DMH and DASA in the areas of bidirectional integration, recovery and co-occurring disorders, although limited by budgetary constraints, clearly reflect vision and principles that emphasize behavioral health as an essential part of overall health in which prevention works, treatment is effective and people do recover. Working within the broader context and resources of the Illinois Department of Human Services, both divisions have a continuing commitment to building systems and continuums of care which are applicable to the provision of mental health and addiction services and cross the lifespan of individuals who need and use these services.

Table 1: Integrated Treatment Continuum for Co-Occurring Disorders

COD-Substance Abuse COD-Mental Health
SA only COD Capable COD Enhanced COD Enhanced COD Capable MH only
Primary Treatment Focus/Philosophy Addiction only Primary Focus is an addiction, -co-occurring disorders are treated

Primary Focus is COD patients

.

Primary focus is on COD patients with philosophy following the IDDT model Focus is on MI; COD patients are treated while adhering to some IDDT treatment philosophies Mental Illness only
Coordination & Collaboration between providers No document of formal coordination or collaboration Formalized and documented coordination or collaboration with mental health agency Most services are integrated within the existing program or routine use of case management staff or staff exchange programs Full array of MH services with integrated substance abuse treatment. IDDT expert as team leader. No IDDT expert some SA experience - some stage based treatment Little to no SA expertise; only routine MH treatment offered.
Stage-wise treatment Not assessed or documented

Clinician assessed and documented, used in planning;

Individualized plan but not explicitly stage based

Formal measure used & integrated in treatment planning; formally prescribed stage-wise treatments Formal measure used & integrated in treatment planning; formally prescribed stage-wise treatments. Clinician assessed and documented routinely, used in planning; not all interventions are stage based. Only routine MH treatments
Motivational Interviewing & Cognitive Behavioral Therapy Rarely used or not at all Used variably, by inexperienced practitioners not spread to entire program Used regularly with experienced practitioners at appropriate stage of treatment Used regularly with experienced practitioners at appropriate stage of treatment Used variably, by inexperienced practitioners not spread to entire program Rarely used or not at all as applied to SA
Process Monitoring Standardized monitoring at a minimum annually and is used to guide improvements Standardized monitoring is only done annually and may not be used to guide improvements Standardized monitoring done every 6 months; results guide program improvements Standardized monitoring including IDDT & GOI fidelity measures, every 6 months; results guides program improvements Standardized monitoring is only done annually and may not be used to guide improvements Standardized monitoring at a minimum annually and is used to guide improvements
Outcome Monitoring Standardized COD outcome monitoring occurs at least once a year and results are shared with practitioners Standardized COD outcome monitoring occurs at least once a year and results are shared with practitioners. Standardized COD outcome monitoring occurs quarterly and results are shared with practitioners Standardized COD outcome monitoring occurs quarterly and results are shared with EBP practitioners Standardized COD outcome monitoring occurs at least once a year and results are shared with practitioners. Standardized COD outcome monitoring occurs at least once a year and results are shared with practitioners
Family education and Support For alcohol or drug problems only Consultant or collaborative agreement with therapist for SUDs and MH onsite group Routine COD family group integrated into standard program format by staff member Clinicians provide family members with education, coping skills training, support & collaboration with treatment team Active family members are able to collaborate with treatment team, some education to family members variably given None focused on COD


Trauma Initiatives

Consistent with Joint commission on Accreditation of Healthcare Organizations (JCAHO) Core Measures, beginning in 2009, a trauma screening is administered upon admission to any DMH hospital. Results of this screening are incorporated into an individualized Personal Safety Plan that identifies potential triggers for the re-experience of trauma as well as types of interventions likely to be most helpful and effective. DMH hospitals have also adopted the trauma sanctuary model, which establishes a therapeutic milieu for information sharing, communication and problem solving.

Since 2008, the Division of Mental Health has been offering Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) groups to youth incarcerated within the Department of Juvenile Justice's Illinois Youth Centers. This program was in response to the growing body of research documenting the high incidence of trauma for youth involved in the juvenile justice system. Groups have been offered in three of the eight Illinois Youth Centers and initial analysis of outcome data has shown promising results.

Military Personnel

In 2008, the Division of Mental Health was awarded a $2 million grant (over 5 years) from the Substance Abuse Mental Health Services Administration. The grant, entitled Jail Diversion - Trauma Recovery (priority to veterans) is designed to divert individuals, with histories of trauma, from the criminal justice system, and into evidence-based trauma treatment in the community. The Illinois Project entitled: Veterans Reintegration Initiative, targets veterans of Iraq and Afghanistan showing trauma symptoms, for jail diversion and enrollment in trauma treatment. The Directors of the Division of Mental Health and the Department of Veterans Affairs co-chair the project's Statewide Advisory Group, which is comprised of stakeholders from other state agencies, the Veterans Administration, the judiciary, community providers, private foundations and veterans with lived experience.

In 2008, the Illinois Legislature enacted Public Act 095-0576 directing the Department of Veterans Affairs, in consultation with the Department of Human Services, to contract with professional counseling specialists to provide a range of confidential and direct treatment services to veterans. The Department of Veterans Affairs, in consultation with the Division of Mental Health, established the Illinois Warrior Assistance Program (IWAP), staffed by mental health professionals through Magellan Health Services. IWAP provides a 24-hour, toll free number for confidential assistance with emotional challenges veterans may face reintegrating into civilian life. Screenings for traumatic brain injury and post-combat trauma reactions are also available through IWAP.

Public Act 095-0576 also directs the Department of Veterans Affairs, in consultation with the Department of Human Services, to:

  • Develop an educational program designed to train and inform primary health care professionals, including mental health care professionals, on the effects of war-related stress and trauma.
  • Provide informational and counseling services for the purpose of establishing and fostering peer support networks through the state for families of deployed members of the reserves and National Guard.
  • Provide veterans' families with a referral network of providers skilled in treating deployment stress, combat stress, and post-deployment stress.

The Division of Mental Health, as a member of the Illinois Families of Fallen Service Member Task Force, has offered the first in a series of outreach events to surviving families of fallen service members.

The Division of Mental Health has longstanding partnerships with members of the judiciary (both local and statewide) and has supported the establishment of Veterans' Specialty Courts throughout the State. The Division of Mental Health has also offered consultation to local private foundations (the Michael Reese Health Trust and McCormick Foundation) regarding their desire to establish outreach services to veterans and their families.

Strengths, Needs, and Priorities of the System

The vision for mental health services in Illinois as articulated in previous plans continues. We envision a well resourced and transformed mental health system that is consumer directed and community driven providing a continuum of culturally inclusive programs which are integrated and effective, a range of direct and support services (including prevention, early intervention, treatment and supports), that support healthy lifelong development through equal access and promote recovery and resilience. The Illinois Vision for Mental Health is that:

"All persons with mental illnesses can recover and participate fully in community life:

  • -The expectation is recovery
  • -The consumer is central

Many of the activities in which the DMH is engaged are providing the foundation to make this vision a reality even in an era of great fiscal challenge.

Important strengths of Illinois' community-based mental health system for adults are described below. It is important to note that while we aptly describe our strengths, significant challenges continue to confront the public mental health service system. Fiscal constraint in the past few years has resulted in limited growth and implementation of a number of initiatives and the discontinuation of others. With the creativity and innovation of the past several years, there has also been increasing awareness of the lack of sufficient resources with which to actualize and transform the service system to fully and rapidly achieve the vision articulated below. In FY2012/FY2013, the system is facing serious fiscal challenges and is anticipating further reduction instead of growth. DMH efforts are currently geared towards finding practical solutions to challenges and sustaining gradual and incremental progress where possible.

Current strengths in the system are:

  • The array of core services available to adults with serious mental illnesses who are enrolled in Medicaid and the crisis services available to all consumers.
  • Commitment to a recovery orientation by mental health system stakeholders.
  • The focus on consumer and family driven care.
  • Commitment to the implementation of evidence-based practices within budgetary constraints.
  • Involvement of consumers in planning, implementing and evaluating the initiatives and ongoing activities of the public mental health system.
  • Ongoing emphasis and efforts to reduce hospitalization.
  • Effective collaborations with other divisions of the IDHS and with other state agencies have been a successful strategy for improving and enhancing services throughout the system.
  • A recently established data warehouse and improvements to the Management Information System expanding access to data which is vital to support decision making.
  • Through external resources, such as the Data Infrastructure Grant, federally funded studies, and DMH initiatives, our databases and analytic capabilities have steadily grown to an extensive array of computerized information that provides an important resource for analyzing service provision and service needs
  • Continuing commitment to develop and implement service models for persons with mental illnesses who are homeless, such as the innovative use of PATH funds. Illinois has continually increased services including expanded intensive outreach to homeless individuals with serious mental illnesses.
  • Active collaboration and effort to develop and evaluate approaches to improving housing services such as Permanent Supportive Housing (PSH) and successful advocacy for appropriations from the state legislature to support these promising approaches.
  • The DMH has made a substantial commitment toward increasing the portion of the DMH funds allocated to community-based treatment versus inpatient services for persons with mental illnesses.
  • In recognition of the increasing role played by federal Medicaid funds, the DMH has worked successfully to increase this revenue source.
  • The DMH has maintained a strong joint public and academic program which continues to include Departments of Psychiatry, Social Work, Psychology, and Nursing in universities across the State. All state hospitals in Illinois have agreements with universities to serve as training sites for psychiatric residency programs. Similar programs with Departments of Social Work, Psychology, and Nursing in universities across the state provide fertile ground for the recruitment of program graduates who are well grounded in public mental health as a result of their residencies.

SECTION II-B, STATE PLAN- CHILD & ADOLESCENT SERVICES

I. Assessment of Strengths and Needs

Description and Overview of Child and Adolescent Services

Illinois has made substantive progress in developing a comprehensive mental health service system for youth with serious emotional disturbances (SED) and their families. In Child and Adolescent services, the emphasis is on resilience and evidence informed practice as components in the systemic transformation process. Many of the activities in which the DMH is engaged are providing the foundation to make this vision a reality.

The Child and Adolescent Services office is led by a board certified Child and Adolescent Psychiatrist and consists of Statewide C&A Staff, some of whom are geographically located in each of five regions of the state. Specialty program grants specific to children and adolescents are managed by Central Office Child and Adolescent Services staff who have expertise in such areas as mental health services in schools, transition services for youth, early childhood services, and mental health prevention and early intervention for children and youth.

The five geographic Comprehensive Community Service Regions (CCSRs) are responsible for contracting activities with 124 child serving agencies which either provide specialized services or are community mental health centers with children's programming. They also collaborate with and monitor local hospitals that provide psychiatric programs for youth. The localized integration of a comprehensive care system including mental health, substance abuse, child welfare, juvenile justice, and education is within their purview. Each CCSR has access to C&A staff specially designated to address child and adolescent and juvenile forensic service issues. Consumer parents (Family Consumer Specialists) are regionally based and function in the critical system role of connecting DMH services to their communities while providing DMH with the consumer family voice and input from their communities.

Being part of DHS has provided an opportunity for the DMH to address a number of challenges within the shared mission of one Department such as: prevention, early intervention, integration of vocational and educational services, coordination and development of Mental Illness and Substance Abuse (MISA) services and, through the coordinated intake process, an opportunity to enhance case finding, early identification, and outreach efforts.

Illinois Systems of Care

System of Care (SOC) grants are funded by the United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. These grants are awarded to the state and local governments to develop and build systems of care for children, youth, and their families. The grants are usually awarded for five year periods. There are three SOC grants currently active in Illinois. Additionally, DMH has applied to SAMHSA for a one year grant to seed a statewide approach to building systems of care. The three current projects are:

The McHenry County System of Care:

A System of Care grant was awarded to McHenry County and funded in 2006. DMH has partnered with the McHenry County Mental Health Board to implement system of care transformation, on a local level. The mission of this project "is to meet the social and/or emotional needs of families, children, and youth by providing leadership to develop and sustain a community of care that provides continuous support and easy access at every level of care. The grant will improve access to services for four underserved populations: preschoolers with serious social/emotional problems, youth with serious emotional disturbances and co-occurring substance abuse problems, young adults 18-21 years old with mental illnesses, and Latino children.

Champaign County- ACCESS Initiative

Through the ACCESS Initiative, the Division of Mental Health together with youth, families, and child-serving agencies in Champaign County will increase capacity to serve children and youth with serious emotional disturbances and their families by transforming the county's services into an integrated network of community-based services and supports that are family-driven, youth-guided and culturally competent. The grant was awarded in FY2010. This initiative is community-based, using a public health facility located in close proximity to at-risk neighborhoods to reduce stigma and promote linkage between physical and behavioral health services and is targeting African American youth with SED, ages 10-17 who are involved with (or at risk of involvement with) the juvenile justice system.

Project Connect-White, Saline, and Gallatin Counties

This System of Care grant was awarded in FY2010. Project Connect is a collaborative initiative for youth with serious emotional disturbances and their families with the mission of providing a seamless System of Care for the three rural, southeastern Illinois counties (White, Saline, and Gallatin) that is family-driven, youth-guided, strengths-based, sustainable, culturally and linguistically competent. The three counties have high poverty rates, low levels of adult education, high levels of disability, and high Medicaid enrollment. The area is substantially underserved for mental health, with only 10% of the children and youth with serious emotional disturbances receiving special education services; outpatient services are limited, resulting in 10% of youth with serious emotional disturbances being hospitalized each year. Project Connect is available to all children, birth to age 21, in these counties, but targets three groups that are particularly in need of additional support: (1) Youth transitioning to adulthood (age 16-21), (2) youth receiving special education services, and (3) youth undergoing major developmental transitions (into grade school, into middle school, and into high school). The initiative is implementing universal screening of youth through the schools at three points in their K-12 education; hiring Family Resource Developers and Care Managers to work in concert with school-based social workers and mental health service providers in the community; and offering evidence-based practices to support youth and family development (such as Wraparound services, parent skills training, and services focused on transitioning to adulthood).

Illinois United for Youth-(IUY)

In addition to the three current SOC Grants, a new grant application was submitted to SAMSHA for a 12 month System of Care Expansion Grant. The Illinois United for Youth System of Care Expansion Planning Initiative (IUY) will result in the development of a comprehensive strategic plan for integrating the system of care philosophy into the delivery of a full array of behavioral health services for youth with serious emotional disturbances statewide throughout Illinois. The objectives of IUY will build upon and reflect the goals of current system of care work including infrastructure development and sustainability, youth and family involvement, readiness for the adoption and implementation of core SOC principles across the state and the development of a statewide SOC blueprint including action steps that aim to create and sustain a statewide system of care. Of highest priority will be the development of a statewide lead family organization and an SOC primer training opportunity for key stakeholders.

The collective experience acquired from the three current SAMSHA funded Systems of Care in Illinois and the work of the Interagency Child Serving Clinical Care Coordination Committee, which has been planning for statewide change since Fall 2010 will provide direction for initiating, planning and implementation of the Initiative. As with the current grants, the strategic planning will leverage the commitment of youth, their families, the child serving state agencies that serve them and a myriad of stakeholders.

The IUY Planning Team looks forward to the opportunity to apply lessons learned from current SOC projects and the challenge of strategic planning for statewide expansion of SOC ideology should the Grant application be accepted.

System of Care concepts have also captured the attention of the Illinois Children's Healthcare Foundation (ILCHF) which has a single vision: to ensure every child in Illinois has the opportunity to grow up healthy and the philosophy that health care must address the whole child, and that the healthcare system in Illinois must be responsive to the needs of all children. Working through grantee partners across the state, the Foundation focuses its grant-making on identifying and funding solutions to the barriers that prevent children from accessing the ongoing health care they need. Through a process of research, listening, and planning, the Foundation has focused its current grant making in two high needs areas in children's health: Improving oral health of Illinois' children and addressing the mental health needs of children in Illinois. The Foundation believes the mental health of children is as important to their overall well-being as their physical health. Since its inception, ILCHF has supported efforts to bring together coordinated and integrated community-based primary care and mental health services for children.

Individual Care Grants for Children with Mental Illness

The DMH Individual Care Grant (ICG) Program provides funds for residential treatment or intensive community treatment for children and adolescents with serious emotional disturbances who meet the criteria of severe mental illness and impaired reality testing. The Illinois Mental Health Collaborative for Access and Choice (the Collaborative) provides support for administrative procedures. The ICG program is family driven, meaning that families make the decision regarding whether they wish to utilize their grant for residential or community based services. These decisions are generally made with consultation from the mental health providers working with the family. Services provided include intensive, home-based support, treatment, and therapeutic stabilization services that allow the child to remain at home. The ICG program is unique in the sense that parents do not have to relinquish custody of their children to obtain these services. An ICG Advisory Council was established in FY2001 and continues to provide input to planning and service delivery.

Community-based ICG services are coordinated through agencies funded to provide SASS services. For some youth, the Community Based ICG program serves as an excellent "step down" transition from residential care, for others, the community-based services are effective in preventing the need for institutional placement. Community-based ICG services are also an effective transitional support for the movement from child and adolescent services to adult services. The SASS agencies work with families to identify appropriate support services, serve as a fiscal agent by purchasing the services specified in an approved plan, and monitor their effectiveness in meeting the youth's clinical needs. The program offers a number of supports, including child support services, case coordination services, behavior management services, and therapeutic stabilization services. In FY2010, 150 youth were served in Community-Based care out of the 374 youth in the ICG Program, which represented 40% of the total population and is consistent with the percent served in Community-Based care in previous years. ICG services are available across the state.

Early Intervention for Children of Incarcerated Parents

An early intervention program located in Chicago's North Lawndale community, successfully piloted in the past few years, serves children of incarcerated parents. Utilizing a Multi-Family Group format, the 14-week curriculum of Strengthening Families for the Future Program designed for at risk families is employed to reconstruct relationships within the families. The program also provides case management, mentoring, tutoring, and individual/family therapy. Referrals to the program come from local elementary schools, social service agencies, Cook County Jail, and the state's corrections system. There were several program service enhancements initiated over the last year including crisis counseling, career counseling and assessments and community education with presentations at schools, health fairs and local psychiatric hospitals. A total of 116 children and youth and 31 parents, totaling 147 families received direct service this year.

The success of this project led to its replication in Southern Illinois, in Madison and St. Clair Counties. This program employs clinicians that are responsible for the clinical work and for outreach as well as stakeholder education. Family support, case management, individual and group therapy are provided. Children and youth are eligible if they have at least one parent incarcerated with a release date no further out than two years and an intention of returning to a primary parenting role. Upon the parents' release, they are reunified with their child and linked to the resources in the community. Currently there are twenty families being served.

Mental Health and Juvenile Justice

Youth in the juvenile justice system have disorders that can be effectively treated with psychopharmacological and behavioral interventions. These interventions are usually more successful when they are coordinated with other major service systems impacting the child and family. Research has demonstrated that the majority of juveniles in detention centers meet the criteria for a psychiatric diagnosis and one in six has a serious mental illness. Many of those also have a co-morbid substance abuse disorder (Teplin, et al. 2005). The juvenile justice system frequently either fails to identify these youth or fails to provide the necessary mental health treatment. The Mental Health Juvenile Justice (MHJJ) program was conceived and implemented to address this critical need. MHJJ provides an alternative to incarceration for juvenile detainees with serious mental illnesses, by arranging for the necessary mental health services to address individual clinical needs. The Division of Mental Health initially funded MHJJ as a pilot project in 2000 in just seven counties and subsequently expanded the project to each of the 17 Illinois counties with a detention center and one county without a detention center. The program was initially conceived as an alternative to secure detention, though eligibility criteria have been expanded to intercept youth at the earliest stages of justice involvement. Since FY2008 two community agencies in Cook County have offered MHJJ services with the goal increasing outreach and linkage to the Latino community. The MHJJ program now covers 34 Illinois counties, involves 21 community agencies and has approximately 60 community-based clinical staff participating.

Initiatives of the Illinois Department of Healthcare and Family Services (DHFS)

DHFS, the Illinois Medicaid Agency, is implementing initiatives that impact mental health service delivery. One initiative is the All Kids insurance program that significantly expands medical and mental health services to children across the state. A second initiative is Disease Management, which seeks to manage and coordinate services across service systems for individuals with targeted diagnoses.

Child and Adolescent Service System

Illinois has made substantive progress in developing a comprehensive mental health service system for youth with serious emotional disturbances (SED) and their families. Illinois envisions a well resourced and transformed mental health system that is consumer directed and community driven with a continuum of integrated and effective culturally inclusive programs and services including prevention, early intervention and treatment that promote healthy lifelong development through equal access and support recovery and resilience. In Child and Adolescent services, the emphasis is on resilience and evidence informed practice as components in the systemic transformation process. Many of the activities in which the DMH is engaged are providing the foundation to make this vision a reality even in an era of great fiscal challenge.

Service System Strengths

Important strengths of Illinois' community-based mental health system in relation to children/adolescents are described below. It is important to note that while we aptly describe our strengths, significant challenges continue to confront the public mental health service system. Fiscal constraint in the past few years has resulted in limited growth and implementation of a number of initiatives and the discontinuation of some others. With the creativity and innovation of the past several years, there has also been increasing awareness of the lack of sufficient resources with which to actualize and transform the service system to fully and rapidly achieve the vision articulated below. In FY 2012, the system is facing significant fiscal challenges and is anticipating further reduction instead of growth. DMH efforts are currently geared towards finding practical solutions to challenges and sustaining gradual and incremental progress where possible.

  • The array of essential services that is available to youth with serious emotional disturbances who are enrolled in Medicaid and their families.
  • The commitment to evidence informed practices and the dissemination of information regarding the implementation of evidence-informed practices that lead to resilience.
  • The consistent commitment and ongoing efforts to divert children and adolescents from inpatient and residential treatment to services in their home communities as exemplified by the SASS (Screening, Assessment and Support Services) program and the DMH Individual Care Grant (ICG) Programs. These individualized ICG or SASS services include intensive home-based support, treatment and respite care which allow the child to remain at home.
  • Planning for family driven care as the foundation for current and future planning efforts.
  • The on-going collaboration with the Children's' Mental Health Partnership has been fruitful in providing the resources needed to advance several vitally needed initiatives including services to youth in transition, early intervention, and the promotion of Evidence Informed Practices.
  • Family Resource Developer positions have been created and maintained across the state and have also been an active component of the System of Care initiatives.
  • Collaborative efforts, pilot projects, and vocational/employment supports to address the needs of youth with serious emotional disturbance transitioning to adulthood, including those transitioning from correctional settings and the child welfare system.
  • Maintenance and further expansion of the clinical outcomes analysis system for children/adolescents that can generate multi-level data reporting.
  • The state health care coverage program that offers comprehensive, affordable health insurance for children in Illinois assures that every uninsured child, regardless of income or medical condition has access to health care, including mental health services. Additionally healthcare coverage is extended to parents living with their children 18 years old or younger and relatives who are caring for children in place of their parents.
  • Through external resources, such as the Data Infrastructure Grant, federally funded studies, and DMH initiatives, our databases and analytic capabilities have steadily grown to an extensive array of computerized information that provides an important resource for analyzing service provision and service needs
  • Collaboration with IDHS Divisions and state agencies to ensure continuity of care and service integration is a multifold strength of the DMH service delivery system for children and adolescents.
  • The statewide Mental Health Juvenile Justice (MHJJ) program brings services to youth in county detention centers across the State in collaboration with juvenile justice.
  • Long-standing collaborations are in place with the DCFS, the ISBE and the DASA. The DMH has partnered with these agencies to implement the wraparound approach to the delivery of children's services as well as to provide or coordinate delivery of mental health services. More recently, collaboration with DCFS and DHFS expanded the provision of SASS services.
  • Three System of Care grants in Illinois are addressing collaborative issues and shaping service delivery systems. Illinois has applied for System of Care statewide planning grant.
  • Innovative collaborative programs addressing the needs of children in the inner city including Project Launch and the Early Intervention for Children of Incarcerated Parents, both located in Chicago's Westside communities.
  • The IDHS Homeless Youth program has existed for many years and provides outreach and a range of services for homeless youth ages 14-21. In Chicago, Beacon Therapeutic Center's Shelter Outreach Services (S.O.S.) program utilizes a preventive model which focuses on intervention with children and parents in the shelter setting and provides targeted case management and mental health services to women and children in 22 shelters on the south, north, and west sides of Chicago. Services focus on the identification of untreated mental illness, developmental delays, substance abuse, needs assessment, advocacy, coordination services and follow-up supportive services.
  • The DMH has made a substantial, successful and sustained commitment to increasing the portion of the DMH funds allocated to community-based treatment for children and adolescents with serious emotional disturbance and their families.
  • In recognition of the increasing role played by federal Medicaid funds, the DMH has worked successfully to increase this revenue source to benefit children's services.
  • The DMH has maintained a strong joint public and academic program which continues to include Departments of Psychiatry, Social Work, Psychology, and Nursing in universities across the State as evidenced by specialization and curricula appropriate to children with SED.


II. Unmet Service Needs and Critical Gaps in the Service System

DMH conducts ongoing and multi-pronged assessment activities and processes to identify unmet services needs and gaps in the service delivery system using data based processes. The following activities provide examples of these processes.

The DMH has developed an enterprise level management information system in collaboration with its' Administrative Services Organization (AS0), the Illinois Mental Health Collaborative for Access and Choice. The data collection through this system is used by DMH to perform analyses to determine unmet service needs and gaps in the service delivery system. For example, merging access related data with consumer level demographic information is helpful in looking at the characteristics of persons being served and detecting disparities in access to treatment as well as potential service needs. DMH is also undertaking a geo-access analysis to look at the availability of specific key services across the state. Data collected through the MIS is also used to determine penetration rates using the prevalence data that is referenced below.

As discussed previously, the DMH service delivery system is regionally based. At the this level, assessments of local service needs and deficits are ongoing efforts performed by DMH and ASO staff during monitoring visits, and by convening regional advisory committee and other meetings with providers, and consumer and family members. Continuity of care is assessed and discussed in regional continuity of care work groups consisting of state hospital staff and community mental health providers convened by DMH regional staff.

The Illinois Mental Health Planning and Advisory Council (IMHPAC) and its sub-committees represent a wide range of constituencies who bring issues forward for attention and discussion. For example, the Child and Adolescent Committee which meets bimonthly and consists of more than 100 members from across in the State representing providers, family members, and a range of stakeholders, regularly discusses issues and needs related to Child and Adolescent Services. In the adult arena, focus groups were recently convened to evaluate Olmstead-related transition needs of individuals with serious mental illnesses living in long term care facilities as part of the planning for the implementation of the Williams vs. Quinn Consent Decree. As a result of these activities DMH administrative staff are very aware of critical gaps and service needs in the service delivery system.

The advent of Health Care Reform will necessitate further assessment of the relationship of health services and behavioral health services: that is, the health care needs of persons with SMI and access to mental health services for persons with primary health care issues. The recent policy summit on bi-directional integration of primary and behavioral healthcare convened by DMH with the support of DASA, DPH, and DHFS, has begun the conversation and engendered thought about how to move forward, and will be instrumental in planning for unmet needs. As we know, individuals with serious mental illnesses are at risk of having higher morbidity and mortality rates when compared with other populations. Planning with regard to access to healthcare will be critical.

Block Grant Planning - Mental Health Planning Council

As an essential component of this year's planning for the mental health block grant submission, the Planning Committee of IMHPAC asked the membership and sub-committees to discuss and identify unmet needs in the mental health service system and present their findings for discussion.

Adult Services

The following are Unmet Needs in the Adult Mental Health Service System which have been identified by the Illinois Mental Health Planning and Advisory Council:

  • Access to Services by Uninsured and Under-Insured individuals
  • Affordable Housing
  • Psychiatric Services
  • Medication for Indigent Populations-Specifically, individuals with Serious Mental Illnesses who are indigent need access to Psychiatrists and Physicians and the ability to obtain anti-psychotic medications at minimal or no cost.
  • Mental Health services for individuals with mental illness who are homeless persons
  • Mental Health services for veterans with veterans with mental illnesses
  • Training and education in existing service venues on dynamic issues and mental health interventions in serving the LGBTQ population
  • Reduction of the cracks and slippages in service for individuals with both Developmental Disability and Mental Illness.
  • Restoration of funding for the Community Hospital Inpatient Service programs (CHIPs)
  • Emphasize and increase consumer roles in service provision with support for Peer Run Services in the State

Children and Adolescents-Unmet Service Needs and Critical Gaps

The following are Unmet Needs specific to the Child Mental Health Service System which have been identified by the Illinois Mental Health Planning and Advisory Council:

  • Assuring young children access to the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) which affords an array of services targeted to the prevention of behavioral health problems.
  • Increase school-based counseling and mental health services
  • Intensive Community Service programs for children and families (for families requiring longer term intervention beyond brief screening, assessment and support services (SASS), and for those that do not qualify for ICG community services)
  • Restoration of Flexible Funding for special services for children with serious emotional disturbances (SED)

The "Prevalence and Access" Gap

Prevalence estimates and access data are gathered and reported yearly and reflect the gap that exists between the probable number of adults in the state with SMI and children/youth with SED and the actual numbers of those receiving services in the public mental health system.

Adults

The CMHS definition and methodology for prevalence estimation for adults is published in final notice form in the Federal Register Volume 64, Number 121, June 24, 1999. The methodology provides a calibrated point estimate of the 12-month number of persons who have Serious Mental Illness, age 18 and older in Illinois. This does not include persons who are homeless and institutionalized. The prevalence estimate provided by CMHS is 5.4%. Based on the adult population for Illinois, it is estimated that in FY2010 there were 523,752 adults with serious mental illnesses residing in Illinois. Information on the number of persons served in FY2011 is derived from the Uniform Reporting System (URS) Tables 2A and 2B, which is currently being prepared. National Outcome Measures (NOMs)/Performance Indicators with quantitative targets related to increased access to services are described in the Performance Indicators Section The number of individuals with Serious Mental Illnesses (DMH eligible population) reported as receiving services from DMH-funded agencies in FY2010 was 120,196, approximately 94.7% of the total number of adults receiving services (126,883). When viewed in conjunction with the prevalence rate estimates provided above, DMH is purchasing services for approximately 24% of the adult population who needs mental health services. Of course, some individuals in need of services, may be receiving those services from providers who do not contract with DMH for service delivery and who consequently do not report these services.

Children and Adolescents

For an estimate of Children and Adolescents with Serious Emotional Disturbance, Illinois has used the 7% estimate provided in the CMHS notice in the Federal Register, Volume 63, Number 137, July 17, 1998 based on the midpoint of the number estimated at the lower limit of a level of functioning of 50 (LOF=50) and the number estimated at the upper limit of that level of functioning (LOF=50 to 60). The figure has been updated by CMHS using 2009 census information to 110,105 or 7% of the population of children and adolescents aged 9 to 17 based on a 17.8% (FY2008) poverty rate. The number of youth with Serious Emotional Disturbance (eligible population) reported served in FY 2010 was 34,581, approximately 96.2% of the total served (36,242). FY 2011 data will be provided in the Implementation Report. When viewed in conjunction with the prevalence rate estimates provided above, DMH is purchasing services for approximately 32% of the child/adolescent population that needs mental health services. As with the adult estimates, some individuals in need of services, may be receiving those services from providers who do not contract with DMH for service delivery and who consequently do not report these services.

Addressing Unmet Needs and Critical Service Gaps

Although not all unmet needs and service gaps can be addressed due to resource issues and other factors, the DMH has addressed some of these needs as explicated in the next section and as elucidated in the priorities, goals and objectives that are described.

III. State Planning Priorities

Table 2:  State Planning Priorities for FY2012 - FY2013

Number State Priority Title State Priority Detailed Description
1 Adults-Assurance of an effective array of clinical and support services. Assurance of an effective array of clinical and support services for persons enrolled in Medicaid and services which are essential for ongoing clinical care and support of individuals with serious mental illnesses who are not enrolled in Medicaid during this period of fiscal constraint.
2 Adults-Promote Provision of Evidence-Based Services Promotion of Evidence Based Practices for individuals for whom DMH purchases services within the context of service benefit packages established by DMH for the Medicaid and non-Medicaid populations in need of mental health services.
3 Adults and Children/Adolescents- Bi-directional Integration of Primary Health Care and Behavioral Health Care. Bi-directional Integration of Primary Health Care and Behavioral Health Care.
4 Adults- Advancement of the recovery vision. Advancement of the recovery vision including Wellness Recovery Action Planning, expansion of the scope and quality of consumer and family participation, and promotion of the utilization of the Certified Recovery Support Specialist (CRSS) credential.
5 Adults - Address the mental health needs of individuals who are homeless, individuals who live in rural areas, and those who are elderly. Maintain and improve the provision of mental health services to persons who are homeless, to persons who reside in rural areas, and to elderly persons. (Criterion 4)
6 Adults and Children/Adolescents-Advancement of the use of data to support decision-making. Advancement of the use of data to support decision-making.
7 Adults- Maintain a comprehensive system to serve the forensic needs of court -involved consumers. Maintain a comprehensive system to serve the forensic needs of court -involved consumers whose access to inpatient and outpatient services is ordered by the Court.
8 Adults/Child and Adolescent -Planning, within budgetary constraints, to address the needs of uninsured and underinsured consumers Planning, within budgetary constraints, to address the needs of uninsured and underinsured adult and child and adolescent consumers who may remain unable to access services through the venue of ACA Health Care Reform by 2014.
9 Child and Adolescent-Assurance of an effective array of clinical and support services for children and adolescents. Assurance of an effective array of clinical and support services for children and adolescents enrolled in Medicaid and the provision of services which are essential for ongoing clinical care and support of those with serious emotional disturbances who are not enrolled in Medicaid during this period of fiscal constraint.
10 Child and Adolescent Advancement of family-driven care Advancement of family-driven care through parent education, parent-to parent supports, and promotion of the Certified Family Partnership Professional credential. Continued expansion of the scope and quality of parent and youth involvement. (Criterion 1)
11 Child and Adolescent -Enhancement of collaborative efforts with state and local partners to address the mental health needs of youth Enhancement of collaborative efforts with state and local partners to address the mental health needs of youth in the juvenile justice system, students in public schools, and the implementation of early interventions for families of young children
12 Child and Adolescent - Promotion of Evidence-Informed Practices Promotion of Evidence-Informed Practices and continue to expand the use of evidence informed practices in treatment programs throughout the State.
13 Child and Adolescent -Encourage and facilitate the use of the Public Health Model Encourage and facilitate the use of the Public Health Model in the delivery of Mental Health services.
14 Child and Adolescent- Advancement and expansion of the use of video-conferencing and Tele-psychiatry Advancement and expansion of the use of video-conferencing and Tele-psychiatry in clinical work in rural areas and partnering with universities and other stakeholders in planning initiatives to better align service delivery for children and adolescents in rural areas.
15 Child and Adolescent- Address the mental health needs children/adolescents who are homeless and those who reside in rural areas. Plan the delivery of mental health services for children/adolescents with SED and their families who are homeless and for those who reside in rural areas utilizing interactive communication technology and academic/community partnerships to improve service alignments.


IV. Objectives, Strategies and Performance Indicators

Table 3:  Objectives, Strategies and Performance Indicators FY2012 through FY2013

Priority Goal  Strategy  Performance Indicator  Description of Collecting and Measuring Changes in Performance Indicator
Adults-Assurance of an effective array of clinical and support services Continue to assure that a comprehensive array of community-based services is available to adults in need of mental health services (Criterion I.)

Ensure that the following services are available:

Mental health assessment

Treatment plan development, review and modification:

Assertive community treatment, case management, community support (individual, group and residential), crisis intervention, mental health intensive outpatient, psychosocial rehabilitation psychotropic medication administration, monitoring, and training; short-term diagnostic and mental health services, therapy/counseling, transitional ACT, and oral interpretation and sign language

Work with system partners to provide supportive services including educational services, services provided by local school systems under the Individuals with Disabilities Education Act (IDEA), substance abuse services (through DASA), services for co-occurring mental health and substance abuse disorders, medical and dental (through DHFS for Medicaid eligible individuals), and Community Integrated Living Arrangements (CILA).

Number of adults who are (a) Medicaid eligible or (b)non-Medicaid eligible who receive mental health services. DMH funded providers by contract must submit demographic, clinical information and claims data for all individuals receiving services funded using DMH dollars. The DMH provides data specifications to assure consistency of reporting. Registration data is submitted directly to the DMH information system which is operated by the DMH's Administrative Services Organization (ASO). Claims data, which is submitted to the state Medicaid agency Healthcare and Family Services (HFS), is returned to the ASO after processing where it is stored with registration information in the DMH data warehouse. This information is used as a basis for developing reports and for analytic purposes, and is the basis for reporting the data used to populate the majority of the URS tables
Adults-Promote Provision of Evidence Based Practices Promote Evidence Based Practices for individuals for whom DMH purchases services within the context of service benefit packages established by DMH for the Medicaid and non-Medicaid populations in need of mental health services. During FY2012 and FY2013, maintain the implementation of Evidence Based Supportive Employment.  Number of consumers receiving supported employment in FY2012 and FY2013. National Outcome Measure Data for this indicator are generated through a special web-based database created specifically for the DMH SE initiative. Fidelity and outcomes data are submitted to the DMH SE coordinator. As always, DMH has developed specifications for reporting thatDMH funded providers must use when submitting data. DMH only reports data for teams that have been found to exhibit fidelity to the evidenced based practice model.
Adults-Promote Provision of Evidence Based Practices  Promote Evidence Based Practices for individuals for whom DMH purchases services within the context of service benefit packages established by DMH for the Medicaid and non-Medicaid populations in need of mental health services. During FY2012 and FY2013, continue provision of Assertive Community Treatment that meets national fidelity model requirements. Number of persons with SMI receiving Assertive Community Treatment in FY2012 and FY2013. (National Outcome Measure). DMH funded providers by contract must submit demographic, clinical information and claims data for all individuals receiving services funded using DMH dollars. The DMH provides data specifications to assure consistency of reporting. Registration data is submitted directly to the DMH information system which is operated by the DMH's Administrative Services Organization (ASO). Claims data, which is submitted to the state Medicaid agency Healthcare and Family Services (HFS), is returned to the ASO after processing where it is stored with registration information in the DMH data warehouse. This information is used as a basis for developing reports and for analytic purposes, and is the basis for reporting the data used to populate the majority of the URS tables.
Adults-Promote Provision of Evidence Based Practices Promote Evidence Based Practices (See Above).  By the end of FY 2013, through the provision of rental subsidies, implement a statewide permanent supportive housing initiative which targets an additional 300 consumers acquiring decent, safe, and affordable housing and support services in a manner consistent with the national standards for this evidence based practice. Number of consumers who acquire appropriate permanent supportive housing. (National Outcome Measure) Individuals receiving permanent supported housing were not previously required to be registered for mental health treatment services. Therefore, it was necessary to create a special database to track access to and receipt of permanent supportive housing. The data for this indicator will be generated from permanent supportive housing applications which are stored in the special database, as well as a special PSH outcomes database.
Adults-Children and Adolescents-Bi-directional Integration of Primary Health Care and Behavioral Health Care.  Work with system partners to identify next steps in planning for bi-directional integration of primary health and behavioral health care. 

1. Review evaluations of bi-directional health care summit held in June 2011.

Meet with system partners to continue planning efforts for bi-directional integration of primary health and behavioral health care.

Follow-up meeting with system partners to continue planning efforts.  Minutes of meetings held with system partners.
Adults-Advancement of the Recovery vision. Establish a comprehensive system of care based upon principles of Recovery and Resilience in which consumers are knowledgeable and empowered to participate and provide direction at all levels of the system. Educate consumers of mental health services in leadership, personal responsibility and self-advocacy, through participation in regional Recovery Conferences. Number of regional Recovery Conferences held each year.  Document each regional recovery conference event. Aggregate data across regions by year to enable comparisons across years.
Adults-Advancement of the Recovery vision  Establish a comprehensive system of care based upon principles of Recovery and Resilience in which consumers are knowledgeable and empowered to participate and provide direction at all levels of the system.  Enhance the recovery orientation of mental health services through continuing education of certified WRAP Facilitators. Number of regional WRAP continuing education/refresher trainings conducted each year. Each training event will be documented when held. Data will be aggregated by fiscal year for comparison across years.
Adults-Advancement of the Recovery vision Establish a comprehensive system of care based upon principles of Recovery and Resilience in which consumers are knowledgeable and empowered to participate and provide direction at all levels of the system.  Conduct a series of statewide teleconference designed to disseminate important information to consumers across the State. Number of statewide teleconferences held each year. Document each teleconference event and aggregate by year for comparison across years.
Adults-Advancement of the Recovery vision Establish a comprehensive system of care based upon principles of Recovery and Resilience in which consumers are knowledgeable and empowered to participate and provide direction at all levels of the system   Support the role of Certified Recovery Support Specialists and their deployment statewide by hosting webinars for providers to help increase agencies' understanding of the role, value, function, and advantages of hiring CRSS professionals and by providing competency training events for individuals interested in the CRSS credential. Number of training events held each year to increase stakeholder understanding of the CRSS credential and to increase competency in CRSS domains. Document each training event and aggregate by year for comparison across years.
Adults and Children/Adolescents- Advancement of the use of data to support decision-making Use Quantitative data to assess access to care and perception of treatment outcomes to provide data for decision support. (Criterion 2) Assess access to care by tracking the number of individuals who received treatment partitioned by race, gender and age. Number of adults and number of children/adolescents receiving services from DMH-funded community-based providers. DMH funded providers by contract must submit demographic, clinical information and claims data for all individuals receiving services funded using DMH dollars. The DMH provides data specifications to assure consistency of reporting. Registration data is submitted directly to the DMH information system which is operated by the DMH's Administrative Services Organization (ASO). Claims data, which is submitted to the state Medicaid agency Healthcare and Family Services (HFS), is returned to the ASO after processing where it is stored with registration information in the DMH data warehouse. This information is used as a basis for developing reports and for analytic purposes, and is the basis for reporting the data used to populate the majority of the URS tables.
Adults and Children/Adolescents- Advancement of the use of data to support decision-making Use Quantitative data to assess access to care and perception of treatment outcomes to provide data for decision support. (Criterion 2) Conduct a consumer survey to assess perception of care to determine the extent to which consumers and caregivers report positive outcomes that are attributable to treatment received.  Percentage of: (a) adult consumers and (b) caregivers of youth reporting positively about outcomes. The DMH will utilize the MHSIP Adult Consumer Perception of Care Survey and the Youth Services Survey for Families to collect this data. This year, a random stratified sample of adults receiving treatment in June 2011 is being selected for this year's survey. This sample will be disseminated via mail in October2011with a goal of all data collected by early November. Similarly a random stratified sample of caregivers of children and adolescents receiving services in June 2011 is also being selected to receive the survey. This method will be used for the surveys for FY2012 and FY2013. The indicator values will be compared with data collected in succeeding years.
Adults- Maintain a comprehensive system to serve the forensic needs of court-involved consumers. Maintain a system of care to address the mental health needs of consumers with criminal justice involvement.   Monitor and maintain linkages to community services for individuals with serious mental illness released from Illinois jails. Percentage of eligible individuals released from jail who are linked to community-based services. A daily cross match of individuals receiving mental health services with individuals in jails in selected jurisdictions is used to identify individuals participating in the jail data linkage project. Data will be collected to track the number of individuals who are linked with community based mental health service providers. Data will be aggregated across the year for comparison with data from succeeding years.
Adults/Child and Adolescent- Planning, within budgetary constraints, to address the needs of uninsured and underinsured consumers. Identify resources to purchase mental health services for uninsured and under-insured consumers. Use financial resources from the state general revenue fund, Federal Fund Participation (FFP), and grants as a basis to fund the purchase of mental health services. Enhance human resources of the public mental health system through continued support of public/academic linkages, mental health and law enforcement training, and the training and coordination of providers of emergency and disaster services.  No indicators for this goal. No indicators are identified for this goal.
Child and Adolescent- Assurance of an effective array of clinical and support services for children and adolescents Continue to assure that a comprehensive array of community-based services is available to children and adolescents in need of mental health services (Criterion I.)

Ensure that the following services are available:

These services include: Mental health assessment,

Treatment plan development, review and modification: Screening, Assessment and Support Services (SASS), case management, community support (individual, group and residential), crisis intervention, mental health intensive outpatient, psychotropic medication administration, monitoring, and training; short-term diagnostic and mental health services, therapy/counseling, Individual Care Grant for Children with Mental Illness (ICG/MI) and oral interpretation and sign language

Work with system partners to provide supportive services including educational services, services provided by local school systems under the Individuals with Disabilities Education Act (IDEA), substance abuse services (through DASA), services for co-occurring mental health and substance abuse disorders, medical and dental (through DHFS for youth who are Medicaid eligible), and Wraparound services. 

Number of youth who are (a) Medicaid enrolled or (b)non-Medicaid eligible who receive mental health services.  DMH funded providers by contract must submit demographic, clinical information and claims data for all individuals receiving services funded using DMH dollars. The DMH provides data specifications to assure consistency of reporting. Registration data is submitted directly to the DMH information system which is operated by the DMH's Administrative Services Organization (ASO). Claims data, which is submitted to the state Medicaid agency Healthcare and Family Services (HFS), is returned to the ASO after processing where it is stored with registration information in the DMH data warehouse. This information is used as a basis for developing reports and for analytic purposes, and is the basis for reporting the data used to populate the majority of the URS tables. Data will be collected by fiscal year to compare change across years.
Child and Adolescent Advancement of family-driven care Establish a system of care that is family driven and emphasizes services that are evidence-based. Facilitate parent-to-parent support through the use of Family Resource Developers in system of care grants.  Number of Family Resource Developers hired in System of Care grant-funded programs. The number of parents hired as system family resource developers for system of care grants will be aggregated across the year for comparison with data collected for subsequent years.
Child and Adolescent Advancement of family-driven care  Establish a system of care that is family driven and emphasizes services that are evidence-based. In FY2012 and FY2013 advance Family Driven Care in Illinois by certification of parent providers as Family Partner Professionals. The number of individuals who are credentialed as CFPPs by the end of each fiscal year.  The number of parents certified as Family Partner Professionals will be aggregated across the year for comparison with data collected for subsequent years.

Child and Adolescent-

Enhancement of collaborative efforts with state and local partners to address the mental health needs of youth.

Integrate services for children/adolescents across service systems and the developmental stages from early childhood through young adulthood. (Criterion 3-Juvenile Justice)

In FY2012 and FY2013, increase the number of youth receiving services through the Mental Health Juvenile Justice Initiative (MHJJ).

 .

Number of youth served by the MHJJ program statewide.  Aggregate the number of youth receiving services from the mental health juvenile justice program across the year that will be compared with data from subsequent years

Child and Adolescent-

Enhancement of collaborative efforts with state and local partners to address the mental health needs of youth.

Integrate services for children and adolescents across service systems and the developmental stages from early childhood through young adulthood. (Criterion 3-Schools) Provide technical assistance and implementation support to educators, parents, organization and other state agencies on the coordination of the Illinois Interconnected Systems Model of School Based Mental Health. Number of Technical Assistance events in each fiscal year Aggregate data on the number of technical assistance events held across each of the fiscal years for comparison with subsequent years.

Child and Adolescent-

Enhancement of collaborative efforts with state and local partners to address the mental health needs of youth.

Advance the implementation of evidence-informed practices in the child and adolescent service system through FY2013.   Implement video based training methodologies and develop additional evidence-based content in an effort to increase and improve statewide EIP training.  The number of training events (including video-based) held to advance evidence-informed practices  Each training event will be documented and the data aggregated across the year for comparison with subsequent years.
Child and Adolescent -Encourage and facilitate the use of the Public Health Model Establish and nurture local systems of care, embedded in a public health model, consistent with the values and principles of CASSP and Family Driven Care to implement a prevention and early intervention initiative known as "Reaching Out to Help"   In FY2012 and FY2013, fully establish and implement the Reaching Out to Help initiative which is a 3-tiered public health model. Tier 1 consists of universal health promotion/prevention activities which target an entire population to promote and enhance emotional wellness by increasing developmentally appropriate mental health skills. Tier 2 is early intervention targeting children at greater risk of developing risky behaviors and mental health concerns. Tier 3 are treatment activities targeting children identified as having significant mental health concerns that require referral and linkage to clinical mental health treatment. Develop a baseline for measurement of outcomes and the implementation of local systems of care for the Reaching Out to Help Initiative.  The number of children and adolescents participating in Tier 1, Tier 2, and Tier 3 in FY 2012 and FY2013. Aggregate the number of children/adolescents participating in Tiers 1,2, and 3 of the "Reaching Out to Help" Initiative across the year for comparison with subsequent years of data.
Child and Adolescent- Advancement and expansion of the use of video-conferencing and Tele-psychiatry Advance and expand the use of video-conferencing and Tele-psychiatry in clinical work and partner with universities and other stakeholders to plan initiatives to better align service delivery for children and adolescents in rural areas. Through FY2013, continue to implement Tele-psychiatry services in seven rural sites in Illinois and, contingent upon funding opportunities, plan for further expansion of the program. Number of youth living in rural areas receiving services through Tele-psychiatry.  Aggregate data on the number of youth receiving Tele-psychiatry services in rural areas across each year for comparison with subsequent years of data.

Child and Adolescent-

Address the mental health needs children/adolescents who are homeless and those who reside in rural areas.

 Maintain and increase provision of mental health services to families and children who are homeless and to those who reside in rural areas. (Criterion 4)  Track the number of youth with serious emotional disturbances who are homeless and receiving mental health services.   Number of individuals under age 18 who are homeless and who are receiving services. (National Outcome Measure) DMH funded providers by contract must submit demographic, clinical information and claims data for all individuals receiving services funded using DMH dollars. The DMH provides data specifications to assure consistency of reporting. Registration data is submitted directly to the DMH information system which is operated by the DMH's Administrative Services Organization (ASO). Claims data, which is submitted to the state Medicaid agency Healthcare and Family Services (HFS), is returned to the ASO after processing where it is stored with registration information in the DMH data warehouse. This information is used as a basis for developing reports and for analytic purposes, and is the basis for reporting the data.

SECTION III-C, Use of Block Grant Dollars for Block Grant Activities


Table 4:  Services Purchased Using Reimbursement Strategy (Page 29 of the Application Guidance)

Start Year: 2012, End Year: 2013

Reimbursement Strategy Services Purchased Using the Strategy
Grant/Contract Reimbursement The Illinois plan for the expenditure of the FY2012 and FY2013 Community Mental Health Services Block Grant for adults and children/adolescents is primarily directed at providing psychiatric leadership services across the state with a small amount allocated for special projects. The psychiatric leadership services include training and supervision of clinical staff as well as the provision of some services. The funding allocation is consistent with the State Mental Health Plan. Approximately 26% of block grant funds are allocated to Child and Adolescent Services.

SECTION III (PARTS D THROUGH P), NARRATIVE PLAN

D. Activities that Support Individuals in Directing the Services

Implementation of self-directed care in its fullest sense remains distant in Illinois. Over the years there have been several programs which provided participant directed options to very limited recipient groups with specified funds. In one instance recipients were chosen out of a pool of qualified applicants by lottery. Flexible funding for SASS programs allowed families of children and adolescents with Serious Emotional Disorders to request and receive supports needed beyond the traditional mental health services, but this funding ended with the budget crisis in 2010. The current economic climate of the State is not allowing for the allocation of funds directly to consumers nor the infrastructure required to carry out the tasks associated with self-directed care. However, current recovery oriented and consumer education efforts are orienting and positioning consumers and clinical providers toward person centered planning and consumer /family self-directed care:

  • A significant step in this direction has been the establishment of the Wellness Recovery Action Plan (WRAP) model in Illinois. Thousands of consumers throughout the state have benefited from receiving orientation and education in the principles and components of this emerging best practice in recovery-based services. The WRAP curriculum was also modified to address the needs of youth and has been piloted in several agencies in various parts of the State including Chicago, central Illinois, and southeastern Illinois.
  • Consumer education activities, credentialing processes for recovered consumers and for parents of children with SED, and the consumer to consumer/parent to parent supports are all designed to inform and enhance the abilities of consumers and families to be more directive about the services they receive and to participate more effectively in monitoring, advocacy, and policy leadership activities. Current efforts are described in Section II. (See the Adult Plan and the Child Plan for further detail.)
  • Illinois has developed an initiative addressing family driven care. Family Driven Care as defined by the Federation of Families for Children's Mental Health, means that families have a primary decision making role in the care of their own children as well as the policies and procedures governing care for all children in their community, state, tribe, territory and nation. This includes: (1) Choosing culturally and linguistically competent supports, services, and providers; (2) Setting goals; (3)Designing, implementing and evaluating programs; (4) Monitoring outcomes; and (5) Partnering in funding decisions. A commission on Family Driven Care was established in FY2010. Regional surveys have been conducted to gain information on identified mental health needs, family and provider satisfaction with the services available, and the extent to which the system is responsive to the needs and issues encountered by families of youth with serious emotional disturbances. The Commission and activities to increase family voice and directedness in the care of children is continuing. (See Section II- Child Services Plan)
  • Family and youth partners are active in all aspects of Illinois System of Care projects, including planning, governance, care coordination, administration and evaluation. SOC services are delivered through individualized, comprehensive plans of care, guided by strengths and needs the youth and family, supported by trained family advocates, and coordinated by a single care manager to achieve goals across all life domains and child-serving systems.

E. Data and Information Technology

IT Systems Maintained by the Division of Mental Health

The DMH utilizes data to support decision making in a wide variety of areas including utilization management, quality improvement activities, resource allocation and planning efforts. As such, data is frequently analyzed and interpreted and utilized for these purposes throughout the year. Information is disseminated to a wide variety of entities in different formats that have been designed to be user-friendly. Through the use of quantitative measures of organizational functioning, comparisons can be made against a standard over extended time or between organizational units. Target levels for the performance indicators provide focus for evaluation and planning.

Two primary data systems are used to collect administrative data for individuals receiving DMH funded services. Each system and the type of information recorded and reported are displayed in the table below.

Type of Information Information System Used to Collect Data
Provider Characteristics

DMH ASO Information System;

DHS Contracting System

Consumer Enrollment, Demographics and characteristics DMH ASO Information System
Admission, Assessment and Discharge DHS/DMH MIS - Clinical Inpatient System
Services Provided DMH ASO Information System
Prescription Drug Utilization DHS/DMH MIS - Clinical Inpatient System - State Operated Hospital Services Only

DMH/ASO Community Reporting System

DMH worked with its Administrative Services Organization (ASO) the Illinois Mental Health Collaborative for Access and Choice to design and develop a comprehensive information system that "went live" in September of 2008. Community mental health agencies are required to use data standards and specifications developed by DMH and the Collaborative as the basis for submitting data. Since, the initial implementation of the system, DMH has made several modifications to enhance data collection requirements and to permit collection of data that is compatible with Uniform Reporting System requirements as developed under the State Infrastructure Grants (DIGs).

DMH funded community providers are contractually required to register all individuals funded with any DMH dollars in the DMH/ASO Community Reporting Information System. Until June 30, 2011, claims for all services were also submitted to this system. However as of July 1, 2011, legislation now requires all claims to be submitted directly to the Illinois Medicaid agency Healthcare and Family Services MMIS. Processing of claims is subject to business rules established by DMH, thus the linkage between registrations of individuals for services and claims submission has been retained. DMH reporting standards require full reporting of consumer and service data by community providers.

DMH State Hospital Reporting

The DMH operates nine state hospitals and one facility for persons who are sexually violent. DMH state hospital staff are required to record and report data using a system developed by the DHS. This system, which is known as the Clinical Inpatient System (CIS), is used to collect demographic, clinical and service data.

Data Warehouse

DMH has worked with the Collaborative to develop a data warehouse which is maintained by the Collaborative. The warehouse stores data related to eligibility, registration, billing/services information, a provider database, and service authorization in one place. DMH now has unprecedented access to this data.

Unique Identifiers and Federal Data Standards

Since FY2006 all individuals seeking mental health services have been assigned unique ID numbers referred to as RINS. RINS are also being assigned to consumers who access services under other Divisions within DHS, as well as to individuals receiving services through the Child Welfare System and Corrections. The use of RINS has improved tracking of services received by consumers across state systems, as well as increasing accuracy in the un-duplication of consumers receiving services in the mental health system. The extent to which each of the two DMH information systems incorporate unique provider and consumer identifiers is described in the table below.


Unique Identifiers/Federal Standard Status DMH ASO MIS DHS/DMH CIS
NPI Required Yes No
Unique Provider Identifier Yes Yes
Unique Client Identifier Yes Yes
Client Level Data/Claims-Encounters at the Service Level Yes Yes

Use of ICD 10

Note: preparing to move from ICD-9

No No
Use of CPT/HCPS Yes Yes
Unique Identifier permitting linkage with Medicaid provider identifier for data aggregation Yes Partial
Medicaid data used to routinely used to produce reports Yes Yes

Linkage between the DMH Information Systems and the State Medicaid MMIS

The use of unique provider and consumer identifiers provides the ability for DMH to work with the state Medicaid agency Healthcare and Family Services to aggregate Medicaid and non-Medicaid claims at the level of the provider.

Illinois has developed a health information exchange strategic plan. Efforts in this arena have been delegated to the state Medicaid agency HFS. The vision and mission of Illinois' efforts to develop a statewide HIE are incorporated in the recently enacted Illinois Health Information and Technology Act 2 , which states "The State of Illinois has an interest in encouraging the adoption of a health information system to improve the safety, quality and value of health care, to protect and keep health information secure, and to use the health information exchange system to advance and meet population health goals. The Plan also outlines Illinois' current and future strategies to leverage existing EHR capacity, investment and broad stakeholder commitment to advance the HIE goals in Illinois (see synopsis below). The Illinois Plan may be found at the following website address: http://www.hie.illinois.gov/assets/hiesop.pdf

The goals of the Illinois HIE Strategic and Operational Plan, which are aligned with those of the Illinois State Health Improvement Plan, State Medicaid program, and EHR Incentive Program, are to:

  • Improve health care quality and outcomes
  • Improve patient safety
  • Enhance public health and disease surveillance
  • Control the cost of health care
  • Reduce health disparities

The objectives related to these overarching goals are to:

  • Protect the privacy and security of identifiable health information
  • Promote the adoption and Meaningful Use of EHR
  • Facilitate quality reporting and measurement
  • Encourage information technology-enabled care delivery
  • Develop a statewide HIE

The Illinois HIE initiative will employ the following strategies to achieve its goals and objectives:

  • Increase EHR adoption through implementation of the Medicaid EHR Incentive Program, support for the Medicare EHR Incentive Program and participation in other programs that encourage practitioners and hospitals to adopt EHR
  • Facilitate secure exchange of EHR by developing statewide HIE infrastructure in accordance with evolving national standards and protocols and all applicable state and federal laws
  • Increase the use of e-prescribing by increasing awareness of the benefits to both patients and providers and removing existing barriers to use of e-prescribing technology
  • Increase the electronic transmission of structured laboratory results by supporting interoperable standards and removing barriers to the sharing of data
  • Increase the sharing of patient care summaries by aligning programs and payment mechanisms to encourage and incent this activity
  • Increase awareness and public support for the use of EHR through a communications plan that delivers accurate and complete information about EHR and HIE in culturally-relevant formats
  • Increase broadband deployment through coordinated activities with the Illinois Broadband Deployment Council and participation in the federal Broadband Opportunities Program
  • Provide focused resources for safety net providers and their patients by identifying additional technical resources for EHR adoption and supporting workforce development programs to retrain existing workers in the transition from a paper to an EHR environment
  • Develop a plan for financial sustainability of the statewide HIE by calculating a value model for each entity that will participate in the statewide HIE and devising a revenue model that distributes costs reasonably and fairly

Illinois has received a planning grant to create a statewide health information exchange. However mental health has not been an active participant in planning around the exchange of mental health related data.

F. Quality Improvement Reporting

Quality Improvement Mission and Vision

The Division of Mental Health Quality Management Committee serves as the primary point of contact for communication and planning in respect to Quality Assurance and Continuous Quality Improvement. The Quality Management Committee works with Division staff to assess the degree to which the Division meets requirements; recommends actions to bring the Division into compliance with requirements, and recommends actions that will improve the Division's ability to meet its requirement.

The core values and concepts of continuous quality improvement include continuous assessment of key activities with an eye toward improving processes and outcomes, consumer service and focus, decisions based on facts, data and analysis, employee involvement/empowerment and teamwork. The Quality Management Committee partners with the various units within the Division to ensure that stated needs, issues and concerns are addressed. The Quality Management Committee reviews and provides advice related to various quality improvement work products and engages in problem-solving to resolve issues and risk where needed. The Committee lends support to units within the Division to ensure successful implementation of continuous quality improvement efforts and ensure quality of service delivery.

Quality Reviews, Standards and Provider Audit Requirements

Quality standards and provider audit requirements are defined by Illinois Administrative Code (Title 19, Part 507). Quality improvement and program and financial decision-making rely on relevant, accurate data and insightful planning based on reliable data sources. A necessary and important ingredient of any system established to support management and program improvement activities is a system of monitoring and accreditation. The system for monitoring community providers includes the following activities:

  • Certification Reviews: Performed by the DHS Bureau of Accreditation, Licensure, and Certification (BALC). These reviews verify that the sites and services of providers are meeting standards for Medicaid certification. These reviews are performed at least every 3 years, more often if significant findings are discovered in an earlier review.
  • Clinical Practice and Guidance Reviews: Provided annually as a DHS/DMH collaborative effort to guide providers in meeting best-practice standards, including recovery principles.
  • Fidelity Reviews: A review by DHS/DMH providing feedback to providers on fidelity to specific service definitions, with the goal of ensuring that providers are maintaining fidelity and identifying areas that need improvement.
  • Post-payment Reviews: A review of Medicaid and Non-MCO services following payment of services billed examining documentation, including medical necessity for such services. This review is provided by the Collaborative. Findings resulting in a request for recoupment are subject to an appeals process.

Monitoring reviews are followed by an exit conference in which results are shared with managers of the programs reviewed. The DMH regional staff respective to the provider reviewed and other DMH staff also receive monitoring review results. Tools and protocols regarding reviews are available on the DMH Web site. Agencies with identified deficits are expected to develop corrective action plans which are then monitored by DMH regional staff.

Performance Measurement

Data is used for monitoring and the results are shared with a range of stakeholders. National Outcome Measures (NOMs) and other performance data are incorporated into the DMH quality improvement plan as reports reflecting the performance of the total system are produced. When there are challenges meeting performance targets, a more specific and detailed analysis of data elements and processes is performed to determine the causes of the problem. Determining the problem then leads to finding a solution. A similar process is used to address situations wherein performance targets are routinely exceeded.

The DMH regularly produces reports reflecting service trends, system performance, and financial status. The use of surveys reflecting views of consumers and caregivers is an important element in improving services and service delivery. Survey results are available on the DMH Web site. The system also includes a Web site address for inquiries regarding conferences, presentations, training, registration, financial issues, monitoring tools, and clinical issues, among them utilization management

The Division has developed a number of state specific indicators and measures that are regularly monitored and reviewed. The National Outcome Measures have been incorporated into this process. Many of these indicators and measures are described in the priorities, goals and indicators section of this application.


G. Consultation with Tribes

This section is not applicable. Illinois has no Tribal reservations within its boundaries. Primary health care, community health and mental health services are provided to medically underserved members of federally recognized American Indian Tribes and family members residing in the City of Chicago area by the American Indian Health Service of Chicago, Inc. This agency, incorporated in 1975, operates as a non-profit charitable organization and is not funded through DMH. Further information may be obtained from the agency's Website at www.aihschicago.org.

H. Service Management Strategies

To ensure quality services and compliance with standards in the Illinois Medicaid Rule, DMH has developed and implemented a Utilization Management (UM) Program. Specifically, this is the vehicle through which DHS/DMH ensures that individuals being served receive the services best suited to support their recovery needs and preferences, that cost effective services are provided in the most appropriate treatment setting, and are consistent with medical necessity criteria and evidence-based practices. By implementing the UM Program, DHS/DMH strives to achieve a balance between the needs, preferences, and well-being of persons in need of mental health services, demonstrated medical necessity, and the resources available to serve their needs. The DHS/DMH UM Program was developed in collaboration with the Department of Healthcare and Family Services, the State Medicaid agency.

The UM program is based on the following principles:

  • Utilization Management is a dynamic, quality improvement process that can evolve and change as additional data, new research, and other new information become available.
  • Utilization Management must be based on data.
  • Individuals accessing services should have a consistent threshold of medical necessity statewide.
  • Utilization Management should strive to minimize administrative costs where possible.
  • Authorization must be clinically focused and conducted by qualified staff.
  • Utilization Management should primarily focus on outliers by identifying patterns of underutilization and overutilization and focusing clinical review and management protocols on outliers to ensure that service utilization patterns are appropriate to the recovery needs of the individuals being served.

DMH is employing a "Thresholds Model" in Utilization Management for the following services: therapy/counseling, psychosocial rehabilitation and community support group. DHS/DMH requires clinical review and authorization when the number of services received by an individual exceeds the 75th percentile as compared to all users of that service statewide. The thresholds for each service were established on the basis of an analysis of FY2009 utilization data. In other words, authorization is only required on outliers. This means that at least 75% of existing consumers are not expected to require authorization for their services because their utilization, based on historical patterns, will not exceed the clinical review threshold. Thresholds are the same for adults and children/adolescents and are calculated by provider and consumer per fiscal year. An example of a current threshold is that authorization is required to continue to provide Therapy Counseling to a specific individual beyond 10 hours in a specific fiscal year. Providers are required to obtain authorization prior to receiving reimbursement for services delivered to consumers beyond the specified thresholds. Authorization for reimbursement is made based upon the medical necessity of the consumers.

The DMH has required pre-authorization of Assertive Community Treatment and Community Support Team services for a number of years.

Utilization Management for Services Purchased Using Block Funds

Currently, MHBG dollars are largely directed to psychiatric leadership for which utilization thresholds have not been established. Methodology is in place to track the allocation of funds for this service and providers are required to submit reporting for some activities associated with this service. DMH is working to improve and enhance the mechanisms that are in place to better track data associated with psychiatric leadership services. As DMH continues to plan for and adapt to the changing fiscal and service environment, there may be some necessary shifting and reallocation of block grant funds within the appropriate guidelines established by SAMHSA.

I. State Dashboard

Illinois has already developed a state dashboard that will easily be adapted as needed for federal block grant requirements. During FY2010, recognizing that the current economic environment requires that information be available quickly in a user-friendly format to assist and support decision making and planning efforts, Illinois DMH engaged in a cutting edge project to develop a tool to provide staff with rapid access to information and key performance indicators that could be used for monitoring, evaluation and decision support. The end result of this initiative was two web-based Dashboards which received recognition at the national level for their innovative style and design.

The Dashboard needed to be user-friendly and intuitive, and it needed to provide information at the level of an individual provider as well as summary information at the regional and state level for comparison purposes. The initiative evolved through three phases: Phase I focused on key indicators for fiscal monitoring, Phase 2 focused on clinical and population descriptive measures and indicators, and Phase 3 on the "story board" presentation. The key performance indicators and measures incorporated in the dashboards reflect areas of ongoing priority for the Division, including some of the National Outcome Measures of SAMHSA and the values expressed in the New Freedom Commission Report. Data elements include penetration rates, race, ethnicity, age, living situation and criminal justice involvement of individuals receiving services and a wide range of fiscal measures such as percent of contract earned, percent of claims adjudicated as Medicaid, and quality-related indicators. Many of the indicators that are identified by priority are included in the Dashboard that has been developed. The Dashboards are intended for regional staff, contract managers, clinical managers and executive staff at the DMH. It enables them to access data quickly and easily to guide decisions relating to access, utilization, and quality at the provider, regional and state levels. The Illinois Mental Health Collaborative is responsible for programming the Dashboard and maintaining the data warehouse for DMH. A screenshot of the two Dashboards are included in the Block Grant as attachments.

J. Suicide Prevention Planning

In Illinois, more than 1,000 persons die by suicide each year and suicide fluctuates yearly between being the second or third leading cause of death for adolescents. Interest, organized efforts, and advocacy for suicide prevention in Illinois resulted in legislative action. In 2004, the Suicide Prevention, Education and Treatment Act (PA093-0907) was passed by the General Assembly and signed by the Governor directing the Illinois Department of Public Health (IDPH) to appoint the Illinois Suicide Prevention Strategic Planning Committee composed of representation of statewide organizations and local agencies that focus on the prevention of suicide and support services to survivors. To unify planning and suicide prevention efforts, an alliance was formed between a coalition of stakeholders and the strategic planning committee that was recognized in law by the General Assembly in 2008. The mission of the Illinois Suicide Prevention Alliance (the Alliance) as stated in the law is "to reduce suicide and its stigma throughout Illinois by collaboratively working with concerned stakeholders from the public and private sectors to increase awareness and education, provide opportunities to develop individual and organizational capacity in addressing suicide prevention, and advocate for access to treatment." DMH is a member of the Alliance and has actively participated in the development of the 2007 Illinois Suicide Prevention Strategic Plan. The Plan is attached to this Application. It may also be accessed at:

http://www.idph.state.il.us/about/chronic/Suicide_Prevention_Plan_Jan-08.pdf

The Alliance and IDPH are required to provide an annual report to the General Assembly. The 2010 Annual Report is still in the draft stage and undergoing internal review. The 2009 Annual Report which was completed in June 2010, is attached as an update.

In reference to military personnel and their families, representatives from the Veteran's Administration programs in Illinois have been active stakeholders and have attended Alliance meetings for the past several years. At its recent meeting, the Alliance approved amending its By-Laws to add a military/VA representative to its membership.

K. Technical Assistance Needs

Illinois has recently identified technical assistance needs in the following areas:

  • Integration of mental health in healthcare reform efforts
  • Workforce development and cost effective models of staff education.
  • Managed Care impact on mental health services, especially around integrated models versus carve out models.

Although not so much technical assistance as advocacy, we also urge SAMHSA to continue efforts to include mental health in national conversations with regard to health information exchange and health information technology. In terms of exchange of information, it would be helpful for SAMHSA:

  • To convene forums for sharing of information by states and other entities around health care reform, health information exchange and workforce development. These forums could be convened through Webinars or through on-site forums to encourage in-depth conversation.
  • Incorporate the many products, resources developed over the years by the states to support work in the arena of data collection, outcomes and other performance measures

Active advocacy by SAMHSA is needed to both obtain funding in order to assist State Mental Health Authorities (SMHAs) in health information exchange activities as well as to include SMHAs in health information planning activities at the state and federal levels.

Resources that would be helpful to Illinois include:

  • Grants, Contracts and other fiscal supports to support the work of the DMH given that the mental health budget has been drastically reduced and some services are no longer available
  • Infrastructure dollars to support health care reform and health information exchange activities
  • Flexibility to fund some services/programs identified as a priority by the state.

Dollars and resources are urgently needed to undertake the above activities. Mental Health must have greater visibility!

L. Involvement of Individuals and Families

The provision of mental health care that is consumer and family driven is an important priority of the Illinois Division of Mental Health. This priority is consistent with the current emphasis on involving consumers and families in orienting the mental health system towards recovery, and to improve access to, and accountability for mental health services. A variety of initiatives are being implemented to support consumer participation.

On the Mental Health Planning Advisory Council

A concerted effort has been made to ensure that consumers and family members play an important role in planning for mental health services. Representation by consumers and parents of children with serious emotional disturbances has increased. Consumers and/or family members co-chair the MHPAC, as well as all MHPAC sub-committees.

WRAP Initiative.

The Wellness Recovery Action Plan (WRAP) model is well established in Illinois. Through WRAP classes in community agencies and the introduction of the principles of WRAP at consumer forums and conferences, thousands of consumers throughout the state have benefited from receiving orientation and education in the principles and components of this evidence-based practice in recovery-oriented services. Since the inception of the Wellness Recovery Action Plan (WRAP) Initiative in Illinois, more than 300 individuals (including consumers currently receiving services) have received Certificates of Achievement as WRAP Facilitators, through their completion of a 40-hour intensive course. Refresher/Continuing Education courses are held in each region bi-annually for Certified WRAP Facilitators. Six regional WRAP refresher trainings were conducted between July 1, 2010 and April 30, 2011. The average number of participants per session was 15.

Regional Recovery Conferences

Consumer education is provided through a variety of venues in the state. DMH Recovery Support Specialists work with stakeholders to design, plan and convene annual recovery conferences in each DMH region. These conferences often have a well-known and /or national speaker who delivers the keynote address and who sets the "tone of recovery" for the conference. Two regional consumer conferences were held between July 1, 2010 and April 30, 2011. More than 500 consumers, family members, providers, DMH and other state agency staff attended these conferences.

Consumer participation objectives for FY 2012/2013 support the DMH priority for furthering work on the recovery vision in Illinois, by encouraging consumers and family members to participate in decision-making and service planning. Some of these objectives are continuations of efforts initiated in prior fiscal years.

Consumer Education and Support Initiative

Dissemination of accurate information regarding services for consumers is the primary focus of the Consumer Education and Support Initiative. DMH has recognized the need for providing consumers with the tools they need to cogently and effectively participate in the development and evaluation of the service system. The goal of this project is to ensure that consumers of mental health services receive current, accurate and balanced information regarding changes in the service delivery system, empowering them to take an active, participatory role in all aspects of service delivery. In FY2011, eight statewide consumer education calls have been held between July 1, 2010 and April 30, 2011. There was an average of 480 participants for each consumer education teleconference. These calls provided a forum for discussion of service information, performance data, new developments, and emerging issues to promote consumers' awareness and knowledge.

Recovery oriented training

In addition to the regional recovery conferences and statewide consumer education calls, recovery oriented training sessions were held in a variety of venues for all interested stakeholders in FY2011. Audiences for these sessions included diverse stakeholder groups, educating consumers of mental health services, family members of consumers, mental health and addiction professionals, advocates, college students, occupational therapy professionals, and many others. Topics for these sessions have included the foundational principles of mental health recovery, Wellness Recovery Action Planning (WRAP), mentoring, advocacy, crisis planning, recovery support, spirituality, and others. Recovery oriented training events and presentations will continue in FY2012 and FY2013.

Certified Recovery Support Specialist (CRSS)

In collaboration with the Illinois Certification Board (ICB), the Divisions of Mental Health, Rehabilitation, and Alcoholism and Substance Abuse have developed the Illinois Model for Certified Recovery Support Specialist (CRSS). The CRSS, through collaboration with the ICB, is competency-based rather than curriculum-based. Individuals are certified as having met specific predetermined criteria for essential competencies and skills. The purpose of certification is to assure that individuals who meet the criteria for CRSS provide quality services. The credentials granted through the certification process will: (1) be instrumental in helping guide employers in their selection of competent CRSS professionals, (2) define the unique role of CRSS professionals as health and human service providers and (3) provide CRSS professionals with validation of, and recognition for their skills and competencies. Access to this credential became available through the ICB beginning in July of 2007.

As a means of disseminating information regarding the credential, the DHS/DMH developed a brochure entitled "Employing Persons with the CRSS Credential" and the ICB provided staff presence at regional recovery conferences to distribute information and respond to questions. DMH staff and the Mental Health Collaborative for Access and Choice designed a study guide for use by individuals seeking to obtain their certification that was published online in November 2009.

Individuals attending consumer conferences, statewide consumer education and support teleconferences, and regional WRAP Refresher trainings, receive CEU's toward achieving or maintaining their credential through the ICB. A total of 150 individuals received competency training for the CRSS credential and are preparing for application and examination with the Illinois Certification Board (ICB). As of May 1, 2011, 132 individuals had achieved their CRSS certification, and all are in good standing with the Illinois Certification Board (ICB).

In FY2011, the Office of Recovery Support Services continued to work with other system partners, including the ICB and the Mental Health Collaborative for Access and Choice (MHCAC), to develop training and study materials for those seeking to obtain their CRSS. Additional information regarding this cutting edge approach in credentialing for mental health peer specialists can be found at http://www.iaodapca.org/forms/crss/CRSS_Model.pdf 

In FY2012, the DMH Office of Recovery Services is planning to host webinars for providers to help increase agencies' understanding of the role, value, function, and advantages of hiring CRSS professionals with the aim of increasing the number of agencies hiring CRSS professionals in FY2013.

Family Participation

The participation of parents/caregivers and adolescents in planning and evaluating the quality of mental health services is an important aspect of the Illinois public mental health system. DMH has maintained this effort as a priority with activities directed toward increasing family voice and participation in the provision of C&A services statewide and in DMH Regions. Planning is currently underway to develop and establish a statewide family organization to support parents and caregivers of children with Serious Emotional Disturbance. DMH continues to:

  • Support the establishment of Family Resource Developers, parents and caregivers of children with SED in the role of assisting families within Screening Assessment and Support Services (SASS) programs by providing training for FRD's , and monthly FRD regional meetings.
  • Employ Family Consumer Specialists (FCS) as C & A staff members of DMH in each region of the state. All five of the DMH regions now have a Family Consumer Specialist actively involved.
  • Increase family participation in Regional Planning Councils, and the IMHPAC. The Child and Adolescent sub-committee of the Illinois Mental Health Planning and Advisory Council has been successfully co-chaired by a parent who exhibits strong leadership and advocacy skills and a community mental health agency director. This committee has become increasingly influential within the IMHPAC.
  • Partner with and provide technical assistance and logistical support to the ICG parent group that is concerned with the enhancement of the quality of services in the Individual Care Grant (ICG) program and continues to be a robust voice in developing child services in Illinois.
  • Require that Family Resource Developers are members of teams that provide services to youth and their families.

Family Resource Developers

DMH has required that Family Resource Developers (FRDs) be hired in SASS agencies. Increasing value has been placed on the expertise FRDs bring to the SASS teams and their support role has expanded. Monthly meetings are held for the FRDs in order to provide education, resource development and support for the positions.

Family Driven Care

Illinois was one of six states that received a SAMHSA award in 2009 that paid expenses to participate in a policy academy focused on Family Driven Care. This project supported collaboration with other child serving systems and supporters (DCFS, ISBE, CHP, DJJ, DASA, IFF, ICMHP) to address the extent to which the system is Family Driven. The project has involved surveys of families and providers, development of a multi-agency Family Driven Care Commission, and the beginning development of a state recognized certification for parent providers. The Family Driven Care Commission led the development of the Certified Family Partner Professional (CFPP) credential. The CFPP will assist in ensuring the quality of care that is provided to client families by peer parents in many of the child-serving systems. Certification will be accomplished through a mandatory training and experience protocol and the successful completion of a written examination. The goal for this credential is that it will be recognized in Illinois Medicaid Rule (Rule 132), and CFPP's will be authorized to provide services at the Mental Health Practitioner (MHP) level. The expectation is that moving the system to truly family driven care will require ongoing effort for several years.

Parent /Caregiver Education

Family Consumer Specialists host monthly statewide 'Parent Empowerment Calls' to provide parents with information that will allow them to more effectively drive and evaluate their children's care and the system at large. Consumer conferences for parents on evidence-based practices are scheduled, and education campaigns for families on the use of outcome measures are being developed. To support the discussion, the EBP committee has designed a brochure on Evidence Informed Practice for parents in order to help families know what to ask for and expect regarding care for their children.

M. Use of Technology

Interactive Communication Technologies

Communication Technologies have been very valuable in conducting the day to day business of the Division of Mental Health and in providing a medium for conducting stakeholder meetings and furthering training and education.

  • Video conferencing business meetings between offices of DMH (Springfield, Chicago, and Regional Offices) has become commonplace.
  • Meetings of the Illinois Planning and Advisory Council are conducted interactively through video conferencing between Springfield and Chicago with telephone conference inclusion for members unable to reach either location. Council Committees meet by video-conferencing from multiple locations in the State as well as bringing individuals in by telephone. The Child & Adolescent Committee, for example, conducts a two hour bi-monthly interactive meeting with over 100 members participating from all parts of the State.
  • Consumer Education and Parent Empowerment Call-Ins have been of inestimable value in informing consumers and parents across the State about current issues in the system, clinical developments, and resource information. In FY2010, eleven consumer call-ins were conducted with 300 to 700 participants in each call and seven parent empowerment call-ins garnered at least 180 participants for each call.
  • Monthly Teleconferences in the areas of Utilization Management, Assertive Community Treatment and Information Technology have been used as a cost-effective means to provide technical assistance to the network of providers with whom DMH contracts.

DMH worked with the Mental Health Collaborative for Access and Choice (the Collaborative), its contracted Administrative Services Organization, to develop and maintain two innovative Websites which can be easily accessed by consumers and providers.

  • The WRAP Locator provides current information to consumers on the Wellness and Recovery Action Plan classes located everywhere in the State thereby allowing consumers to choose a convenient location and a desirable format. WRAP facilitators are accommodated in entering the information about WRAP classes scheduled to begin or ongoing classes which are of interest.
  • Referral Connect is available to both consumers and providers and allows them to search for a mental health provider based on location and type of service provided. There are two versions of ReferralConnect that are accessible. The first is a version that maintains listings of more than 50,000 providers and offers the ability to search for services throughout Illinois and across the United States. The second version is Illinois-specific containing more detailed information about specific service availability and type of service.

In rural areas where there are shortages of psychiatrists, especially child psychiatry, Tele-psychiatry has been a very valuable tool to provide and improve the quality of clinical work (See Objective C4.1). Public Act 95-16 (July, 2007) permits rural Medicaid patients in Illinois to receive treatment through Tele-psychiatry - primarily videoconferencing - to provide psychiatric care to offset the long distances and limited access to transportation that make it difficult for rural persons to obtain adequate mental healthcare.

The efforts described above are generally expected to continue over the next year.

Use of Interactive Technology to Support the Integration of Mental Health Services and Addiction Treatment with Primary Care and Emergency Medicine

As discussed in another section of the Block Grant plan, the DMH in partnership with other DHS Divisions and state agencies convened a bi-directional healthcare summit in June 2011. Interactive technology was used effectively to promote this effort. The day- long summit itself was available via webcast providing an opportunity for a large and diverse audience to participate. Additionally videos of the presentations are posted on the DHS/DMH website, as well as written materials produced for and from the Summit. It is expected that these efforts will continue as the DMH moves forward with system partners on this important initiative.

Health Information Technology

The Governor's Office has appointed the state Medicaid Authority, Healthcare and Family Services, as the lead agency for the state with regard to health information technology and health information exchange. On July 27, 2010, Governor Pat Quinn signed a bill into law to create a secure framework for the sharing of electronic health information in Illinois. The new law created the Health Information Exchange and Technology Act and established a state authority to operate the Illinois Health Information Exchange (HIE). House Bill 6441 creates the framework necessary for providers and insurers to share health records electronically. The HIE will provide health care providers with a secure system to access a patient's comprehensive medical history, avoid duplicate tests and procedures, and assure the accuracy of prescription drugs and other medical orders.

The new law creates the Health Information Exchange Authority to establish and operate the HIE and foster the widespread adoption of electronic records and participation in the HIE. The legislation also creates an eight-member board to govern the authority. The directors of the Illinois Departments of Healthcare and Family Services, Public Health, and Insurance and the Secretary of the Illinois Department of Human Services, or their designees, and a designee of the Office of the Governor, serve as ex-officio members of the Authority. The Division of Mental Health, as the SMHA, does not, however, have a major role in this initiative.

As mental health/behavioral health is not currently an eligible recipient of dollars to support activities related to Health Information Exchange, or to assist in developing Electronic Health Records, there are simply no dollars available to assist in undertaking these important tasks during a time of unprecedented cuts to the state mental health budget. In effect, mental health is being left out of an extremely critical conversation and has not been given an opportunity to play an active role in larger state health information activities. As a result, there has been little opportunity to ensure that mental health/behavioral health needs and requirements are addressed. Although DMH staff have worked for many years on developing data standards, data definitions, and performance measures that could greatly support work in this arena, this work is not being incorporated into health information exchange activities. For example, over the last few years, DMH has been working with a very small, nearly non-existent budget, to begin planning around electronic health record development and implementation for the nine state psychiatric hospitals that it operates. If the infrastructure is not put into place and funds are not available to develop EHRs for this system, the state may very well have HIE activities occurring with private entities, but the state hospitals will not be able to participate in these activities.

Barriers to Promoting Interactive Communication Technology

Although DMH has been able to promote Interactive Communication Technology in many venues as described above, the primary barrier to expanding this effort into other arenas rest with the lack of availability of resources to do so. At present, the DMH does not intend to use ICT to collect data for program evaluation at provider and client levels. In terms of data collection and measures to judge the use and effectiveness of ICTs that are used, DMH may consider addressing these issues

N. Support of State Partners

Adult Services

DMH exerts ongoing leadership through system integration initiatives, competence development, consumer development and continuous quality improvement. Emphasis is on developing systems integration at the statewide level that parallels the relationships that community mental health centers develop at the local level.

The IDHS Umbrella

The Illinois Department of Human Services (IDHS) manages human service systems in the State, including management of the public mental health system through the Division of Mental Health. The mission of the IDHS is to assist Illinois residents in achieving self-sufficiency, independence and health to the maximum extent possible by providing integrated family-oriented services, promoting prevention, and establishing measurable outcomes in partnership with communities. The IDHS is able to connect eligible clients to a wide range of human services at one location because it administers community health and prevention programs, oversees programs for persons with developmental disabilities, mental health and substance abuse problems, provides rehabilitation services, and helps low-income persons with financial support, employment, training, child care, and other necessary family services. Local office staff use a family-centered approach to identify client needs; determine eligibility for benefits; link clients to appropriate programs, and refer them to services in their community. Increasing systems integration among the divisions and offices of IDHS improves the accessibility of support services for the mental health service system and enhances service delivery for individuals coping with mental illness.

The Division of Human Capital Development (DHCD) oversees programs that help clients to achieve self-sufficiency including employment and training services, child care and family services, and financial support services. This Division serves over one million DHS customers each month through income supports such as: cash assistance, food stamps, medical programs, employment and training programs, help with child care, emergency assistance, refugee and immigration services, homeless services, and specialized social services. DHCD has six regional and 106 local Family Community Resource Centers that serve as the first point of contact for many IDHS clients. These offices offer direct transitional services and a link to employers and key community organizations.

The Division of Alcoholism and Substance Abuse (DASA) funds and monitors a network of community-based substance abuse treatment programs. These programs provide a full continuum of treatment including outpatient and residential programs for persons addicted to alcohol and other drugs.

DMH and the Division of Alcoholism and Substance Abuse (DASA) have collaborated for many years to address services for individuals with co-occurring disorders. Initiatives have included the establishment of consortiums comprised of mental health and substance abuse providers to collaborate on treatment provision, cross-training of providers from both service systems focusing on integrated treatment, and the funding of an institute to provide training to service providers across the state.

The Division of Developmental Disabilities (DDD) provides respite care, developmental training, and family support services to help individuals with developmental disabilities to become independent. Services are provided through residential facilities and programs that help disabled individuals live at home or in a community living center. DMH and DDD share leadership tasks in addressing the needs of persons with Autistic Spectrum disorders (ASD) and joint efforts are ongoing to resolve service issues for those consumers who have been dually diagnosed with a developmental disability and a mental disorder.

The Division of Rehabilitation Services (DRS) oversees programs serving persons with disabilities that include vocational training, home services, educational services, advocacy, information and referral. Also provided are a variety of services for persons who are blind, visually impaired, deaf or hard of hearing.

DMH and DRS are partnering to increase the access of persons with serious mental illnesses to vocational rehabilitation services and to improve the coordination of psychiatric and vocational services. DMH, DRS, and DASA have worked collaboratively with the Illinois Certification Board (ICB) to develop the Illinois Model for Certified Recovery Support Specialist (CRSS) that defines baseline criteria for CRSS professionals and provides a professional certification that is competency based. DMH and DRS continue to jointly assess their service systems to determine what gaps exist locally and emphasize technical assistance for needed program modifications.

Relationship of the DMH to the Illinois Departments and Organizations

Mental Health and the Justice System

In addition to oversight and management of inpatient hospital services for persons with mental illnesses who have been declared unfit to stand trial (UST) or not guilty by reason of insanity (NGRI), the DMH Forensic Services collaborates with a range of agencies in the Criminal Justice System including:

  • Illinois Department of Corrections
  • Illinois Department of Juvenile Justice (Established in FY2006)
  • Administrative Offices of the Illinois Courts
  • Illinois Criminal Justice Authority
  • Illinois State Police
  • Illinois Sheriff's Association
  • Cook County Department of Corrections
  • County Jails and Juvenile Detention Centers (statewide)
  • Local law enforcement agencies and organizations (statewide)

IDHS/DMH has assumed a leadership role in the development of significant statewide initiatives for justice-involved individuals with mental illness and has been instrumental in developing integrated processes of identification, reentry linkage, and service delivery between the criminal justice, mental health and substance abuse networks, and recovery support services, such as housing and employment. These efforts have laid the groundwork for a more comprehensive and effective diversion approach based on leveraging existing successful intervention models, enhancement of capacity, and increased availability of clinically appropriate services.

These two initiatives demonstrate partnering support and an increasing clinical role in serving individuals with mental illnesses who have been adjudicated in the criminal courts:

The Jail Data Link Project is a pilot program between the Cook County Department of Corrections (CCDOC) and the mental health system begun in FY2000 has now expanded to other sites around the state. The initial program effort was implemented through Thresholds, a community mental health center, and was designed to serve adults diagnosed with serious mental illnesses who are detained at CCDOC (pre-trial). The project received a Gold Award from the American Psychiatric Association. A key aspect of this project was the development of a database for the daily exchange of information between Cook County Jail and the community mental health provider. This initiative is more fully described in Section II (Adult Plan-Goal 1).

Rockford Crisis Services Collaborative, a collaboration in the Rockford area between DMH Forensic services staff, Janet Wattles Community Mental Health Center, Singer Mental Health Center, and Rockford Jail, in which liaisons developed strategies for providing post release and emergency mental health services to detainees of the Rockford Jail. The emphasis of services is on detainees with misdemeanors who are known to local mental health providers. As a result, a mental health court was established that provides for diversion, discharge planning, and service linkage to Janet Wattles Community Mental Health Center. This program began initial operations during FY 2005.

Law Enforcement and Crisis Intervention Training

The DMH regularly collaborates with law enforcement agencies and emergency services at general hospitals to facilitate appropriate and effective psychiatric intervention to persons who are in crisis. Each DMH Region is committed to working on improving relationships through cross-training events for law enforcement officers and mental health staff of community agencies. DMH has worked collaboratively with a number of law enforcement agencies to provide training targeting police officers that interface with individuals with mental illnesses.

Illinois Housing Development Authority

The availability of safe, decent, and affordable housing is a necessary component of a comprehensive community support system. DMH has worked at forging dialogue and partnerships with the Illinois Housing Development Authority (IHDA), a group with a legislative mandate to oversee and advise on Housing in Illinois, which includes the broader spectrum of state government in its membership, as well as local housing authorities, housing developers and other finance entities.

Illinois Department on Aging

The DMH works closely with the Illinois Department on Aging (DOA) to increase training opportunities in the geriatric field, to improve the quality and accessibility of services for elderly persons with mental illness, and to enhance networking, collaboration and coordination of programs and services in provider networks. Training, consultation and technical assistance have been provided in the area of mental health and aging as well as promotion of public awareness of geriatric mental health concerns.

Child Services

Collaboration with the IDHS Division of Community Health and Prevention

The Division of Community Health and Prevention (DCHP) service purview encompasses community health services, family and youth development, violence prevention and intervention, and addiction prevention. The DCHP includes: Maternal and Child Health Services, Comprehensive Services for Youth, Substance Abuse Prevention, the Teen REACH Program, and Violence Prevention and Education Services. Collaboration, cross training, and consultation between DMH and DCHP has continued:

  • A statewide perinatal mental health consultation service has been established for providers to use when a screening indicates that a pregnant or postpartum woman may be suffering from depression. This service is accessed by a toll free number and provides consultation with psychiatrists specializing in women's health issues, information about medications that may be used in the management of perinatal depression during and/or after pregnancy, and referral and linkage to available mental health resources. This program was formed in collaboration with DCHP, HFS (Illinois Healthcare and Family Services), and DMH.
  • Early Intervention Services provided through DCHP for children under three years of age who are experiencing delays in one or more of the following areas: cognitive development; physical development; language and speech development; psycho-social development; and self-help skills. Evaluations and assessments are provided at no cost to families. Families with eligible children receive an Individualized Family Service Plan (IFSP) listing the services and support that must be made available to the family. DMH Child and Adolescent Services is supporting this program through efforts to increase community mental health provider capacity to serve any mental health needs of the children identified through these screenings; capacity-building programs include collaboration in the Illinois' Children's Mental Health Partnership's Early Childhood Consultation project providing early childhood mental health consultants to participating community mental health agencies, and the addition this year of the Devereaux Early Childhood Assessment tools to the DMH Child and Adolescent Services web-based outcomes system for children ages 0-5 served in the community mental health services system.
  • Project LAUNCH: DCHP and DMH Child and Adolescent Services leadership are serving as Co-Principal Investigators for this SAMHSA-awarded, 5 year grant program focusing on the healthy developmental needs of children ages 0-8 years. The project has both a statewide and a local component and currently both statewide and local scans are being conducted to assess needs and resources available to children and their caretakers in this important age range. Following these scans, both statewide and local strategic plans are to be developed with the Technical Assistance provided by SAMHSA regarding resources and services needs of this population and their caretakers. The local component of the project provides services to this population and their caretakers, including mental health consultants based in the local community and are available to multiple child caring providers there.

Mental Health Services Provided for Youth Through Other State Agencies

An overview of mental health services to youth and families in Illinois would be incomplete without the acknowledgement of the programs provided through state departments other than DHS. Screening Assessment and Support Services (SASS) are services provided by the Department of Children & Family Services (DCFS) for children who are under the guardianship of the Department. The Department of Health and Family Services (DHFS) funds SASS services for children enrolled in Medicaid. The Illinois Children's Mental Health Partnership (ICMHP) has partnered with DMH in providing a range of pilot projects affording services including early intervention, for youth transitioning from DMH funded C&A services to adult services and for any youth with mental health needs and/or social/emotional impairment who is transitioning from correctional services to the community. ICMHP directly manages a mental health consultation program for children under the age of 5. The Illinois State Board of Education (ISBE) provides mental health services through school districts for children who need them in the school setting. The Department of Juvenile Justice (DJJJ) employs mental health professionals who provide services in that Department's Youth Centers. Within DHS, the Comprehensive Community-Based Youth Services Program (CCBYS) provides mental health services to youth ages 10-17 who are at risk of involvement in the child welfare and /or juvenile justice system. The program has a statutory mandate to provide short-term crisis intervention services to youth who have run away from home or whose parents will not allow them to return to their home; or who are generally beyond the control of their parents. By law, the program must be available in every area of the state, 24 hours a day.

Juvenile Justice

The DMH has a Juvenile Forensic Program that develops treatment programs for forensic youth who are court-ordered into mental health care (i.e. unfit to stand trial or not guilty by reason of insanity). The Juvenile Forensic Program oversees the DMH Mental Health Juvenile Justice Initiative (MHJJ), which links minors in juvenile detention centers who have a major mental illness and sometimes co-occurring substance abuse problems to comprehensive community-based care. MHJJ began as a pilot program in FY2000 and expanded statewide by the end of FY2002. MHJJ is available at all the detention centers in Illinois.

Illinois State Board of Education (ISBE)

The DMH has pursued the Positive Behavioral Interventions and Supports (PBIS) model of collaboration between education and mental health through work on our States' current three System of Care Grants and through collaborative efforts with the Children's' Mental Health Partnership. The Division of Mental Health is currently funding six school-based Mental Health programs in collaboration with ISBE and the Illinois Children's Mental Health Partnership, and these have been successful in implementing the three-tiered model of schools-based mental health and development collaborations, helping not only students in all three tiers of the model, but schools staff such as teachers, and parents as well. Work is continuing to expand the education/mental health partnership of these schools and mental health programs. (See Section II-B Child Plan-Goal 3)

Child Welfare

DMH continues to work closely with Department of Children & Family Services, the child welfare agency, on a number of initiatives related to the mental health needs of children in the child welfare system including the Screening, Assessment, and Support Services (SASS) Program, which is an interagency collaboration between DMH, DCFS, and HFS (Healthcare and Family Services). This SASS program provides 24/7 access to children, youth, and their families in crisis in the State and is accessed through a 1-800 CARES line number statewide.

O. The Illinois Mental Health Planning and Advisory Council

Description of Role and Activities

The Illinois Mental Health Planning and Advisory Council (IMHPAC) advises the DMH on mental health issues. The Advisory Council is a body of 53 members, which includes consumers and representatives from public and private organizations that plan, operate, and advocate for mental health and support services for persons with serious mental illness. Established in 1992, the Advisory Council's participation in the analysis of Illinois' mental health system has yielded a significant public/private partnership that focused on restructuring public mental health services in Illinois and guided the development of a strategic plan for consumer-responsive, community-based, and cost-effective service delivery. The Council approved a set of By Laws at the end of FY2002 and has revised them as needed.

Each DMH Community Comprehensive Service Region (CCSR) is represented on the Council. Providers, consumers, family members and parents of children with SED who are members of the Council may also act in an advisory capacity in the Regions. State employees representing principal state agencies with respect to mental health, education, criminal justice, vocational rehabilitation, housing, and a variety of social services as well as representatives of organizations that are significant stakeholders and advocates are full members of the Council. Expansion of the Council membership to encompass behavioral health including representation of the Alcoholism and Substance Abuse community of providers and consumers, representation of primary health care, and representation of the Health Information Exchange Authority in FY2012 and FY2013 is currently being discussed.  

The Advisory Council currently has several sub-committees including an Executive Committee, Planning Advisory Committee, and Substantive Committees. The Substantive Committees include: Adult Inpatient, Child and Adolescent Services, and Adult Community Services. Other committees may be appointed as needed. The Council as a whole meets six times a year to review new developments, monitor the progress of initiatives, and discuss problematic issues in the mental health service system. Each subcommittee also meets at least six times a year, during alternating months of the full council meeting. Each subcommittee is co-chaired by a consumer or family member and a provider or other council member. The Council advises DMH on its policies and plans and advocates for improvements in the mental health system. The Council has identified critical funding needs in the public mental health service system, and members of the Council, privately and through their affiliations developed a Mental Health Summit to lobby for additional funding. The focus, coordination, and organization of their efforts have been instrumental in bringing mental health issues to public and legislative attention, founding an infrastructure for further advocacy, and participating in DMH efforts to generate more revenue for community mental health services.

The activities of monitoring, reviewing and evaluating the allocation and adequacy of mental health services within the state are an integral component of developing the state plan. The Planning Committee of the Advisory Council meets regularly with DMH staff to develop and review the state plan. Members of the IMHPAC participate in statewide planning meetings convened by the Division of Mental Health. Based on feedback provided by a wide range of stakeholders, key priorities for the mental health service delivery system are identified. These priorities include expanding work in the areas of: recovery, implementation of evidence-based practices, permanent supportive housing, children's mental health issues and mental health and justice system involvement.


State Mental Health Planning Council Membership List and Composition

Table 7-List of Planning Council Members

Name Type of Membership Agency /Organization Represented  Address, Phone, Fax& E-Mail
Anselmo, Frank Others (not state employees or providers) Community Behavioral Health Association (CBHA)

3085 Stevenson Drive

Springfield, IL 62703

217-585-1600

fanselmo@cbha.net

Backstein, Cindy Family Members of Individuals in Recovery

26 Camberley Road

Springfield, IL 62712

217-498-8774

backstein@mchsi.com

Blank, Wendy State Employees

IL Dept. of Corrections

(Criminal Justice)

Stateville CC

16830 South Rt. 53

Crest Hill, IL 60403

815-727-3607 ext.6220

630-450-2204 (cell)

Wendy.Blank@DOC.Illinois.gov

Buss, Donna Consumers/Survivors/Ex-patients (C/S/X)

620 Dakota Street

Crystal Lake, IL 60012

815-354-1577

815-455-2925 (fax)

dbuss@mc708.org 

Carmichael, Michele State Employees Illinois State Board of Education

100 N. 1st Street

Springfield, IL 62777-0001

217/782-5589

mcarmich@isbe.net

Carter, N'Dana Consumers/Survivors/Ex-patients (C/S/X)

4915 S. Washington Park Court

Chicago, IL 60615

(773) 624-6281

ergoqueen@hotmail.com

Connor, Ray Family Members of Individuals in Recovery

1218 N. Grove Ave

Oak Park, IL 60302

847-426-3692

847-649-8915(Fax)

rayconnor@comcast.net

Cooke, Andrea Consumers/Survivors/Ex-patients (C/S/X)

3445 S. Rhodes Ave,Apt.1207

Chicago, IL 60616

708-381-9088

a-cooke@sbcglobal.net

Daum, Denise Provider

Executive Director

Community Resource Center

101 South Locust

Centralia, IL 62801

618-533-1391

618-533-0012 (fax)

ddaum@crconline.info

Daxenbichler, Cindy Family Members of Individuals in Recovery

116 Daddono Circle

Bloomington, IL 61701

309-642-1080

Taurus463@comcast.net

Denson, Linda

Co-Chair

Consumers/Survivors/Ex-patients (C/S/X) Sankofa Organization of IL

7619 Parnell

Chicago, IL 60660

312-805-1751

312-747-9380

773- 651-4882 (FAX)

ldsankofail@aol.com

Feinberg, Ellen Consumers/Survivors/Ex-patients (C/S/X)

1819 N. Humboldt Blvd.

Apt. 307

Chicago, IL 60647

773-489-2669 (H)

773-274-2150 (W)

Feinberg_ellen@yahoo.com 

Ford-Whitsett

Smith, Pamela

Consumers/Survivors/Ex-patients (C/S/X)

10719 S. LaSalle Street

Chicago, IL 60628

(312)547-9791 (cell)

773-722-7900 X 4028 (W)

773-722-0644 (Work Fax)

pfordwhitsett@sbcglobal.net

Frazier, Sondra Family Members of Individuals in Recovery

6957 South Jeffery Blvd.

Chicago, IL 60649-1521

773-324-6644

lasalf@aol.com 

French, A.J Consumers/Survivors/Ex-patients (C/S/X)

129 Steiss Rd, Suite B

Glen Carbon, IL 62034

618-792-2049

sacred.creations@thebridge.to

Friedman, Fred Consumers/Survivors/Ex-patients (C/S/X) Next Steps,NFP

6513 North Sacramento

Chicago, IL 60645

773-274-2150

fred@nextstepsnfp.org

Heyrman, Mark

Others -

Representative

of Advocacy

Organizations

Legal Assistance Foundation

University of Chicago

6020 S. University Ave.

Chicago, IL 60637-

773-753-4440

773-702-2063 (Fax)

m-heyrman@uchicago.edu

Hopkins, Dennis, PsyD. Provider Iroquois Mental Health Center

323 West Mulberry Street

Watseka, IL 60970

815-432-5241

dhopkins@imhc.net

Irving, Anne Others (not state employees or providers)-

Representative

Labor Relations AFSCME

29 N. Wacker, Ste 800

Chicago, IL 60601

312-641-6060

312-346-1016 (Fax)

AIrving@afscme31.org 

James, Brian Consumers/Survivors/Ex-patients (C/S/X)

210 Avenue "c"

Danville, IL 61832

(217) 442-3200 Ext.132 (Work)

hopebrianjames@yahoo.com 

Jarman, Lynn Provider LINC

#1Emerald Terrace

Suite 200

Swansea, IL 62226

LJarman@lincinc.org 

Kalra, Antar Consumers/Survivors/Ex-patients (C/S/X)

211 Elgin, Apt. 6J

Forest Park, IL 60130

708-771-0472

antar7@sbcglobal.net

Kopera, Anthony Provider

CEO

Community Counseling Centers of Chicago

4740 North Clark Street

Chicago, IL 60640

773-769-0205

tony.kopera@c4chicago.org

Lake, Virginia Consumers/Survivors/Ex-patients (C/S/X) Thresholds

202 North Schuyler Ave

Suite 205

Kankakee, IL 60901

815-935-8886

vlake@thresholds.org

Larson, Nanette State Employees

Director of Recovery Support Services,

Division of Mental Health

5407 University St.

Peoria, IL. 61614

309-693-5228

Nanette.Larson@illinois.gov 

Laytham, Erin

Council Secretary

Others (not state employees or providers)- Illinois Association of Rehab. Facilities

206 South Sixth Street

Springfield, IL 62701

217-753-1190 ext 111

217-525-1271 (Fax)

elaytham@iarf.org 

Lindahl, Teri Family Members of Individuals in Recovery McHenry County Mental Health Board

4100 Veterans Parkway.

McHenry, IL 60050

815-353-9900

815-669-2570

tlindahl@familyservicemch.org

Martinez, Daniel MD Provider

Child Psychiatrist

Lutheran Social Services

4840 W. Byron St.

Chicago, IL 60641

773-282-7800

dmartinez@discoverccs.org

Nance, Mike Consumers/Survivors/Ex-patients (C/S/X) Heritage Grove

365 East Waggoner St.

Decatur, IL 62526-4695

217-423-4715

Mnance62@gmail.com 

Nolen, Kim Family Members of Individuals in Recovery

1753 186th Place

Homewood, IL 60430-3806

708-798-2820

knolen@sbcglobal.net 

O'Shea, Lynn Provider Association for Individual Dev.

309 West New Indian Trail Court

Aurora, IL 60506

630-966-4001

630-844-9884 (Fax)

loshea@the-association.org

Oulvey, Gene State Employees

Office of Rehabilitation Services

(Vocational Rehabilitation)

618 E. Washington, 3rd Fl

Springfield, IL 62794

217-720-9378

217-524-7549 (Fax)

Gene.Oulvey@illinois.gov

Overturf, Anita Consumers/Survivors/Ex-patients (C/S/X)

1464 Queeny Ave

Sauget, IL 62206

618-974-8424

Anitaoverturf.crss@yahoo.com

Pluta, William

State Employees

(Housing)

IL Housing Development Authority

Office of Housing Coordination Services

401 North Michigan Avenue, Suite 900

Chicago, IL 60611

312-836-5354

312-832-2191 (Fax)

wpluta@ihda.org 

Shustitzky, John

Council Co-Chair

Provider President and CEO, Pillars

333 North LaGrange Road

LaGrange Park, IL 60526

708-995-3500

jshustitzky@pillarscommunity.

Org

Smith, Dennis R.

State Agency Rep

Medicaid/Social Services

IL Dept. of Healthcare and Family Services

201 South Grand Ave East

Springfield, IL

217-782-2570

Dennis.R.Smith@illinois.gov

St. Clair, Cathy Consumers/Survivors/Ex-patients (C/S/X)

6301 N. Sheridan, #8D

Chicago, IL 60660

(312) 630-0278

cstclair@centerforprogress.org

Tolbert, Lisa Provider

Exec. Director

Delta Center

1400 Commercial Ave

Cairo, IL 62704

618-734-2665 ext 213

ltolbert@deltacenter.org 

Thomas, Lora

Council Treasurer

Others (not state employees or providers) NAMI

218 West Lawrence

Springfield, IL 62704

217-522-1403

Thomas.lora@sbcglobal.net

Walker, Christine Family Members of Individuals in Recovery.

399 Ridge Avenue

Winnetka, IL 60093

847-446-6436 (Home)

847-338-1505 (Cell)

critique@sbcglobal.net 

Willenborg, Melinda Family Members of Individuals in Recovery

157 County Road 700 North

Neoga, IL 62447

217-273-5394

mindywillenborg@yahoo.com

Vyverberg, Bob, Ed.D. *Official DMH Representative State Agency Rep.

Chief of Staff

Division of Mental Health

5407 N. University

Peoria, IL. 61614

(309) 693-5228

Robert.Vyverberg@illinois.gov

Zych, Gilbert Others (not state employees or providers) Lyons Township Mental Health Commission

6404 Joliet Road

Countryside, IL 60525

708-352-2992

708-354-7212 (fax)

ltmhc@lyonsts.com 


 

Table 6:  Planning Council Composition by Type of Member

Type of Membership  Number

Percentage of

 Total Membership

TOTAL MEMBERSHIP (As of 7/20/11) 47
Individuals in Recovery 14
Family Members of Individuals in Recovery 8
Vacancies (Individuals & family members) 2
Others (Not state employees or providers) 6
TOTAL Individuals in Recovery, Family Members & Others 30 63.83%
State Employees 7
Providers 8
Leading State Experts 0
Federally Recognized Tribe Representatives N/A
Vacancies 2
TOTAL State Employees & Providers 17 36.17%

P. Public Comment on the FY2012/FY2013 Illinois Mental Health Block Grant Application

The development of the state mental health block grant plan is made available for public comment in multiple ways. (1) The Illinois Mental Health Planning and Advisory Council (MHPAC) includes consumers of mental health services and family members who also participate in a range of advocacy groups such as the Mental Health Summit, the Mental Health Association and the Illinois Alliance for the Mentally Ill. Council members regularly consult with their respective advocacy groups during the development of the state plan. (2) All Council meetings are open to the public. Council meeting dates are set up a year in advance to facilitate participation. Persons with an interest in the state plan may attend meetings at which the plan is discussed and provide feedback and comments. (3) The Planning Committee of the MHPAC reviewed the FY2012/2013 Block Grant Plan during its development and requested comment and input from all members of the Council. This year, the Committee requested specific feedback on the Council with regard to unmet needs. Developments and issues in Block Grant Planning have also been discussed at all IMHPAC meetings in the past year. (4) A Notice requesting public comment and a working draft of the Plan was posted on the DHS Website on August 26, 2011. (5) The final state block grant application and proposed plan will be posted on the web site for the Division of Mental Health (www.dhs.state.il.us) in September. The public can access this DHS DMH Internet site. Interested parties have been instructed to contact Dr. Mary E. Smith to provide comment. Contact information is provided on the website. Detailed comments that have been provided thus far are on file at the DMH. Additional comments submitted after the final draft of the plan is posted will be reviewed by the MHPAC planning committee.

The Illinois Mental Health Planning Advisory Council (MHPAC) has delegated detailed work on the Mental Health Block Grant Application to the MHPAC Planning Committee which is comprised of consumers, a parent of a child with SED, providers, advocates, and is staffed by the mental health block grant planner. This committee meets every other month for three hours during which a variety of topics are discussed including block grant objectives, performance measures and indicators and service initiatives. Members of the planning committee make special presentations to the full MHPAC Council on various components of the plan to ensure that all members understand the content of the plan