Illinois CESSA Statewide Advisory Committee
Quarterly Updates on the Crisis Continuum
Fiscal Year 2024 Quarter 4 April 1, 2024- June 30, 2024
988
There was a significant change in the 988 program during the fourth quarter of Fiscal Year 2024. PATH, Inc, currently the officially-designated statewide backup Suicide and Crisis Lifeline Call Center (LCC) was not selected through a competitive process to continue in this role. Through a competitive process, Centerstone was selected to take over responsibilities previously provided by PATH, Inc.
Centerstone is a current Lifeline participant, handling 988 calls, chats, and texts on national and regional levels outside Illinois. With extensive experience in this field, the agency employs a hybrid staffing model that includes both in-person and remote call takers. This approach positions them well to meet the staffing requirements necessary to meet the operational needs in Illinois. Routing of Illinois calls, texts and chats will begin to Centerstone from Vibrant on 7/1/2024.
The leadership of PATH, Inc. informed staff about the loss of grant funding in April 2024. Consequently, the call center experienced notable staff attrition, causing their call answer rate to drop from 77% in March 2024 to 60% in May 2024. This decline has also negatively affected the overall in-state call answer rate, which fell from 80% in March 2024 to 66% in May 2024.
Despite the decline in the State's overall call answer rate related to this transition, other Illinois call centers have continued to see improvements in their performance. For example, Lake County achieved a call answer rate of 85% in May 2024, marking their highest call answer rate to date. Additionally, the State realized its highest monthly call volume since the beginning of the 988 program, with 15,475 calls in May 2024 identified as coming into the Lifeline network from Illinoisans.
Deflection
Deflection is a collaborative intervention connecting public safety and public health systems to create community-based pathways to treatment and other services to address social determinants of health without entry into the legal system. The Illinois Department of Human Services Division of Substance Use Prevention and Recovery (SUPR) have partnered with the Illinois State Police (ISP) to bring the deflection initiative to ISP drug enforcement districts across the state. Through the collaboration of IDHS/SUPR and ISP, the Treatment Alternatives for Safe Communities (TASC) and their Center for Health and Justice, brought communities together as defined by the drug enforcement districts to build a network of services in communities that serve as an alternative to arrest for individuals who are encountered by law enforcement. Forty counties across Illinois either have an active deflection initiative or are building an initiative that supports the work of ISP and the local communities by connecting individuals to services.
Program 590
Program 590 Mobile Crisis Response Teams (MCRT) Project Directors continue to meet monthly in cluster meetings, configured by their assigned CESSA EMS Regions. Additionally, during the quarter, DMH hosted monthly Learning Collaborative presentations. April's Learning Collaborative showcased a presentation from the IDHS/Division of Developmental Disabilities/Trinity Services, Inc (Part II) - crisis engagement for individuals who have developmental/intellectual disabilities. The May Learning Collaborative showcased the Living Room model (presented by Comprehensive Community Behavioral Health Center, East St. Louis) and the benefit of is 24-hour model as a stabilizing alternative for some individuals who are experiencing mild - moderate acuity in psychiatric or behavioral health crises. During this quarter Program 590 MCRT agencies and staff also had benefit of a series of trainings. The training topics included: Asian/Asian American Mental Health; Perinatal Mental Health Crisis and Suicide; Autism and Intellectual and Developmental Disabilities 101; and Impact on Implicit Bias (Parts A & B).
To assure availability of community based, mobile crisis response, a survey was sent to all Program 590 MCRT awardees to reaffirm their ability to provide 24-hour, in person, mobile crisis response. Follow-up meetings were held with those agencies that did not meet the 2021 requirements. Those agencies found out of compliance were placed on a Corrective Action Plan with a compliance turnaround date of November 1, 2024. Where issues of concern were identified with Program 590 MCRT operations, DMH conducted onsite monitoring visits.
Monthly training, Learning Collaborative presentations and cluster meetings will continue to be provided during the next quarter.
Certified Community Behavioral Health Clinics
As written last quarter, Certified Community Behavioral Health Clinics (CCBHC) are federally designated providers that offer a full range of mental health, substance use recovery and limited physical health services, offering truly integrated care for customers. CCBHCs are responsible for provider Mobile Crisis Response and other crisis services to all customers in their service area. The Department of Healthcare and Family Services, in collaboration with the Department of Human Services' Divisions of Mental Health (DMH) and Substance Use Prevention and Recovery (SUPR), submitted an application to participate in the federal Illinois' CCBHC Demonstration Program to the Substance Abuse and Mental Health Services Administration (SAMHSA). If Illinois' application is approved, Illinois will be able to fully certify 19 CCBHC locations across the state, providing enhance access to integrated services for Illinois customers. Awards will be announced in June 2024. If awarded, Illinois will begin CCBHC services on October 1, 2024.
Community Emergency Services and Support Act (CESSA)
This quarter saw the CESSA Statewide Advisory Committee (SAC) meet once virtually and once in-person. Both meetings complied with the Open Meetings Act. The SAC continued to enjoy robust participation and consensus from constituents across the many sectors connected under CESSA's legislative mandate. This consensus was most evident in a vision statement and values passed unanimously by the SAC at its May in-person meeting. That meeting also included meaningful conversations between SAC members and Regional Advisory Committee (RAC) Chairs and Co-Chairs from across the state. A primary outcome of that meeting is a shared commitment to communicate more clearly and co-develop activities to drive CESSA forward. Minutes and recordings of meetings of the Statewide Advisory Committee, the Regional Advisory Committees and the Technical Subcommittees can be found here.
The majority of the eleven RACs continued to convene monthly, with varying degrees of member engagement and efficacy. Many of their official activities have centered on identifying participants for the pre-tests and pilots of the changes to the Standards and Protocols as reflected in the Interim Level Risk Matrix, with both set to begin in early FY25. With these activities, the work of the RACs is anticipated to continue to shift to a "hyper-local focus" - a smaller geography than the multi-county RACs. The legislative changes addressing structural issues should assist in the success of these efforts. As of late June 2024, both Houses in the Illinois General Assembly passed SB 3648, sponsored by Senator Robert Peters. In summary, this bill would extend the CESSA implementation deadline from July 1, 2024, to July 1, 2025, and add provisions that allow for the appointment of a different RAC Chair if specific conditions are met and for the RACs to establish subregional committees.
Work on the pre-tests and pilots progressed as members of the Subject Matter Experts Work Group met with protocol vendors PowerPhone, Priority Dispatch, and APCO to update their protocols to align with the Interim Risk Level Matrix.
Illinois State Overdose Action Plan
The Illinois State Overdose Action Plan (SOAP) is a collaborative effort across systems and stakeholders to form a strategic framework to address the overdose epidemic in Illinois. More information regarding the Illinois SOAP can be found here: https://www.dhs.state.il.us/page.aspx?item=93882.
Strengthening and Transforming Behavioral Health Crisis Care in Illinois Act
The purpose of this Act is to: improve the quality and access to behavioral health crisis services; reduce stigma surrounding suicide, mental health, and substance use conditions; and provide a behavioral health crisis response that is equivalent to the response already provided to individuals who require emergency physical health care in the State.
The stakeholder group required of this act has met monthly since December 2023. The group is led by the Chief Behavioral Health Officer and facilitated by the Office of Medicaid Innovation. Input is being provided by a comprehensive group of stakeholders, including individuals served and their families, crisis continuum providers, state partners, municipalities, and trade associations. A report is due to the Illinois General Assembly at the end of July 2024 and will also include recommendations from a comprehensive cost analysis currently being conducted by Chartis and the Jane Addams Center for Social policy and Research, University of Illinois Chicago. Once submitted, the report will also be made available on the DHS website.
