HB2944ham001 102ND GENERAL ASSEMBLY

Rep. Barbara Hernandez

Filed: 3/19/2021

10200HB2944ham001 LRB102 14030 KTG 24014 a

AMENDMENT TO HOUSE BILL 2944

AMENDMENT NO. ______. Amend House Bill 2944 by replacing everything after the enacting clause with the following:

"Section 1. Short title. This Act may be cited as the Alternatives to Crisis Escalation (ACE) Act.

Section 5. Purpose. This Act is intended to strengthen and bring community awareness to underutilized Medicaid mental health and substance use crisis response services, called adult mobile crisis response services, to enable timely community-based stabilization, symptom management, and connection to treatment before crisis symptoms escalate to an emergent level, and to enable similar crisis response services for anyone regardless of insurance status.

Section 10. Public awareness campaign. The Department of Public Health, or a third-party contractor with experience in successful public education and awareness campaigns selected by the Department of Public Health, shall develop and lead a 2-year educational campaign within each of Illinois' 11 health regions on the availability of adult mobile crisis response services within each region and how to access such services. The Department of Public Health shall develop and implement this public awareness and educational campaign in collaboration with community stakeholders, including the types of organizations and individuals listed in paragraph (5), the Department of Healthcare and Family Services, and the Department of Human Services. This campaign shall align with and be coordinated with any rollout of a centralized 988 crisis line in Illinois for the development of a coordinated mental health and substance use crisis response system of care and to ensure aligned messaging around such services. Such a campaign shall also take into account crisis services, if any, offered under Section 15, and shall begin by no later than January 1, 2022.

(1) The public awareness campaign shall be culturally competent and locally tailored to ensure local buy-in and community understanding and use of adult mobile crisis response services.

(2) Any written public or community awareness materials must be written in plain, easy-to-understand language, and shall be available in multiple languages that are representative of the communities in a particular health region.

(3) All written or visual materials, videos, webinars, presentations, social media, or other methods of communication or marketing used for increasing community awareness and public support and use of adult mobile crisis response services shall be specifically tailored for different types of community stakeholders or audiences, including, but not limited to, healthcare providers, law enforcement, and community groups, for purposes of increasing support for and use of such services.

(4) The public awareness and educational campaign shall be directed toward community entities and actors, including, but not limited to, those listed in paragraph (5), that are likely to come into contact with individuals in crisis or that have broad community involvement and support, as well as to individuals who might seek mental health or substance use crisis support services.

(5) The following types of stakeholders shall be included as partner-stakeholders in the development of the campaign:

(A) Individuals who have or might use adult mobile crisis response services.

(B) Mental health and substance use disorder organizations representing individuals and family members, including peer support networks.

(C) Hospitals and primary care clinics.

(D) Local law enforcement, including units trained in crisis intervention team training.

(E) Law enforcement associations.

(F) The Illinois Law Enforcement Training Standards Board.

(G) The Illinois State Police.

(H) Local fire departments.

(I) Municipalities.

(J) Faith-based organizations.

(K) Food pantries.

(L) Homeless shelters.

(M) Local public officials.

(N) Nursing homes, specialized mental health rehabilitation facilities, and facilities that qualify as an institution for mental diseases as defined in 42 U.S.C. 1369(d)(i).

(N) Other community organizations or providers that may come into frequent contact with individuals in a mental health or substance use crisis, or that have broad community support and involvement.

Section 15. Enabling universal access to adult mobile crisis response services. Subject to appropriation, the Department of Human Services shall establish a grant program for purposes of providing adult mobile crisis response services to any adult age 18 or older experiencing a mental health or substance use crisis regardless of insurance status. The adult mobile crisis response services covered by this grant shall mirror the adult mobile crisis services covered by Illinois' Medicaid program at a minimum. Such grant shall also cover linkage, case management, and any wrap around treatment and support services that are medically necessary for up to 90 days following a mental health or substance use crisis. Such grant shall also support the service provider's work on enrolling the individual in Medicaid if they are eligible for enrollment. The grant services covered in accordance with this Section shall not be used to pay for adult mobile crisis response services or other services for individuals enrolled in Illinois' Medicaid program, or for individuals whose private insurance plan covers similar mobile crisis response or wrap around services. The Department of Human Services' Division of Mental Health and Division of Substance Use Prevention and Recovery shall convene a working group of providers and other stakeholders for purposes of receiving meaningful input on development of the grant program covered by this Section to ensure that there is no duplication of services, and to avoid placing any unnecessary barriers that impede access to crisis response services. This grant program for adult mobile crisis response services shall not replace or diminish existing Department of Human Services grants for crisis services, and are intended to fill the gap in mobile crisis response services for individuals not covered by Medicaid.

Section 20. Strengthening CARES line capacity and implementing best practices.

(a) By no later than one year after the effective date of this Act, the Department of Healthcare and Family Services, with meaningful stakeholder input and input from states and localities across the country that have implemented nationally recognized or emerging best practices in crisis response systems of care, shall do all of the following:

(1) Develop and implement training and protocols for individuals answering crisis calls to the Crisis and Referral Entry Services (CARES) line that support and enable providing triage and de-escalation to CARES line callers when appropriate and safe. The Department of Healthcare and Family Services shall ensure that CARES line call takers are trained mental health professionals, which may also include peers who are individuals with a lived experience of a mental health or substance use condition.

(2) Develop and implement protocols and training for CARES line staff to conduct quality control and caller satisfaction follow up.

(3) Ensure coordination of adult mobile crisis response services and CARES line services with other existing and future crisis response services and hotlines, such as any future 988 centralized crisis line that may be established.

(b) By no later than one year after the effective date of this Act, the Department of Healthcare and Family Services, with meaningful input from adult mobile crisis response and CARES line providers and organizations representing individuals and families with lived experience of mental health and substance use conditions, shall identify crisis response policies and practices that must be standardized across providers to ensure quality and consistency of crisis response care, and shall identify strategies to expand staffing for CARES line call takers to reduce wait times. Any standardization of policies and practices must also allow for variability to ensure the ability to effectively provide these services in a manner that reflects the unique needs of the communities served in each health region.

(c) The Department of Healthcare and Family Services shall convene a workgroup that includes the appropriate stakeholders to help inform the development and implementation of this subsection.

Section 25. Use of data to strengthen CARES line responses and adult mobile crisis response services.

(a) The Department of Healthcare and Family Services shall annually track the following data related to CARES line calls for purposes of developing a crisis response system of care in each of Illinois' 11 health regions.

(1) The number and percentage of calls to the CARES line by adults in a mental health crisis by health region.

(2) The number and percentage of calls to the CARES line by adults in a substance use crisis by health region.

(3) The number and percentage of CARES line calls for which adult mobile crisis response services were rejected or not provided and why.

(4) The annual percentage increase or decrease from the previous year in CARES line calls for mental health crises and for substance use crises following the first year of data collection.

(5) The number of callers to the CARES line who needed to be referred to a second provider due to a wait list or the inability to access timely services.

(b) The Department of Healthcare and Family Services shall track the following data annually related to adult mobile crisis response services by using the data reported by adult mobile crisis response providers of such services on the Illinois Medicaid – Crisis Assessment Tool.

(1) Demographics (race, gender expression, and Illinois health region of residence) for individuals who received adult mobile crisis response services.

(2) The number of providers delivering adult mobile crisis response services in each of Illinois' 11 health regions, and the zip codes in which they operate.

(3) The number and percentage of adult mobile crisis response services calls that involved law enforcement, including transportation services and safety risks.

(4) The types of mental health or substance use services to which individuals are linked and the percentage of that type of linkage through the year following receiving adult mobile crisis response services, including:

(A) Hospital emergency rooms.

(B) Inpatient hospitalization.

(C) Crisis stabilization or triage units.

(D) Detoxification services.

(E) Substance use disorder residential treatment.

(F) Outpatient substance use disorder treatment.

(G) Living room services.

(H) Assertive community treatment.

(I) Community support treatment.

(J) Case management.

(K) Individual or group mental health or substance use services.

(L) Placement in a nursing home, an institution for mental diseases, or a specialized mental health rehabilitation facility.

(c) The data collected under this Section shall be reported annually on the official website of the Department of Healthcare and Family Services by July 1st of each year beginning in calendar year 2022.

Section 30. Rulemaking Authority. The Departments of Public Health, Human Services, and Healthcare and Family Services shall adopt, within one year after the effective date of this Act, any rules necessary to implement the provisions of this Act.

Section 99. Effective date. This Act takes effect upon becoming law.".