Rep. Lindsey LaPointe

Filed: 3/10/2023

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 3230

2    AMENDMENT NO. ______. Amend House Bill 3230 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Strengthening and Transforming Behavioral Health Crisis Care
6in Illinois Act.
 
7    Section 5. Findings. The General Assembly finds that:
8    (1) 1,440 Illinois residents died from suicide in 2021, up
9from 1,358 in 2020 or a 6% increase.
10    (2) An estimated 110,000 Illinois adults struggle with
11schizophrenia, and 220,000 with bipolar disorder.
12    (3) 3,013 Illinois residents died due to opioid overdose
13in 2021, a 2.3% increase from 2020 and a 35.8% increase from
142019.
15    (4) Too many people are experiencing suicidal crises, and
16mental health or substance use-related distress without the

 

 

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1support and care they need, and the pandemic has amplified
2these challenges for children and adults.
3    (5) On July 16, 2022, the U.S. transitioned the 10-digit
4National Suicide Prevention Lifeline to 9-8-8, an
5easy-to-remember 3-digit number for 24/7 behavioral health
6crisis care.
7    (6) The ultimate goal of the 9-8-8 crisis response system
8is to reduce the over-reliance on 9-1-1 and law enforcement
9response to suicide, mental health, or substance use crises,
10so that every Illinoisan is ensured appropriate and supportive
11assistance from trained mental health professionals during his
12or her time of need.
13    (7) The 3 interdependent pillars of the 9-8-8 crisis
14response system include someone to call (Lifeline Call
15Centers), someone to respond (Mobile Crisis Response Teams),
16and somewhere to go (Crisis Receiving and Stabilization
17Centers).
18    (8) The transition to 9-8-8 provides a historic
19opportunity to strengthen and transform the way behavioral
20health crises are treated in Illinois and moves us away from
21criminalizing mental health and substance use disorders and
22treating them as health issues.
23    (9) Having a range of mobile crisis response options has
24the potential to save lives.
25    (10) Individuals who interact with the 9-8-8 crisis
26response system should receive follow-up and be connected to

 

 

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1local mental health and substance use resources and other
2community supports.
3    (11) Transforming the Illinois behavioral health crisis
4response system will require long-term structural changes and
5investments. These include strengthening core behavioral
6health crisis care services, ensuring rapid post-crisis
7access, increasing coordination across systems and State
8agencies, enhancing the behavioral health crisis care
9workforce, and establishing sustainable funding from various
10streams for all dimensions of the crisis response system.
 
11    Section 10. Purpose. The purpose of this Act is to improve
12the quality and access to behavioral health crisis services;
13reduce stigma surrounding suicide, mental health, and
14substance use conditions; provide a behavioral health crisis
15response that is equivalent to the response already provided
16to individuals who require emergency physical health care in
17the State; improve equity in addressing mental health and
18substance use conditions; ensure a culturally and
19linguistically competent response to behavioral health crises
20and saving lives; build a new system of equitable and
21linguistically appropriate behavioral crisis services in which
22all individuals are treated with respect, dignity, cultural
23competence, and humility; and comply with the National Suicide
24Hotline Designation Act of 2020 and the Federal Communication
25Commission's rules adopted July 16, 2020 to ensure that all

 

 

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1citizens and visitors of the State of Illinois receive a
2consistent level of 9-8-8 and crisis behavioral health
3services no matter where they live, work, or travel in the
4State.
 
5    Section 15. Cost analysis and sources of funding.
6    (a)(1) Subject to appropriation, the Department of Human
7Services, Division of Mental Health, shall use an independent
8third-party expert to conduct a cost analysis and determine
9actuarially sound costs associated with developing and
10maintaining a statewide initiative for the coordination and
11delivery of the continuum of behavioral health crisis response
12services in the State, including all of the following:
13            (A) Crisis call centers.
14            (B) Mobile crisis response team services.
15            (C) Crisis receiving and stabilization centers.
16            (D) Follow-up and other acute behavioral health
17        services.
18    (2) The analysis shall include costs that are or can be
19reasonably attributed to, but not limited to:
20        (A) staffing and technological infrastructure
21    enhancements necessary to achieve operational and clinical
22    standards and best practices set forth by the 9-8-8
23    Suicide and Crisis Lifeline;
24        (B) the recruitment of personnel that reflect the
25    demographics of the community served; specialized training

 

 

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1    of staff to assess and serve people experiencing mental
2    health, substance use, and suicidal crises, including
3    specialized training to serve at-risk communities,
4    including culturally and linguistically competent services
5    for LGBTQ+, racially, ethnically, and linguistically
6    diverse communities;
7        (C) the need to develop staffing that is consistent
8    with federal guidelines for mobile crisis response times,
9    based on call volume and the geography served;
10        (D) the provision of call, text, and chat response;
11    mobile crisis response; and follow-up and crisis
12    stabilization services that are in response to the 9-8-8
13    Suicide and Crisis Lifeline;
14        (E) the costs related to developing and maintaining
15    the physical plant, operations, and staffing of crisis
16    receiving and stabilization centers;
17        (F) the provision of data, reporting, participation in
18    evaluations, and related quality improvement activities as
19    may be required;
20        (G) the administration, oversight, and evaluation of
21    the Statewide 9-8-8 Trust Fund;
22        (H) the coordination with 9-1-1, emergency service
23    providers, crisis co-responders, and other system
24    partners, including service providers; and
25        (I) the development of service enhancements or
26    targeted responses to improve outcomes and address gaps

 

 

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1    and needs.
2    (3) The Department of Human Services, Division of Mental
3Health, and independent third-party experts shall obtain
4meaningful stakeholder engagement on the cost analysis
5conducted in accordance with paragraphs (1) and (2).
6    (b) The Department of Human Services, Division of Mental
7Health, and independent third-party experts, with meaningful
8stakeholder engagement, shall provide a set of recommendations
9on multiple sources of funding that could potentially be
10utilized to support a sustainable and comprehensive continuum
11of behavioral health crisis response services.
12    (c) The Department of Human Services, Division of Mental
13Health, may hire an independent third-party expert, amend an
14existing Department of Human Services contract with an
15independent third-party expert, or coordinate with the
16Department of Healthcare and Family Services to amend and
17utilize an independent third-party expert contracted with the
18Department of Healthcare and Family Services.
 
19    Section 20. Behavioral health crisis workforce.
20    (a) The Department of Human Services, Division of Mental
21Health, with meaningful stakeholder engagement shall do all of
22the following:
23        (1) Examine eligibility for participation as an
24    Engagement Specialist under the Division of Mental
25    Health's Crisis Care Continuum Program. As used in this

 

 

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1    paragraph, "Engagement Specialist" means an individual
2    with the lived experience of recovery from a mental health
3    condition, substance use disorder, or both.
4        (2) Consider many additional experiences, including
5    but not limited to, being a parent or family member of a
6    person with a mental health or substance use disorder,
7    being from a disadvantaged or marginalized population that
8    would be valuable to this role and can help provide a more
9    culturally competent crisis response. This includes the
10    need for crisis responders who are African American,
11    Latinx, have been incarcerated, experienced homelessness,
12    identify as LGBTQ+, or are veterans.
13        (3) Consider how that expansion impacts the unique
14    training and support needs of Engagement Specialists from
15    different populations.
16        (4) Allow providers to use their clinical discretion
17    to determine responses by one individual or by a
18    two-person team depending on the nature of the call with
19    access to an Engagement Specialist.
20        (5) Collect feedback on other policies to address the
21    behavioral health workforce issues.
22    (b) The Department of Human Services, Division of Mental
23Health, shall implement a process to obtain meaningful
24stakeholder engagement not later than 6 months after the
25effective date of this Act.
 

 

 

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1    Section 25. Action plan. Not later than 12 months after
2the effective date of this Act, the Department of Human
3Services, Division of Mental Health, shall submit an action
4plan to the General Assembly on the activities under Sections
515 and 20 of this Act. The action plan shall be filed
6electronically with the General Assembly, as provided under
7Section 3.1 of the General Assembly Organization Act, and
8shall be provided electronically to any member of the General
9Assembly upon request. The action plan shall be published on
10the Department of Human Services' website for the public.
 
11    Section 30. Coordination across State agencies.
12    (a) The Department of Human Services, Division of Mental
13Health, and the Department of Healthcare and Family Services
14shall convene a stakeholder working group immediately after
15the effective date of this Act to develop recommendations to
16coordinate programming and strategies to support a cohesive
17behavioral health crisis response system.
18    (b) The stakeholder working group shall:
19        (1) Identify logistical challenges and solutions and
20    define a process to ensure the Illinois crisis response
21    system established by the Division of Mental Health's
22    Crisis Care Continuum Program and the Department of
23    Healthcare and Family Services' Medicaid Mobile Crisis
24    Response is coordinated across the lifespan.
25        (2) Consider cross-program identification and

 

 

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1    alignment of providers within geographic regions,
2    messaging regarding the 9-8-8 Suicide and Crisis Lifeline
3    and the Illinois Crisis and Referral Entry Services
4    (CARES) lines, and coordination between disparate program
5    plan goals to ensure that crisis response services are
6    delivered efficiently and without duplication.
7    (c) The stakeholder working group shall at least include
8Division of Mental Health Crisis Care Continuum Program
9providers, Pathways to Success providers, parent, and family
10advocates, and associations that represent behavioral health
11providers and shall meet no less than once per month.
12    (d) Not later than 6 months after the effective date of
13this Act, the Department of Human Services, Division of Mental
14Health, in collaboration with the Department of Healthcare and
15Family Services, shall submit an action plan to the General
16Assembly on the activities under Section 30 of this Act. The
17action plan shall be filed electronically with the General
18Assembly, as provided under Section 3.1 of the General
19Assembly Organization Act, and shall be provided
20electronically to any member of the General Assembly upon
21request. The action plan shall be published on the Department
22of Human Services' website for the public.
 
23    Section 99. Effective date. This Act takes effect upon
24becoming law.".