101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB0219

 

Introduced , by Rep. Mary E. Flowers

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Children's Mental Health Local Integrated Fund Act. Creates local children's mental health collaboratives. Defines "local children's mental health collaborative" as an entity formed by the agreement of representatives of the local system of care, including mental health services, social services, correctional services, education services, health services, and vocational services for the purpose of developing and governing an integrated service system. Provides that, to qualify as a local children's mental health collaborative and be eligible to receive start-up funds, the representatives of the local system of care and nongovernmental entities such as parents of children in the target population; parent and consumer organizations; community, civic, and religious organizations; private and nonprofit mental and physical health care providers; culturally specific organizations; local foundations; and businesses, or at a minimum one county, one school district or special education cooperative, one mental health entity, and one juvenile justice or corrections entity, must agree to the following: (1) to establish a local children's mental health collaborative and develop an integrated service system; (2) to commit resources to providing services through the local children's mental health collaborative; and (3) to develop a plan to contribute funds to the children's mental health collaborative.


LRB101 04707 RLC 49716 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB0219LRB101 04707 RLC 49716 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Children's Mental Health Local Integrated Fund Act.
 
6    Section 5. Purpose. The General Assembly finds that
7children with emotional disturbances or who are at risk of
8suffering those disturbances often require services from
9multiple service systems including mental health, social
10services, education, corrections, juvenile court, health, and
11employment and economic development. To better meet the needs
12of these children, it is the intent of the General Assembly to
13establish an integrated children's mental health service
14system that:
15        (1) allows local service decision makers to draw
16    funding from a single local source so that funds follow
17    clients and eliminates the need to match clients, funds,
18    services, and provider eligibilities;
19        (2) creates a local pool of State, local, and private
20    funds to procure a greater medical assistance federal
21    financial participation;
22        (3) improves the efficiency of use of existing
23    resources;

 

 

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1        (4) minimizes or eliminates the incentives for cost and
2    risk shifting; and
3        (5) increases the incentives for earlier
4    identification and intervention.
5    The children's mental health integrated fund established
6under this Act must be used to develop and support this
7integrated mental health service system. In developing this
8integrated service system, it is not the intent of the General
9Assembly to limit any rights available to children and their
10families through existing federal and State laws.
 
11    Section 10. Definitions. In this Act:
12    "Child" means a person under 18 years of age.
13    "Department" means the Department of Human Services.
14    "Emotional disturbance" means an organic disorder of the
15brain or a clinically significant disorder of thought, mood,
16perception, orientation, memory, or behavior that:
17        (1) is detailed in a diagnostic code list published by
18    the Secretary; and
19        (2) seriously limits a child's capacity to function in
20    primary aspects of daily living such as personal relations,
21    living arrangements, work, school, or recreation.
22    "Emotional disturbance" is a generic term and is intended
23to reflect all categories of disorder described in the clinical
24code list published by the Secretary as usually first evident
25in childhood or adolescence.

 

 

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1    "Family" means a child and one or more of the following
2persons whose participation is necessary to accomplish the
3child's treatment goals:
4        (1) a person related to the child by blood, marriage,
5    or adoption;
6        (2) a person who is the child's foster parent or
7    significant other; or
8        (3) a person who is the child's legal guardian or
9    custodian.
10    "Individualized rehabilitation services" means
11alternative, flexible, coordinated, and highly individualized
12services that are based on a multiagency plan of care. These
13services are designed to build on the strengths and respond to
14the needs identified in the child's multiagency assessment and
15to improve the child's ability to function in the home, school,
16and community. Individualized rehabilitation services may
17include, but are not limited to, residential services, respite
18services, services that assist the child or family in enrolling
19in or participating in recreational activities, assistance in
20purchasing otherwise unavailable items or services important
21to maintain a specific child in the family, and services that
22assist the child to participate in more traditional services
23and programs.
24    "Integrated fund" means a pool of both public and private
25local, State, and federal resources, consolidated at the local
26level, to accomplish locally agreed-upon service goals for the

 

 

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1target population. The fund shall be used to help the local
2children's mental health collaborative to serve the mental
3health needs of children in the target population by allowing
4the local children's mental health collaboratives to develop
5and implement an integrated service system.
6    "Integrated service system" means a coordinated set of
7procedures established by the local children's mental health
8collaborative for coordinating services and actions across
9categorical systems and agencies that results in:
10        (1) integrated funding;
11        (2) improved outreach, early identification, and
12    intervention across systems;
13        (3) strong collaboration between parents and
14    professionals in identifying children in the target
15    population, facilitating access to the integrated system,
16    and coordinating care and services for these children;
17        (4) a coordinated assessment process across systems
18    that determines which children need multiagency care
19    coordination and wraparound services;
20        (5) a multiagency plan of care; and
21        (6) individualized rehabilitation services.
22    Services provided by the integrated service system must
23meet the requirements set out in this Act. Children served by
24the integrated service system must be economically and
25culturally representative of children in the service delivery
26area.

 

 

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1    "Local children's mental health collaborative" or
2"collaborative" means an entity formed by the agreement of
3representatives of the local system of care including mental
4health services, social services, correctional services,
5education services, health services, and vocational services
6for the purpose of developing and governing an integrated
7service system.
8    "Local system of care" means a coordinated network of
9community-based services and supports designed to meet the
10challenges of children and youth with serious mental health
11needs and their families. These partnerships of families,
12youth, public organizations, and private service providers
13work to more effectively deliver mental health services and
14supports that build on the strengths of individuals and fully
15address children's and youths' needs.
16    "Mental health services" has the meaning ascribed to it in
17Section 1-115 of the Mental Health and Developmental
18Disabilities Code.
19    "Multiagency plan of care" means a written plan of
20intervention and integrated services developed by a
21multiagency team in conjunction with the child and family based
22on their unique strengths and needs as determined by a
23multiagency assessment. The plan must outline measurable
24client outcomes and specific services needed to attain these
25outcomes, the agencies responsible for providing the specified
26services, funding responsibilities, timelines, the judicial or

 

 

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1administrative procedures needed to implement the plan of care,
2the agencies responsible for initiating these procedures and
3designate one person with lead responsibility for overseeing
4implementation of the plan.
5    "Respite care" means planned routine care to support the
6continued residence of a child with emotional disturbance with
7the child's family or long-term primary caretaker.
8    "Secretary" means the Secretary of Human Services.
9    "Service delivery area" means the geographic area to be
10served by the local children's mental health collaborative and
11must include at a minimum a part of a county and school
12district or a special education cooperative.
13    "Target population" means children under 18 years of age
14with an emotional disturbance or who are at risk of suffering
15an emotional disturbance as evidenced by a behavior or
16condition that affects the child's ability to function in a
17primary aspect of daily living including personal relations,
18living arrangements, work, school, and recreation, and a child
19who can benefit from:
20        (1) multiagency service coordination and wraparound
21    services; or
22        (2) informal coordination of traditional mental health
23    services provided on a temporary basis.
24    Persons between the ages of 18 and 21 who meet these
25criteria may be included in the target population at the option
26of the local children's mental health collaborative.
 

 

 

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1    Section 15. Local children's mental health collaborative.
2    (a) To qualify as a local children's mental health
3collaborative and be eligible to receive start-up funds, the
4representatives of the local system of care and nongovernmental
5entities such as parents of children in the target population;
6parent and consumer organizations; community, civic, and
7religious organizations; private and nonprofit mental and
8physical health care providers; culturally specific
9organizations; local foundations; and businesses, or at a
10minimum one county, one school district or special education
11cooperative, one mental health entity, and one juvenile justice
12or corrections entity, must agree to the following:
13        (1) to establish a local children's mental health
14    collaborative and develop an integrated service system;
15        (2) to commit resources to providing services through
16    the local children's mental health cooperative; and
17        (3) to develop a plan to contribute funds to the
18    children's mental health collaborative.
19    (b) Two or more children's mental health collaboratives may
20consolidate decision making, pool resources, and collectively
21act on behalf of the individual collaboratives, based on a
22written agreement among the participating collaboratives.
23    (c) Each local children's mental health collaborative
24must:
25        (1) notify the Secretary within 10 days of formation by

 

 

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1    signing a collaborative agreement and providing the
2    Secretary with a copy of the signed agreement;
3        (2) identify a service delivery area and an operational
4    target population within that service delivery area. The
5    operational target population must be economically and
6    culturally representative of children in the service
7    delivery area to be served by the local children's mental
8    health collaborative. The size of the operational target
9    population must also be economically viable for the service
10    delivery area;
11        (3) seek to maximize federal revenues available to
12    serve children in the target population by designating
13    local expenditures for services for these children and
14    their families that can be matched with federal dollars;
15        (4) design, develop, and ensure implementation of an
16    integrated service system that meets the requirements for
17    State and federal reimbursement and develop interagency
18    agreements necessary to implement the system;
19        (5) expand membership to include representatives of
20    other services in the local system of care including
21    prepaid health plans under contract with the Secretary to
22    serve the needs of children in the target population and
23    their families;
24        (6) create or designate a management structure for
25    fiscal and clinical responsibility and outcome evaluation;
26        (7) spend funds generated by the local children's

 

 

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1    mental health collaborative as required in this Act;
2        (8) explore methods and recommend changes needed at the
3    State level to reduce duplication and promote coordination
4    of services, including the use of uniform forms for
5    reporting, billing, and planning of services;
6        (9) submit its integrated service system design to the
7    Department for approval within one year of notifying the
8    Secretary of its formation;
9        (10) provide an annual report and the collaborative's
10    planned timeline to expand its operational target
11    population to the Department; and
12        (11) expand its operational target population.
13    (d) The members of a local children's mental health
14collaborative may share data on persons being served by the
15collaborative or its members if the person gives written
16informed consent and the information sharing is necessary in
17order for the collaborative to carry out its duties under this
18Section. Data on persons shared under this subsection (d)
19retain the original classification as to each member of the
20collaborative with whom the data is shared. If a federal law or
21regulation impedes information sharing that is necessary in
22order for a collaborative to carry out duties under this
23Section, the appropriate State agencies shall attempt to obtain
24a waiver or exemption from the applicable law or regulation.
 
25    Section 20. Integrated local service system. The

 

 

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1integrated service system established by the local children's
2mental health collaborative must:
3        (1) include a process for communicating to agencies in
4    the local system of care eligibility criteria for services
5    received through the local children's mental health
6    collaborative and a process for determining eligibility.
7    The process shall place strong emphasis on outreach to
8    families, respecting the family role in identifying
9    children in need, and valuing families as partners;
10        (2) include measurable outcomes, timelines for
11    evaluating progress, and mechanisms for quality assurance
12    and appeals;
13        (3) involve the family, and when appropriate the child,
14    in developing multiagency service plans to the extent
15    required by law;
16        (4) meet all standards and provide all mental health
17    services as required in this Act, and ensure that the
18    services provided are culturally appropriate;
19        (5) spend funds generated by the local children's
20    mental health collaborative as required in this Act; and
21        (6) encourage public-private partnerships to increase
22    efficiency, reduce redundancy, and promote quality of
23    care.
 
24    Section 25. Revenue enhancement; authority and
25responsibilities. The children's mental health collaborative

 

 

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1shall have the following authority and responsibilities
2regarding federal revenue enhancement:
3        (1) the collaborative must establish an integrated
4    fund;
5        (2) the collaborative shall designate a lead county or
6    other qualified entity as the fiscal agency for reporting,
7    claiming, and receiving payments;
8        (3) the collaborative or lead county may enter into
9    subcontracts with other counties, school districts,
10    special education cooperatives, municipalities, and other
11    public and nonprofit entities for purposes of identifying
12    and claiming eligible expenditures to enhance federal
13    reimbursement;
14        (4) the collaborative shall use any enhanced revenue
15    attributable to the activities of the collaborative,
16    including administrative and service revenue, solely to
17    provide mental health services or to expand the operational
18    target population. The lead county or other qualified
19    entity may not use enhanced federal revenue for any other
20    purpose;
21        (5) the collaborative or lead county must develop and
22    maintain an accounting and financial management system
23    adequate to support all claims for federal reimbursement,
24    including a clear audit trail and any provisions specified
25    in the contract with the Secretary;
26        (6) the collaborative or its members may elect to pay

 

 

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1    the nonfederal share of the medical assistance costs for
2    services designated by the collaborative; and
3        (7) the lead county or other qualified entity may not
4    use federal funds or local funds designated as matching for
5    other federal funds to provide the nonfederal share of
6    medical assistance.
 
7    Section 30. Additional federal revenues. Each local
8children's mental health collaborative shall report
9expenditures eligible for federal reimbursement in a manner
10prescribed by the Secretary. The Secretary shall pay all funds
11earned by each local children's mental health collaborative to
12the collaborative. Each local children's mental health
13collaborative must use these funds to expand the operational
14target population or to develop or provide mental health
15services through the local integrated service system to
16children in the target population. Funds may not be used to
17supplant funding for services to children in the target
18population. As used in this Section, "mental health services"
19are community-based, nonresidential services, which may
20include respite care, that are identified in the child's
21multiagency plan of care.