Rep. Barbara Hernandez

Filed: 3/19/2021

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 2944

2    AMENDMENT NO. ______. Amend House Bill 2944 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Alternatives to Crisis Escalation (ACE) Act.
 
6    Section 5. Purpose. This Act is intended to strengthen and
7bring community awareness to underutilized Medicaid mental
8health and substance use crisis response services, called
9adult mobile crisis response services, to enable timely
10community-based stabilization, symptom management, and
11connection to treatment before crisis symptoms escalate to an
12emergent level, and to enable similar crisis response services
13for anyone regardless of insurance status.
 
14    Section 10. Public awareness campaign. The Department of
15Public Health, or a third-party contractor with experience in

 

 

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1successful public education and awareness campaigns selected
2by the Department of Public Health, shall develop and lead a
32-year educational campaign within each of Illinois' 11 health
4regions on the availability of adult mobile crisis response
5services within each region and how to access such services.
6The Department of Public Health shall develop and implement
7this public awareness and educational campaign in
8collaboration with community stakeholders, including the types
9of organizations and individuals listed in paragraph (5), the
10Department of Healthcare and Family Services, and the
11Department of Human Services. This campaign shall align with
12and be coordinated with any rollout of a centralized 988
13crisis line in Illinois for the development of a coordinated
14mental health and substance use crisis response system of care
15and to ensure aligned messaging around such services. Such a
16campaign shall also take into account crisis services, if any,
17offered under Section 15, and shall begin by no later than
18January 1, 2022.
19        (1) The public awareness campaign shall be culturally
20    competent and locally tailored to ensure local buy-in and
21    community understanding and use of adult mobile crisis
22    response services.
23        (2) Any written public or community awareness
24    materials must be written in plain, easy-to-understand
25    language, and shall be available in multiple languages
26    that are representative of the communities in a particular

 

 

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1    health region.
2        (3) All written or visual materials, videos, webinars,
3    presentations, social media, or other methods of
4    communication or marketing used for increasing community
5    awareness and public support and use of adult mobile
6    crisis response services shall be specifically tailored
7    for different types of community stakeholders or
8    audiences, including, but not limited to, healthcare
9    providers, law enforcement, and community groups, for
10    purposes of increasing support for and use of such
11    services.
12        (4) The public awareness and educational campaign
13    shall be directed toward community entities and actors,
14    including, but not limited to, those listed in paragraph
15    (5), that are likely to come into contact with individuals
16    in crisis or that have broad community involvement and
17    support, as well as to individuals who might seek mental
18    health or substance use crisis support services.
19        (5) The following types of stakeholders shall be
20    included as partner-stakeholders in the development of the
21    campaign:
22            (A) Individuals who have or might use adult mobile
23        crisis response services.
24            (B) Mental health and substance use disorder
25        organizations representing individuals and family
26        members, including peer support networks.

 

 

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1            (C) Hospitals and primary care clinics.
2            (D) Local law enforcement, including units trained
3        in crisis intervention team training.
4            (E) Law enforcement associations.
5            (F) The Illinois Law Enforcement Training
6        Standards Board.
7            (G) The Illinois State Police.
8            (H) Local fire departments.
9            (I) Municipalities.
10            (J) Faith-based organizations.
11            (K) Food pantries.
12            (L) Homeless shelters.
13            (M) Local public officials.
14            (N) Nursing homes, specialized mental health
15        rehabilitation facilities, and facilities that qualify
16        as an institution for mental diseases as defined in 42
17        U.S.C. 1369(d)(i).
18            (N) Other community organizations or providers
19        that may come into frequent contact with individuals
20        in a mental health or substance use crisis, or that
21        have broad community support and involvement.
 
22    Section 15. Enabling universal access to adult mobile
23crisis response services. Subject to appropriation, the
24Department of Human Services shall establish a grant program
25for purposes of providing adult mobile crisis response

 

 

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1services to any adult age 18 or older experiencing a mental
2health or substance use crisis regardless of insurance status.
3The adult mobile crisis response services covered by this
4grant shall mirror the adult mobile crisis services covered by
5Illinois' Medicaid program at a minimum. Such grant shall also
6cover linkage, case management, and any wrap around treatment
7and support services that are medically necessary for up to 90
8days following a mental health or substance use crisis. Such
9grant shall also support the service provider's work on
10enrolling the individual in Medicaid if they are eligible for
11enrollment. The grant services covered in accordance with this
12Section shall not be used to pay for adult mobile crisis
13response services or other services for individuals enrolled
14in Illinois' Medicaid program, or for individuals whose
15private insurance plan covers similar mobile crisis response
16or wrap around services. The Department of Human Services'
17Division of Mental Health and Division of Substance Use
18Prevention and Recovery shall convene a working group of
19providers and other stakeholders for purposes of receiving
20meaningful input on development of the grant program covered
21by this Section to ensure that there is no duplication of
22services, and to avoid placing any unnecessary barriers that
23impede access to crisis response services. This grant program
24for adult mobile crisis response services shall not replace or
25diminish existing Department of Human Services grants for
26crisis services, and are intended to fill the gap in mobile

 

 

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1crisis response services for individuals not covered by
2Medicaid.
 
3    Section 20. Strengthening CARES line capacity and
4implementing best practices.
5    (a) By no later than one year after the effective date of
6this Act, the Department of Healthcare and Family Services,
7with meaningful stakeholder input and input from states and
8localities across the country that have implemented nationally
9recognized or emerging best practices in crisis response
10systems of care, shall do all of the following:
11        (1) Develop and implement training and protocols for
12    individuals answering crisis calls to the Crisis and
13    Referral Entry Services (CARES) line that support and
14    enable providing triage and de-escalation to CARES line
15    callers when appropriate and safe. The Department of
16    Healthcare and Family Services shall ensure that CARES
17    line call takers are trained mental health professionals,
18    which may also include peers who are individuals with a
19    lived experience of a mental health or substance use
20    condition.
21        (2) Develop and implement protocols and training for
22    CARES line staff to conduct quality control and caller
23    satisfaction follow up.
24        (3) Ensure coordination of adult mobile crisis
25    response services and CARES line services with other

 

 

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1    existing and future crisis response services and hotlines,
2    such as any future 988 centralized crisis line that may be
3    established.
4    (b) By no later than one year after the effective date of
5this Act, the Department of Healthcare and Family Services,
6with meaningful input from adult mobile crisis response and
7CARES line providers and organizations representing
8individuals and families with lived experience of mental
9health and substance use conditions, shall identify crisis
10response policies and practices that must be standardized
11across providers to ensure quality and consistency of crisis
12response care, and shall identify strategies to expand
13staffing for CARES line call takers to reduce wait times. Any
14standardization of policies and practices must also allow for
15variability to ensure the ability to effectively provide these
16services in a manner that reflects the unique needs of the
17communities served in each health region.
18    (c) The Department of Healthcare and Family Services shall
19convene a workgroup that includes the appropriate stakeholders
20to help inform the development and implementation of this
21subsection.
 
22    Section 25. Use of data to strengthen CARES line responses
23and adult mobile crisis response services.
24    (a) The Department of Healthcare and Family Services shall
25annually track the following data related to CARES line calls

 

 

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1for purposes of developing a crisis response system of care in
2each of Illinois' 11 health regions.
3        (1) The number and percentage of calls to the CARES
4    line by adults in a mental health crisis by health region.
5        (2) The number and percentage of calls to the CARES
6    line by adults in a substance use crisis by health region.
7        (3) The number and percentage of CARES line calls for
8    which adult mobile crisis response services were rejected
9    or not provided and why.
10        (4) The annual percentage increase or decrease from
11    the previous year in CARES line calls for mental health
12    crises and for substance use crises following the first
13    year of data collection.
14        (5) The number of callers to the CARES line who needed
15    to be referred to a second provider due to a wait list or
16    the inability to access timely services.
17    (b) The Department of Healthcare and Family Services shall
18track the following data annually related to adult mobile
19crisis response services by using the data reported by adult
20mobile crisis response providers of such services on the
21Illinois Medicaid – Crisis Assessment Tool.
22        (1) Demographics (race, gender expression, and
23    Illinois health region of residence) for individuals who
24    received adult mobile crisis response services.
25        (2) The number of providers delivering adult mobile
26    crisis response services in each of Illinois' 11 health

 

 

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1    regions, and the zip codes in which they operate.
2        (3) The number and percentage of adult mobile crisis
3    response services calls that involved law enforcement,
4    including transportation services and safety risks.
5        (4) The types of mental health or substance use
6    services to which individuals are linked and the
7    percentage of that type of linkage through the year
8    following receiving adult mobile crisis response services,
9    including:
10            (A) Hospital emergency rooms.
11            (B) Inpatient hospitalization.
12            (C) Crisis stabilization or triage units.
13            (D) Detoxification services.
14            (E) Substance use disorder residential treatment.
15            (F) Outpatient substance use disorder treatment.
16            (G) Living room services.
17            (H) Assertive community treatment.
18            (I) Community support treatment.
19            (J) Case management.
20            (K) Individual or group mental health or substance
21        use services.
22            (L) Placement in a nursing home, an institution
23        for mental diseases, or a specialized mental health
24        rehabilitation facility.
25    (c) The data collected under this Section shall be
26reported annually on the official website of the Department of

 

 

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1Healthcare and Family Services by July 1st of each year
2beginning in calendar year 2022.
 
3    Section 30. Rulemaking Authority. The Departments of
4Public Health, Human Services, and Healthcare and Family
5Services shall adopt, within one year after the effective date
6of this Act, any rules necessary to implement the provisions
7of this Act.
 
8    Section 99. Effective date. This Act takes effect upon
9becoming law.".