Illinois General Assembly - Full Text of HB1786
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Full Text of HB1786  100th General Assembly




State of Illinois
2017 and 2018


Introduced , by Rep. Mary E. Flowers


See Index

    Amends the Children's Mental Health Act of 2003. Creates the Children's Mental Health Local Integrated Fund Law. Creates local children's mental health collaboratives. Defines a "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 in order 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.

LRB100 05301 RLC 15312 b






HB1786LRB100 05301 RLC 15312 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 5. The Children's Mental Health Act of 2003 is
5amended by adding Sections 20.1, 20.5, 20.10, 20.15, 20.20,
620.25, and 20.30 as follows:
7    (405 ILCS 49/20.1 new)
8    Sec. 20.1. Short title. Sections 20.1 through 20.30 of this
9Act may be cited as the Children's Mental Health Local
10Integrated Fund Law.
11    (405 ILCS 49/20.5 new)
12    Sec. 20.5. Purpose. The General Assembly finds that
13children with emotional or behavioral disturbances or who are
14at risk of suffering those disturbances often require services
15from multiple service systems including mental health, social
16services, education, corrections, juvenile court, health, and
17employment and economic development. In order to better meet
18the needs of these children, it is the intent of the General
19Assembly to establish an integrated children's mental health
20service system that:
21    (1) allows local service decision makers to draw funding
22from a single local source so that funds follow clients and



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1eliminates the need to match clients, funds, services, and
2provider eligibilities;
3    (2) creates a local pool of State, local, and private funds
4to procure a greater medical assistance federal financial
6    (3) improves the efficiency of use of existing resources;
7    (4) minimizes or eliminates the incentives for cost and
8risk shifting; and
9    (5) increases the incentives for earlier identification
10and intervention. The children's mental health integrated fund
11established under this Law must be used to develop and support
12this integrated mental health service system. In developing
13this integrated service system, it is not the intent of the
14General Assembly to limit any rights available to children and
15their families through existing federal and State laws.
16    (405 ILCS 49/20.10 new)
17    Sec. 20.10. Definitions. In Sections 20.1 through 20.30 of
18this Act:
19    "Base level funding" means funding received from State,
20federal, or local sources and expended across the local system
21of care in fiscal year 2018 for children's mental health
22services, for special education services, and for other
23services for children with emotional or behavioral
24disturbances and their families. In subsequent years, base
25level funding may be adjusted to reflect decreases in the



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1numbers of children in the target population.
2    "Child" means a person under 18 years of age.
3    "Children with emotional or behavioral disturbances"
4includes children with emotional disturbances as defined in
5this Section, and children with emotional or behavioral
6disorders as defined in this Section.
7    "Department" means the Department of Human Services.
8    "Emotional or behavioral disorders" means an established
9pattern of one or more of the following emotional or behavioral
11        (1) withdrawal or anxiety, depression, problems with
12    mood, or feelings of self-worth;
13        (2) disordered thought processes with unusual behavior
14    patterns and atypical communication styles; or
15        (3) aggression, hyperactivity, or impulsivity.
16    The established pattern of emotional or behavioral
17responses must adversely affect educational or developmental
18performance, including intrapersonal, academic, vocational, or
19social skills; be significantly different from appropriate
20age, cultural, or ethnic norms; and be more than temporary,
21expected responses to stressful events in the environment. The
22emotional or behavioral responses must be consistently
23exhibited in at least 3 different settings, 2 of which must be
24educational settings, and one other setting in either the home,
25child care, or community. The responses must not be primarily
26the result of intellectual, sensory, or acute or chronic



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1physical health conditions.
2    "Emotional disturbance" means an organic disorder of the
3brain or a clinically significant disorder of thought, mood,
4perception, orientation, memory, or behavior that:
5        (1) is detailed in a diagnostic codes list published by
6    the Secretary ; and
7        (2) seriously limits a child's capacity to function in
8    primary aspects of daily living such as personal relations,
9    living arrangements, work, school, and recreation.
10    "Emotional disturbance" is a generic term and is intended
11to reflect all categories of disorder described in the clinical
12code list published by the Secretary as usually first evident
13in childhood or adolescence.
14    "Family" means a child and one or more of the following
15persons whose participation is necessary to accomplish the
16child's treatment goals:
17        (1) a person related to the child by blood, marriage,
18    or adoption;
19        (2) a person who is the child's foster parent or
20    significant other; or
21        (3) a person who is the child's legal guardian or
22    custodian.
23    "Family community support services" means services
24provided under the clinical supervision of a mental health
25professional and designed to help each child with severe
26emotional disturbance to function and remain with the child's



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1family in the community. Family community support services do
2not include acute care hospital inpatient treatment,
3residential treatment services, or regional treatment center
4services. Family community support services include:
5        (1) client outreach to each child with severe emotional
6    disturbance and the child's family;
7        (2) medication monitoring when necessary;
8        (3) assistance in developing independent living
9    skills;
10        (4) assistance in developing parenting skills
11    necessary to address the needs of the child with severe
12    emotional disturbance;
13        (5) assistance with leisure and recreational
14    activities;
15        (6) crisis assistance, including crisis placement and
16    respite care;
17        (7) professional home-based family treatment;
18        (8) foster care with therapeutic supports;
19        (9) day treatment;
20        (10) assistance in locating respite care and special
21    needs day care; and
22        (11) assistance in obtaining potential financial
23    resources, including those benefits. The county board must
24    offer help to a child with severe emotional disturbance and
25    the child's family in applying for federal benefits,
26    including Supplemental Security Income, medical



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1    assistance, and Medicare.
2    "Individualized rehabilitation services" means
3alternative, flexible, coordinated, and highly individualized
4services that are based on a multiagency plan of care. These
5services are designed to build on the strengths and respond to
6the needs identified in the child's multiagency assessment and
7to improve the child's ability to function in the home, school,
8and community. Individualized rehabilitation services may
9include, but are not limited to, residential services, respite
10services, services that assist the child or family in enrolling
11in or participating in recreational activities, assistance in
12purchasing otherwise unavailable items or services important
13to maintain a specific child in the family, and services that
14assist the child to participate in more traditional services
15and programs.
16    "Integrated fund" is a pool of both public and private
17local, State, and federal resources, consolidated at the local
18level, to accomplish locally agreed-upon service goals for the
19target population. The fund shall be used to help the local
20children's mental health collaborative to serve the mental
21health needs of children in the target population by allowing
22the local children's mental health collaboratives to develop
23and implement an integrated service system.
24    "Integrated service system" means a coordinated set of
25procedures established by the local children's mental health
26collaborative for coordinating services and actions across



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1categorical systems and agencies that results in:
2        (1) integrated funding;
3        (2) improved outreach, early identification, and
4    intervention across systems;
5        (3) strong collaboration between parents and
6    professionals in identifying children in the target
7    population, facilitating access to the integrated system,
8    and coordinating care and services for these children;
9        (4) a coordinated assessment process across systems
10    that determines which children need multiagency care
11    coordination and wraparound services;
12        (5) multiagency plan of care; and
13        (6) individualized rehabilitation services.
14    Services provided by the integrated service system must
15meet the requirements set out in this Law. Children served by
16the integrated service system must be economically and
17culturally representative of children in the service delivery
19    "Local children's mental health collaborative" or
20"collaborative" means an entity formed by the agreement of
21representatives of the local system of care including mental
22health services, social services, correctional services,
23education services, health services, and vocational services
24for the purpose of developing and governing an integrated
25service system.
26    "Local system of care" means a coordinated network of



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1community-based services and supports designed to meet the
2challenges of children and youth with serious mental health
3needs and their families. These partnerships of families,
4youth, public organizations, and private service providers
5work to more effectively deliver mental health services and
6supports that build on the strengths of individuals and fully
7address children's and youths' needs.
8    "Mental health services" has the meaning ascribed to it in
9Section 1-115 of the Mental Health and Developmental
10Disabilities Code.
11    "Multiagency plan of care" means a written plan of
12intervention and integrated services developed by a
13multiagency team in conjunction with the child and family based
14on their unique strengths and needs as determined by a
15multiagency assessment. The plan must outline measurable
16client outcomes and specific services needed to attain these
17outcomes, the agencies responsible for providing the specified
18services, funding responsibilities, timelines, the judicial or
19administrative procedures needed to implement the plan of care,
20the agencies responsible for initiating these procedures and
21designate one person with lead responsibility for overseeing
22implementation of the plan.
23    "Respite care" means planned routine care to support the
24continued residence of a child with emotional or behavioral
25disturbance with the child's family or long-term primary



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1    "Secretary" means the Secretary of Human Services.
2    "Service delivery area" means the geographic area to be
3served by the local children's mental health collaborative and
4must include at a minimum a part of a county and school
5district or a special education cooperative.
6    "Target population" means children under 18 years of age
7with an emotional or behavioral disturbance or who are at risk
8of suffering an emotional or behavioral disturbance as
9evidenced by a behavior or condition that affects the child's
10ability to function in a primary aspect of daily living
11including personal relations, living arrangements, work,
12school, and recreation, and a child who can benefit from:
13        (1) multiagency service coordination and wraparound
14    services; or
15        (2) informal coordination of traditional mental health
16    services provided on a temporary basis.
17    Persons between the ages of 18 and 21 who meet these
18criteria may be included in the target population at the option
19of the local children's mental health collaborative.
20    "Therapeutic support of foster care" means the mental
21health training and mental health support services and clinical
22supervision provided by a mental health professional to foster
23families caring for children with severe emotional disturbance
24to provide a therapeutic family environment and support for the
25child's improved functioning.



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1    (405 ILCS 49/20.15 new)
2    Sec. 20.15. Local children's mental health collaborative.
3    (a) In order to qualify as a local children's mental health
4collaborative and be eligible to receive start-up funds, the
5representatives of the local system of care and nongovernmental
6entities such as parents of children in the target population;
7parent and consumer organizations; community, civic, and
8religious organizations; private and nonprofit mental and
9physical health care providers; culturally specific
10organizations; local foundations; and businesses, or at a
11minimum one county, one school district or special education
12cooperative, one mental health entity, and one juvenile justice
13or corrections entity, must agree to the following:
14        (1) to establish a local children's mental health
15    collaborative and develop an integrated service system;
16        (2) to commit resources to providing services through
17    the local children's mental health cooperative; and
18        (3) to develop a plan to contribute funds to the
19    children's mental health collaborative.
20    (b) Two or more children's mental health collaboratives may
21consolidate decision making, pool resources, and collectively
22act on behalf of the individual collaboratives, based on a
23written agreement among the participating collaboratives.
24    (c) Each local children's mental health collaborative
26        (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 Law;
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    (405 ILCS 49/20.20 new)



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1    Sec. 20.20. Integrated local service system. The
2integrated service system established by the local children's
3mental health collaborative must:
4    (1) include a process for communicating to agencies in the
5local system of care eligibility criteria for services received
6through the local children's mental health collaborative and a
7process for determining eligibility. The process shall place
8strong emphasis on outreach to families, respecting the family
9role in identifying children in need, and valuing families as
11    (2) include measurable outcomes, timelines for evaluating
12progress, and mechanisms for quality assurance and appeals;
13    (3) involve the family, and when appropriate the child, in
14developing multiagency service plans to the extent required by
16    (4) meet all standards and provide all mental health
17services as required in this Law, and ensure that the services
18provided are culturally appropriate;
19    (5) spend funds generated by the local children's mental
20health collaborative as required in this Law; and
21    (6) encourage public-private partnerships to increase
22efficiency, reduce redundancy, and promote quality of care.
23    (405 ILCS 49/20.25 new)
24    Sec. 20.25. 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 fund;
4    (2) the collaborative shall designate a lead county or
5other qualified entity as the fiscal agency for reporting,
6claiming, and receiving payments;
7    (3) the collaborative or lead county may enter into
8subcontracts with other counties, school districts, special
9education cooperatives, municipalities, and other public and
10nonprofit entities for purposes of identifying and claiming
11eligible expenditures to enhance federal reimbursement;
12    (4) the collaborative shall use any enhanced revenue
13attributable to the activities of the collaborative, including
14administrative and service revenue, solely to provide mental
15health services or to expand the operational target population.
16The lead county or other qualified entity may not use enhanced
17federal revenue for any other purpose;
18    (5) the collaborative or lead county must develop and
19maintain an accounting and financial management system
20adequate to support all claims for federal reimbursement,
21including a clear audit trail and any provisions specified in
22the contract with the Secretary;
23    (6) the collaborative or its members may elect to pay the
24nonfederal share of the medical assistance costs for services
25designated by the collaborative; and
26    (7) the lead county or other qualified entity may not use



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1federal funds or local funds designated as matching for other
2federal funds to provide the nonfederal share of medical
4    (405 ILCS 49/20.30 new)
5    Sec. 20.30. Additional federal revenues. Each local
6children's mental health collaborative shall report
7expenditures eligible for federal reimbursement in a manner
8prescribed by the Secretary. The Secretary shall pay all funds
9earned by each local children's mental health collaborative to
10the collaborative. Each local children's mental health
11collaborative must use these funds to expand the operational
12target population or to develop or provide mental health
13services through the local integrated service system to
14children in the target population. Funds may not be used to
15supplant funding for services to children in the target
16population. For purposes of this Section, "mental health
17services" are community-based, nonresidential services, which
18may include respite care, that are identified in the child's
19multiagency plan of care.



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2 Statutes amended in order of appearance
3    405 ILCS 49/20.1 new
4    405 ILCS 49/20.5 new
5    405 ILCS 49/20.10 new
6    405 ILCS 49/20.15 new
7    405 ILCS 49/20.20 new
8    405 ILCS 49/20.25 new
9    405 ILCS 49/20.30 new