Public Act 103-0337
 
HB3230 EnrolledLRB103 29430 KTG 55821 b

    AN ACT concerning mental health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Short title. This Act may be cited as the
Strengthening and Transforming Behavioral Health Crisis Care
in Illinois Act.
 
    Section 5. Findings. The General Assembly finds that:
    (1) 1,440 Illinois residents died from suicide in 2021, up
from 1,358 in 2020 or a 6% increase.
    (2) An estimated 110,000 Illinois adults struggle with
schizophrenia, and 220,000 with bipolar disorder.
    (3) 3,013 Illinois residents died due to opioid overdose
in 2021, a 2.3% increase from 2020 and a 35.8% increase from
2019.
    (4) Too many people are experiencing suicidal crises, and
mental health or substance use-related distress without the
support and care they need, and the pandemic has amplified
these challenges for children and adults.
    (5) On July 16, 2022, the U.S. transitioned the 10-digit
National Suicide Prevention Lifeline to 9-8-8, an
easy-to-remember 3-digit number for 24/7 behavioral health
crisis care.
    (6) The ultimate goal of the 9-8-8 crisis response system
is to reduce the over-reliance on 9-1-1 and law enforcement
response to suicide, mental health, or substance use crises,
so that every Illinoisan is ensured appropriate and supportive
assistance from trained mental health professionals during his
or her time of need.
    (7) The 3 interdependent pillars of the 9-8-8 crisis
response system include someone to call (Lifeline Call
Centers), someone to respond (Mobile Crisis Response Teams),
and somewhere to go (Crisis Receiving and Stabilization
Centers).
    (8) The transition to 9-8-8 provides a historic
opportunity to strengthen and transform the way behavioral
health crises are treated in Illinois and moves us away from
criminalizing mental health and substance use disorders and
treating them as health issues.
    (9) Having a range of mobile crisis response options has
the potential to save lives.
    (10) Individuals who interact with the 9-8-8 crisis
response system should receive follow-up and be connected to
local mental health and substance use resources and other
community supports.
    (11) Transforming the Illinois behavioral health crisis
response system will require long-term structural changes and
investments. These include strengthening core behavioral
health crisis care services, ensuring rapid post-crisis
access, increasing coordination across systems and State
agencies, enhancing the behavioral health crisis care
workforce, and establishing sustainable funding from various
streams for all dimensions of the crisis response system.
 
    Section 10. Purpose. The purpose of this Act is to improve
the quality and access to behavioral health crisis services;
reduce stigma surrounding suicide, mental health, and
substance use conditions; provide a behavioral health crisis
response that is equivalent to the response already provided
to individuals who require emergency physical health care in
the State; improve equity in addressing mental health and
substance use conditions; ensure a culturally and
linguistically competent response to behavioral health crises
and saving lives; build a new system of equitable and
linguistically appropriate behavioral crisis services in which
all individuals are treated with respect, dignity, cultural
competence, and humility; and comply with the National Suicide
Hotline Designation Act of 2020 and the Federal Communication
Commission's rules adopted July 16, 2020 to ensure that all
citizens and visitors of the State of Illinois receive a
consistent level of 9-8-8 and crisis behavioral health
services no matter where they live, work, or travel in the
State.
 
    Section 15. Cost analysis and sources of funding.
    (a)(1) Subject to appropriation, the Department of Human
Services, Division of Mental Health, shall use an independent
third-party expert to conduct a cost analysis and determine
sound costs associated with developing and maintaining a
statewide initiative for the coordination and delivery of the
continuum of behavioral health crisis response services in the
State, including all of the following:
            (A) Crisis call centers.
            (B) Mobile crisis response team services.
            (C) Crisis receiving and stabilization centers.
            (D) Follow-up and other acute behavioral health
        services.
    (2) The analysis shall include costs that are or can be
reasonably attributed to, but not limited to:
        (A) staffing and technological infrastructure
    enhancements necessary to achieve operational and clinical
    standards and best practices set forth by the 9-8-8
    Suicide and Crisis Lifeline;
        (B) the recruitment of personnel that reflect the
    demographics of the community served; specialized training
    of staff to assess and serve people experiencing mental
    health, substance use, and suicidal crises, including
    specialized training to serve at-risk communities,
    including culturally and linguistically competent services
    for LGBTQ+, racially, ethnically, and linguistically
    diverse communities;
        (C) the need to develop staffing that is consistent
    with federal guidelines for mobile crisis response times,
    based on call volume and the geography served;
        (D) the provision of call, text, and chat response;
    mobile crisis response; and follow-up and crisis
    stabilization services that are in response to the 9-8-8
    Suicide and Crisis Lifeline;
        (E) the costs related to developing and maintaining
    the physical plant, operations, and staffing of crisis
    receiving and stabilization centers;
        (F) the provision of data, reporting, participation in
    evaluations, and related quality improvement activities as
    may be required;
        (G) the administration, oversight, and evaluation of
    the Statewide 9-8-8 Trust Fund;
        (H) the coordination with 9-1-1, emergency service
    providers, crisis co-responders, and other system
    partners, including service providers; and
        (I) the development of service enhancements or
    targeted responses to improve outcomes and address gaps
    and needs.
    (3) The Department of Human Services, Division of Mental
Health, and independent third-party experts shall obtain
meaningful stakeholder engagement on the cost analysis
conducted in accordance with paragraphs (1) and (2).
    (b) The Department of Human Services, Division of Mental
Health, and independent third-party experts, with meaningful
stakeholder engagement, shall provide a set of recommendations
on multiple sources of funding that could potentially be
utilized to support a sustainable and comprehensive continuum
of behavioral health crisis response services.
    (c) The Department of Human Services, Division of Mental
Health, may hire an independent third-party expert, amend an
existing Department of Human Services contract with an
independent third-party expert, or coordinate with the
Department of Healthcare and Family Services to amend and
utilize an independent third-party expert contracted with the
Department of Healthcare and Family Services to conduct a cost
analysis and determine sound costs as outlined in this
Section.
 
    Section 20. Behavioral health crisis workforce.
    (a) The Department of Human Services, Division of Mental
Health, with meaningful stakeholder engagement shall do all of
the following:
        (1) Examine eligibility for participation as an
    Engagement Specialist under the Division of Mental
    Health's Crisis Care Continuum Program. As used in this
    paragraph, "Engagement Specialist" means an individual
    with the lived experience of recovery from a mental health
    condition, substance use disorder, or both.
        (2) Consider many additional experiences, including
    but not limited to, being a parent or family member of a
    person with a mental health or substance use disorder,
    being from a disadvantaged or marginalized population that
    would be valuable to this role and can help provide a more
    culturally competent crisis response. This includes the
    need for crisis responders who are African American,
    Latinx, have been incarcerated, experienced homelessness,
    identify as LGBTQ+, or are veterans.
        (3) Consider how that expansion impacts the unique
    training and support needs of Engagement Specialists from
    different populations.
        (4) Allow providers to use their clinical discretion
    to determine responses by one individual or by a
    two-person team depending on the nature of the call with
    access to an Engagement Specialist.
        (5) Collect feedback on other policies to address the
    behavioral health workforce issues.
    (b) The Department of Human Services, Division of Mental
Health, shall implement a process to obtain meaningful
stakeholder engagement not later than 6 months after the
effective date of this Act.
 
    Section 25. Action plan. Not later than 12 months after
the effective date of this Act, the Department of Human
Services, Division of Mental Health, shall submit an action
plan to the General Assembly on the activities under Sections
15 and 20 of this Act. The action plan shall be filed
electronically with the General Assembly, as provided under
Section 3.1 of the General Assembly Organization Act, and
shall be provided electronically to any member of the General
Assembly upon request. The action plan shall be published on
the Department of Human Services' website for the public.
 
    Section 30. Coordination across State agencies.
    (a) The Department of Human Services, Division of Mental
Health, and the Department of Healthcare and Family Services
shall convene a stakeholder working group immediately after
the effective date of this Act to develop recommendations to
coordinate programming and strategies to support a cohesive
behavioral health crisis response system.
    (b) The stakeholder working group shall:
        (1) Identify logistical challenges and solutions and
    define a process to ensure the Illinois crisis response
    system established by the Division of Mental Health's
    Crisis Care Continuum Program and the Department of
    Healthcare and Family Services' Medicaid Mobile Crisis
    Response is coordinated across the lifespan.
        (2) Consider cross-program identification and
    alignment of providers within geographic regions,
    messaging regarding the 9-8-8 Suicide and Crisis Lifeline
    and the Illinois Crisis and Referral Entry Services
    (CARES) lines, and coordination between disparate program
    plan goals to ensure that crisis response services are
    delivered efficiently and without duplication.
    (c) The stakeholder working group shall at least include
Division of Mental Health Crisis Care Continuum Program
providers, Pathways to Success providers, parents, family
advocates, associations that represent behavioral health
providers, and labor unions that represent workers in the
behavioral health workforce and shall meet no less than once
per month.
    (d) Not later than 6 months after the effective date of
this Act, the Department of Human Services, Division of Mental
Health, in collaboration with the Department of Healthcare and
Family Services, shall submit an action plan to the General
Assembly on the activities under Section 30 of this Act. The
action plan shall be filed electronically with the General
Assembly, as provided under Section 3.1 of the General
Assembly Organization Act, and shall be provided
electronically to any member of the General Assembly upon
request. The action plan shall be published on the Department
of Human Services' website for the public.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 7/28/2023