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.



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FISCAL NOTE ACT MAY APPLY
 
 
A BILL FOR
 


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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.