Public Act 103-0273

HB0439 Enrolled LRB103 04009 CPF 49015 b

AN ACT concerning 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

Illinois Youth in Care Timely Provision of Essential Care Act.

Section 5. Findings. The General Assembly finds that:

(1) From 2013 to 2018 more than 500 in-state

residential treatment beds were eliminated for youth in

the care of the Department of Children and Family Services

with serious and ongoing mental health needs.

(2) Development of evidence-based alternatives to

residential treatment, such as therapeutic foster care and

multi-dimensional treatment foster care, has not met the

need caused by the elimination of more than 500

residential treatment beds.

(3) Quality residential treatment, evidence-based

therapeutic foster care, and specialized foster care are

critical components of the system of care for youth in the

care of the Department.

(4) It is imperative that children identified as

requiring residential treatment, therapeutic foster care,

or specialized foster care receive that treatment in a

timely and competent fashion.

(5) One significant barrier to the development of new

residential treatment beds has been the ability to attract

and retain qualified staff.

(6) Community-based providers have a 42%-50% annual

staff turnover rate for caseworkers, supervisors,

therapists, and residential staff.

(7) High rates of staff turnover are directly linked

to poor outcomes for children and youth in care, including

increased lengths of stay, which especially hurt black

children as they are 3 times more likely to languish in

care.

(8) Due to the lack of in-state residential treatment

beds, evidence-based alternatives, and quality specialized

foster homes for youth in care:

(A) Youth in care are waiting long periods of

times in temporary settings where they often receive

inadequate treatment to address their highly acute

needs. The temporary settings also force youth to

experience placement changes that are only necessary

because of the lack of critical beds.

(B) Youth in care are left in locked inpatient

psychiatric units beyond the time that they clinically

need to be hospitalized ("beyond medical necessity")

because the outpatient placement resources they need

are not available. In State Fiscal Year 2022, youth

who were beyond medical necessity remained in

psychiatric hospitals for an average of 75 days longer

than they needed to be in the hospital because of the

lack of placement resources. These stays cause

irreparable harm to youth.

(C) Youth in care identified as needing inpatient

psychiatric care are being denied admission to

inpatient psychiatric units due to the risk that the

youth will not have a placement to discharge to when

they are ready for discharge.

(D) Youth in care are being sent to out-of-state

residential facilities where it is more difficult to

monitor safety and well-being and more costly and

challenging to facilitate achievement of their

permanency goals.

Section 10. Improving access to residential treatment,

evidence-based alternatives to residential treatment, and

specialized foster care. The Department of Children and

Family Services shall develop a written, strategic plan that

comprehensively addresses improving timely access to quality

in-state residential treatment, evidence-based alternatives to

residential treatment, and specialized foster care for youth

in the care of the Department who have significant emotional,

behavioral, and medical needs. The planning process must be

transparent and allow for stakeholder input.

Section 15. Implementation. The strategic plan developed

by the Department of Children and Family Services shall be

finalized and made public no later than one year after the

effective date of this Act. The strategic plan shall be

revised within 6 months after the rate study required under

Section 35.11 of the Children and Family Services Act is

complete and available for review, and the Department shall

incorporate the rate study's recommendations into the

strategic plan. The strategic plan shall include:

(1) Benchmarks and a timeline for implementing each

provision of the plan.

(2) Strategy for obtaining resources needed to

implement each provision of the plan.

(3) Ongoing stakeholder engagement during the

implementation of the plan.