Recommendations from Illinois’s Children’s Behavioral Health Transformation Initiative

By

James Sklar

|

In March 2022, Gov. JB Pritzker launched the Children’s Behavioral Health Transformation Initiative (Transformation Initiative) to evaluate and redesign Illinois’s behavioral health services for children and adolescents. Last month, the Transformation Initiative issued a report detailing its findings and recommendations.

 

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The report is intended to support the state’s 2.8 million children through various providers, entities, services, and state agencies.

The report makes recommendations to promote system improvements based on leveraging existing strengths, data analytics, best practices, stakeholder input, leveraging public-private partnerships, testing strategies, and technology to improve efficiency. 

The team that produced this report worked closely with teams at Chapin Hall at the University of Chicago, which is an independent policy research center that researches and provides achievable solutions to improve the lives of children, families, and communities.

The report details three broad strategies to help make it easier for families to access services for young people with mental health concerns: centralizing and streamlining, adjusting capacity, and intervening earlier.

Centralize and streamline

To ensure families and young people with mental health concerns are obtaining services in an easier fashion, system changes need to be implemented to increase efficiency, reduce duplication, and promote transparency.

  • Develop a care portal – a centralized source for families seeking services, which includes a proof of concept that was tested on a small subgroup of informed stakeholders. The report recommends the creation of a robust, public-facing care portal to help families identify and access services to address their needs.
  • Improve coordination – a more seamless transition and earlier detection of elevated risks to achieve more responsive, timely, and comprehensive coordination for behavioral healthcare. Specific recommendations include changes in statute, better transitions to residential or youth home placements, and better technology and systems.
  • Centralized oversight of residential beds – a process to reduce duplication and enable the state to manage residential resources more effectively because each agency may only be aware of its own incidents. Specific recommendations include a central system to share information, central oversight on licensing, and centralized purchasing to expedite placement in available beds.
  • Implement recourse referral technology – a single consistent approach to link people seeking services to community-based outpatient care. Specific recommendations include using various software platforms to identify and procure a tool from an experienced vendor to apply to all affected state agencies.

Adjust capacity

To ensure capacity adjustments are performed in a consistent and predictable manner, adjustments need to be guided and informed by data analysis, evidence, best practices, and lessons learned from pilots.

  • Regular data analytic review –  a process to be able to make adjustments based on provider capacity information. Specific recommendations include using gap analysis to inform state agency funding opportunities to prioritize the greatest needs, having regular re-assessments of geographic gaps between needs and services, and examining equity and access disparities.
  • Adjust rates regularly – a standardized service of rates across state agencies and providers to ensure consistent compensation is provided for similar services. Specific recommendations include developing standardized rates, making sure needed services can be reimbursed through Medicaid, and maximizing financial participation from Medicaid.
  • Increase capacity – a new way to expand eligibility for current programs and to develop new service types for continued care. Specific recommendations include amending legislative language to expand eligibility, duration, and service types; budget adjustments; streamlining funding and implantation of crisis services; and developing a plan to create, fund, train, and monitor Behavioral Health Aides.
  • Partner with providers – a standard protocol to encourage consistent and transparent development of new programs to meet emerging needs. Specific recommendations include assisting new providers with technical assistance and support to help build upon new and existing relations.

Intervene earlier

To ensure problems are addressed in a more timely manner, they need to be more quickly detected, identified, and assessed so system transformations and appropriate actions can occur faster.

  • Universal screening – an expanded effort to make sure problems are detected earlier for all the youth. Specific recommendations include developing pilot initiatives to screen for behavioral health issues at schools and pediatricians’ offices, conducting a landscape scan to see what screening activities are underway in Illinois, and enhancing screening activities by promoting the availability of resources.
  • Information sharing – a way to lower barriers so information can be shared more easily between state agencies and families to improve seamlessness and speed up interventions. Specific recommendations include making additional information available to care-coordinated entities; leveraging Medicaid resources to support or enhance shared data; and creating a central solution to combine data across agencies to maintain a dashboard accessible to state leaders, local leaders, and health departments.
  • Build a workforce – a new innovative way to attract and retain talent. Specific recommendations include new legislation to address the workforce shortage, developing incentives to diversify the mental health workforce, and partnering with colleges to have feeder programs.
  • Fortifying community networks – a new way to invest in local communities and parent leadership. Specific recommendations include adding a full-time role for local resource coordination to each Care Coordination and Support Organization staffing plan, funding parent leaders’ positions with each Designated Service Area (DSA), and providing DSAs access to resource referral technology.