Entry into this system should be facilitated by comprehensive and coordinated sources of information that help with finding the most appropriate service providers in the local community. Funding decisions from all sources should be based on data indicating best practice strategies and supports, which lead to the best health outcomes. Alternatives to incarceration must be available for people who have mental and behavioral health challenges and/or intellectual/developmental disabilities. The current crisis Funding must be adequate to meet the scope and intensity of needs. This funding should include support from state, county, township, and municipal governmental bodies. In addition, affordable housing, affordable and accessible transportation, job training, case management, respite, and social and recreational services need support. in Illinois’ finances is contributing to the needs in these areas.
The following statements describe the situation in 2016 and present justifications for the position.
* Funding: Currently, the payment for many services occurs through Managed Care Organizations, either through private insurance plans or through public programs, such as Medicaid and Medicare. Funding for services has become available for a larger percentage of the population under the Affordable Care Act, but overall funding continues to be inadequate and should be increased. Both private and public benefits have limitations. Many private insurance plans require high out of pocket payments that may be impossible for individuals to meet. Individuals on Illinois’ Home and Community Based Medicaid Waivers (HCBW) are initially placed on waiting lists for services and may have to travel far from their communities in order to receive services. Waiting list time for HCBW services averages more than 10 years in Kane County. In addition, Medicaid reimbursement rates set by the state continue to be extremely low, and have not been increased in over a decade. Funds granted to service providers by state, county, township, and municipal bodies have largely remained the same or have decreased, and these funds are typically limited by legislation and referendum. Available services vary greatly by location in Kane County. Additional support from all levels of government and from donors to not for profit organizations is needed. Some geographical areas lack funding through 708 boards, 377 boards, or county health departments.
* Housing: There is a serious shortage of affordable housing options and this especially impacts individuals with serious/chronic mental illness and individuals with intellectual/developmental disabilities given their life long conditions. Illinois lags the nation in de-institutionalization and is operating under three consent decrees to accelerate this process. However, there continues to be a critical need for affordable housing, supported housing, and Community Integrated Living Arrangements (CILAs). Progress in this area is delayed by a lack of funding and, in some situations, by community resistance to CILAs.
* Other supports and services: Many additional services, such as affordable and accessible transportation, job training, case management, respite for caregivers, and social and recreational services are underfunded and unavailable to many. The services that are available vary widely from place to place. Kane County lacks a sufficient number of fixed bus routes and paratransit services, especially west of Randall Road. When these services are not available, this again especially impacts individuals with serious/chronic mental illness and individuals with intellectual/developmental disabilities.
* Access to services: There are no comprehensive and coordinated sources of information about how and where to seek services, and these should be created. The 211 phone system, which operates in all but two states, would provide help in finding appropriate local services and in navigating private insurance companies and public supports such as Medicaid. In addition, an easily accessed online resource, either publicly supported or supported through public/private partnership, would also provide guidance in these areas. Transition planning from school services to adult services should be coordinated and enhanced.
* Evidence-based practices: Some data supported intervention programs, such as the diversion of offenders to Treatment Alternative court (TAC), have begun to be adopted, and this process should be increased. All intervention programs and individual services used should be data supported, with a continued and increased focus on health outcomes (instead of health encounters). Best practice interventions such as Critical Incident Training (CIT), Mental Health First Aid, and Assertive Case Management should be used county wide.
* Current crisis in state finance: State grants funding psychiatric services and supportive housing for homeless and mentally ill residents were discontinued in July 2015. The failure to reinstate these grants or to refinance them through Medicaid will result in expensive and unnecessary hospitalizations and incarcerations. In addition, state grants funding respite care, autism services, supportive and supervised housing, and crisis and emergency services for the uninsured have been suspended since July 2015, due to the lack of a state budget. Most providers have continued to provide services since then, but are beginning to exhaust their financial reserves. The failure to reinstate this funding will also result in expensive and unnecessary hospitalizations and incarcerations.
For more information, see our Positions document HERE