Local, State Advocates Sound Alarm on Illinois Mental Health Care Crisis

(Springfield, IL) – Local and state behavioral health advocates are sounding the alarm on Illinois’ swelling mental health crisis.

“Wait times to see a psychiatrist in Illinois’ community mental health system can now range from 4 to 6 months,” said Tim Sheehan, Chairperson of the Public Policy Committee of the Community Behavioral Healthcare Association of Illinois and Vice President of Home and Community Services at the Des Plaines-based Lutheran Social Services of Illinois. “The lack of an adequate behavioral health care workforce is causing longer and longer wait times for people struggling with mental illness to receive care, a situation which has reached crisis proportions in the state.”

Sheehan noted that according to the Illinois Department of Healthcare and Family Services, the inadequate behavioral health workforce is responsible for the state’s “insufficient community behavioral health services capacity.”

In fact, Illinois ranks 30th in mental health workforce availability with 844 people per mental health worker compared to the national median of 752, Sheehan points out.

A top Illinois behavioral health advocacy group leader says that the limited access to front-line mental health care in Illinois is “staggering and shameful” while local community agencies’ budgets are spending more on administrative costs due to the state’s new managed care system.

“There is a staggering and shameful lack of access to behavioral health care represented by a shortage of specialists, such as child and adolescent psychiatrists, advanced practice nurses, and physician assistants,” said Community Behavioral Health Association of Illinois CEO Marvin Lindsey. “Meanwhile, the administrative staff costs of providing community behavioral health services have increased dramatically, by as much as two to five times, since Illinois implemented Medicaid Managed Care.”

Sheehan agreed.

“More money is being devoured by administrative costs associated with paperwork demands of Illinois’ expanded Medicaid Managed Care program and less on investing in an adequate, front-line behavioral health workforce to care for patients,” Sheehan said.

Lindsey, Sheehan and other behavioral health advocates are planning a two-prong state legislative offensive to address Illinois’ deepening mental health care crisis.

“We’re planning on pushing a Resolution in the Illinois General Assembly to declare a ‘mental health care emergency in Illinois’ to raise awareness of the critical problem of access to care,” Lindsey said. “And we are going to advance legislation that would comprehensively address the behavioral health workforce crisis, which is undermining mental health care in Illinois.”

Fixing behavioral health workforce is a “priority,” says Sheehan.

“For community mental health agencies across the state, including Lutheran Social Services of Illinois, providing more support, more training, and a deeper bench to the behavioral health workforce is a top advocacy priority,” said Sheehan. “It’s critical.”

mlindsey@cbha.net

Survey: $142 Million Owed to Mental Health Providers as Psychiatrist Wait Times Mushroom, Services Shudder

(Springfield, IL) – A new survey by a top behavioral health advocate group reveals that the state of Illinois owes community mental health centers statewide a staggering $142 million in unpaid bills, a debt that is squeezing care for people struggling with mental illness and addiction.

The Community Behavioral Healthcare Association of Illinois released on Wednesday a survey of state community mental health providers that shows that these agencies are owed for fiscal year 2017 a total of $142,558,150 or nearly 90% of what has been budgeted for the current fiscal year that expires on June 30.

Moreover, the survey shows that, in Fiscal Year 2016, 73.5% of community agencies had reduced or eliminated behavioral health programs and that in Fiscal Year 2017 an additional 33.7% of agencies further cut or ended services.

“To say that community mental health providers are operating on fumes would be incorrect. They consumed the fumes long ago,” said Community Behavioral Healthcare Association of Illinois C.E.O. Marvin Lindsey. “The financial starvation of providers has shriveled our ability to serve an exploding need to the extent that Illinois is fast becoming a behavioral health system Potemkin Village.”

Continue reading “Survey: $142 Million Owed to Mental Health Providers as Psychiatrist Wait Times Mushroom, Services Shudder”

OP-ED: Rauner Administration 2018 Behavioral Healthcare Budget Fails to Meets its Ambitions

OP-ED: The Rauner Administration’s proposed FY 2018 budget for the Illinois Department of Human Services (DHS) falls dramatically short of the governor’s stated ambition to place behavioral health care at the center of a human services transformation. The money requested and the ambition articulated fail to align.

According to the Governor’s Office of Management and Budget FY 2018 budget book, less than half of the 750,000 people needing mental health treatment in Illinois actually received treatment, but the governor’s proposed budget fails to address this need. In fact, 80,000 people in Illinois have lost access to needed mental health services. This proposed budget also fails to restore the community behavioral health community infrastructure – counselors, case managers, community programs, and facilities that have been pulverized into dust – by the budget impasse that has ravaged community care providers over the last 22 months.

Yet, the governor’s appropriation request for the Division of Mental Health is $36 million less than the FY 2015 GRF actual expenditures. $36 million less. The governor’s stated aim of reducing institutional care and increasing community-based services cannot be achieved with this proposed budget. In fact, it goes backwards.

The governor’s proposed FY 18 DHS budget for the Division of Alcoholism and Substance Abuse (DASA) is no better.

In the DASA budget, there is no recognition of the heroin and opioid wildfire blazing across the state, especially in southern Illinois, suburban counties and on the Westside and Southside of Chicago. According to the Illinois Department of Public Health, a broad swath of southern Illinois counties has been walloped by a 200% plus increase of opioid related overdose deaths between 2010- 2015, with 57% to 74% being between the ages of 25-44. Those numbers are projected to increase. In fact, 24,000 fewer Illinoisans have received addiction treatment services.

Yet, the governor’s appropriation request for DASA is $26 million less than the FY 2015 GRF actual expenditures.

Community providers struggle to operate under a climate of uncertainty of payments. Compounding that problem of payment uncertainty is the problem of potential deeper cuts. ‘Doing more with less’ is fine for a bumper sticker or a campaign speech, but doing with less, in a reality based world in which the books need to be balanced, gets you less. Period.

In the case of behavioral healthcare, getting less means that an untreated mental health crisis can cost a mother her job or, worse, 10 days in county jail. Untreated heroin addiction can cost a life. You can’t put a crisis on a waiting list.

Finally, the two-year budget ordeal has forced longer, bulging client waiting lists, program cuts, agency closures, and employee layoffs in community mental health and addiction agencies across the state. In a March 2017 United Way of Illinois “Stop Gap” survey, 33% of community mental health providers have reduced the number of individuals they can now serve.

The impasse has struck at many constituents of Illinois lawmakers. We encourage legislators, no, we plead with them, to, please, find the will to compromise, to find a way forward. Your constituents are depending on you.

Now is the time for the executive and legislative branches to set partisan politics aside and pass a responsible budget. We insist on an immediate resolution to this crisis.

Is this too much to ask?

Marvin Lindsey, CEO, Community Behavioral Healthcare Association of Illinois

Advocates to Lawmakers: Illinois Should Slash Medicaid Managed Care Organizations from 12 to 5

(Springfield, IL) – At a public hearing before state lawmakers last week in Springfield, Illinois’ top behavioral healthcare advocates recommended that the state reduce the number of its Medicaid Managed Care Organizations under contract from 12 to five.

At a joint Illinois House public hearing on Thursday of the chamber’s human service committees about the Rauner Administration’s plan to reform the state’s $9 billion Medicaid program by, in part, reducing the number of Medicaid Managed Care Organizations under state contract, Community Behavioral Healthcare Association of Illinois CEO Marvin Lindsey told House lawmakers during the four-hour hearing that because of “enormous amount of administrative burden” placed on community behavioral health providers that any new state contract should limit Managed Care providers to “five.”

“Currently, many of our members contract with as many as 7 to 10 Medicaid MCOs, which creates an enormous amount of administrative burden on providers of all sizes, especially small- to moderate- size providers,” Lindsey told legislators. “We support reducing the number from the current number of 12 to 5 to allow providers to focus more time and energy on providing care and treatment instead of being on the phone trying to track down staff from 7-10 MCOs to get authorizations, answers to billing questions or explanations for denied services.”

Under the Rauner Administration’s slated contract “Request for Proposal,” the new Medicaid program calls for more than 80 percent of Medicaid beneficiaries to receive services through managed care, up from 65 percent today. It also extends managed care to every county in Illinois and to children under the care of the Department of Children and Family Services. The new program is scheduled to become effective January 1, 2018.

Today, approximately two million of the state’s 3.1 million Medicaid members are served by managed care plans. But providers and plans have withdrawn from the program in recent months; leading to several counties in central Illinois without any managed care options.

“We support Governor Bruce Rauner’s intent to reduce the number of Medicaid Managed Care Organizations because community behavioral health providers are consumed by navigating a mish-mash of vast, uncoordinated corporate bureaucracies,” said Lindsey. “Those corporate bureaucracies are distracting us from for our core mission: delivering care to individuals working to recovering from mental illness and drug addiction.”

mlindsey@cbha.net

 

OP-ED: Central Illinois Medicaid Managed Care Crisis Shuts Out Mental Health Inpatient Care

OP-ED: – The collapse of the Central Illinois Medicaid Managed network has, effectively, shuttered inpatient psychiatric services for people with schizophrenia, bi-polar disorder and other mental illnesses at regional hospitals.

The January announcement by Decatur Memorial Hospital that it will terminate its contract with Molina Healthcare of Illinois on March 23, 2017 brings the number to four hospitals (St. Mary’s, Decatur; St. John’s, and Memorial, Springfield) that will no longer accept individuals with Molina Medicaid insurance.

This is a crisis.

Molina patients who are now receiving mental health care in community mental health centers or persons in the area in need of inpatient psychiatric care will now loose that access to care.

Gone.

The hobbled network of inpatient psychiatric beds in Central Illinois threatens individuals who have been diagnosed with schizophrenia, bi-polar disorder or co-occurring mental health/substance use disorder and who need immediate, emergency stabilizing care. That’s why Decatur Memorial’s decision has a created a crisis. Hospital doors are shutting on people with severe mental illness.

What’s the impact?

Community mental health providers in the area have been left to scramble around to find an inpatient placement for someone who is in crisis or on the verge of crisis. The nearest state operated psychiatric hospital, the Jacksonville Developmental Center, has a waiting list. A waiting list for psychiatric crisis. Admittance into Jacksonville can consume days because the Medicaid certified individuals who are provided state psychiatric hospital care receive do not trigger managed care organization reimbursement to the Department of Human Services for the cost of this care.

Because no inpatient psychiatric care is available, individuals often are detained in emergency rooms or other non-psychiatric units for extended periods. Sometimes days. This situation will worsen in this region if the Department of Human Services fails to find a solution. Period.

Failure on the part of the state is not an option.

CBHA urgently recommends that the state act expeditiously on its own announcement rolled last September to allow Meridian Health Plan to begin covering persons with Medicaid in central Illinois. We agree with Health & Family Services Director Felicia Norwood who is on the record stating that the expansion of Meridian into the central Illinois region “will assure that our clients have access to managed care options in Central Illinois and the Quad Cities.”

Once Meridian is in operation in the region, we also recommend that the state implement an open enrollment period to allow persons on Medicaid the choice of health plans that will meet their healthcare needs.

We recommend that the state act.

Swiftly.

Marvin Lindsey, CEO, Community Behavioral Healthcare Association of Illinois

Behavioral Health Advocates Hail Illinois’ Selection for National Criminal Justice Reform Project

(Springfield, IL) –  Illinois’ selection as one of just three states out of 20 applicants for participation in the National Criminal Justice Reform Project (NCJRP) has drawn applause from a top Illinois behavioral advocate group.

Chosen by the National Criminal Justice Association Center for Justice Planning and the National Governors Association, the project offers technical assistance to states in the planning and implementation of data-driven, evidence-based practices in the areas of pretrial reform, re-entry and offender recidivism, mental health and substance abuse, reducing incarceration, and information sharing.

“Illinois has been a leader on criminal justice reform in the last several years, and the state’s participation in the National Criminal Justice Reform Project advances that effort,” said Community Behavioral Healthcare Association of Illinois CEO Marvin Lindsey. “Since behavioral health care is a linchpin of any effort to fix our criminal justice system, we look forward, as key stakeholders, to be involved in the national reform effort.”

Illinois Criminal Justice Information Authority Executive Director John Maki, who announced Illinois’ selection on December 21, warmly welcomed the state’s participation.

“We are honored to be a part of the National Criminal Justice Reform Project,” said Maki. “This partnership will be invaluable as Illinois works to fully integrate evidence-based practices that ensure a fair and cost-effective criminal justice system and improve public safety.”

Through the project and with the assistance of an advisory board of national experts, the Governor Bruce Rauner’s office and ICJIA will lead teams of policymakers and key stakeholders on a strategic planning process for advancing reforms within the state’s executive branch.

“Protecting the public’s safety is of paramount importance to Governor Rauner,” said Rodger Heaton, Public Safety Director. “The state’s selection for this grant reflects the many efforts underway to improve our public safety system in sustainable, measurable ways.”

Lindsey said that he “looks forward” for CBHA’s opportunity to share “evidence-based best practices” CJIA to help push executive branch reforms.

“Our community behavioral health providers are working on ground every day implementing evidence-based best practices, and we look forward to working with CJIA and Director Maki wherever we may be helpful,” Lindsey said.

In 2015, the Rauner created the Illinois State Commission on Criminal Justice and Sentencing Reform, an initiative to reduce Illinois’ incarcerated population by 25 percent by 2025.

Lindsey also noted that in August 2015, before the November 2015 release of the infamous Laquan McDonald shooting video, Rauner signed the Police and Community Relations Improvement Act, Senate Bill 1304, sponsored by State Senator Kwame Raoul (D-Chicago), a measure that contains a requirement for police body cameras, training and attention for dealing with individuals suffering from mental health illness.

“The Illinois debate occurred before the MacDonald video became public,” Lindsey said. “I think Senator Raoul’s legislation puts Illinois ahead of a curve on the topic.”

mlindsey@cbha.net

Rauner Signs Bill Authorizing 90-Day Illinois Identification Card for Ex-Offenders

(Chicago) – Governor Bruce Rauner on Thursday signed legislation, Senate Bill 3368, to ensure that any person being released from the Department of Corrections (DOC) or Department of Juvenile Justice (DJJ) has a valid state identification card upon release.

“In order to combat recidivism we need to remove some of the hurdles offenders face when they are released from a detention facility and begin to re-integrate into society,” said Rauner, who was joined by Secretary of State Jesse White, State Senator Kwame Raoul (D-Chicago), State Senator Karen McConnaughay (R-St. Charles), State Rep. La Shawn K. Ford (D-Chicago), and other elected officials at A Safe Haven in Chicago.

“In this case, it’s the simple step of providing an offender with a state ID,” Rauner said. “We thank the bill sponsors for their work on this bipartisan legislation and Secretary of State White for his commitment to implement the new law.”

The measure, which was approved by the General Assembly December, requires the Secretary of State to issue a standard Illinois ID card, at the time of their release, to any person being released from the DOC or DJJ who present their birth certificate, social security card, or other documents authorized by the Secretary, and two proofs of address. For individuals without these documents, the Secretary of State will issue a limited-term, 90-day ID to released individuals who present a verified document from DOC/DJJ with their name, birth date, social security number, and proof of address. They then have 90 days to present this ID at the Secretary of State to receive a standard issue ID.

“This new law helps to reduce some of the barriers men and women face as they try to reenter society,” said White. “This was a cooperative effort to streamline the ID process for those being released while maintaining its security.”

“The simple act of providing low-level offenders with identification will help them to secure employment, housing, and establish financial stability,” said McConnaughay, a member of the Illinois State Commission on Criminal Justice and Sentencing Reform.

“The ID issue for those leaving prisons has been a problem in Illinois for years, and today, thanks to Gov. Rauner’s leadership, we will meet the needs of some of our most vulnerable people in Illinois,” said Ford.

The legislation was one of the recommendations made by the Illinois State Commission on Criminal Justice and Sentencing Reform in their efforts to reduce the state’s current prison population by 25 percent by 2025.
Additional information on the Illinois State Commission on Criminal Justice and Sentencing Reform.

mlindsey@cbha.net