On May 17, the Community Behavioral Healthcare Association of Illinois, the Illinois Association for Behavioral Health, the Illinois Association of Rehabilitation Facilities, and NAMI Illinois, in partnership with the Behavioral Health + Economics Network (BHECON), hosted a forum and legislative breakfast on Advancing Community Behavioral Health. The forum focused on the Integrated Health Homes (IHH) program, a new, fully‐integrated form of care coordination that addresses the physical, behavioral and social care needs of mental health consumers, as well as on evolving federal and state policy issues.
Health policy experts shared updates from the ongoing health care debate in Washington, DC and state agency representatives from the Illinois Department of Human Services talked about how community behavioral health fits into the IHH program and how it will impact people with behavioral health disorders. Participants also heard the latest updates on Illinois’ Section 1115 Medicaid Demonstration Waiver and current state public policy issues, including the Illinois budget crisis and other state legislation that impacts behavioral health.
Federal funding cuts will likely impact behavioral health providers in Illinois
During updates on proposed federal funding levels in future years, speakers generally concurred that states are likely to see less federal money for behavioral health and addiction services at the local level. Proposed cuts to the Substance Abuse and Mental Health Services Administration as well as Medicaid will impact all areas of public health, which in turn impact services for mental health and substance abuse disorders.
Behavioral health is a linchpin in the health and human services transformation effort in Illinois
Panelists noted that the transformation of health and human services in Illinois proposed through its Section 1115 Medicaid Waiver included an unprecedented level of collaboration between the governor’s office and 12 state agencies and departments focusing on prevention and population health, pay for value, quality and outcomes, moving from institutional to community care, education and self-sufficiency, and data integration and predictive analytics. The effort was driven by the disproportionate level of spending on mental health and substance use issues, the large undiagnosed or untreated sub-populations, the underutilization of community services and overutilization of intensive institutional care, and the rapid increase in opioid-related deaths.
The economic burden of not treating serious mental illnesses such as schizophrenia, bipolar disorder, and major depression in Illinois is more than $18 billion.
The rationale for this systems transformation was best illustrated by the fact that while individuals with diagnosed behavioral health needs who receive Medicaid benefits make up about 25% of the population in Illinois, they account for about 56% of the total Medicaid expenditures.
The 1115 Waiver will allow Illinois to realize a set of high-priority benefits, such as providing services for individuals with mental health issues through short-term stays in Institutions for Mental Diseases (IMDs), alongside initiatives that will maximize their effectiveness, such as behavioral and physical health integration.
To date, 33 Health Home models have been developed throughout the United States, but the Illinois model will further advance the state’s current integration efforts by offering all Medicaid beneficiaries a fully-integrated model of care coordination.
Standing in the way of these transformation efforts is the current Illinois budget impasse.
In addition to preventing transformation efforts from moving forward, the budget crisis has caused more than one million Illinoisans to lose access to critical services that protect their lives, panelists said, including 80,000 people who have lost access to needed mental health services. Since the beginning of the budget impasse, 24,000 fewer Illinoisans have received addiction treatment services, according to forum sponsors. Delays in payments due to the lack of a state budget and payment delays from the state to Medicaid managed care organizations have resulted in the closure of facilities, left hundreds of patients without a place to receive treatment services, and put many people out of work.
Every day people with mental health and substance use issues end up on the streets, become homeless, go to jail or even die because they don’t get treatment. Participants in the forum urged the governor and state legislators to negotiate a budget that resolves the current FY17 budget impasse and fully funds behavioral health services and supports in FY18.
Advocates Head to the Hill
After hearing from the panelists, forum attendees headed to the Illinois state house to advocate for the importance of having a state budget in place so that those with behavioral health disorders will continue to receive vital services.
- Kristine Herman, Bureau of Behavioral Health, Dept. of Healthcare & Family Services
- Andrew Kessler, Slingshot Solutions, Washington, DC
- Danielle Kirby, Div. of Alcoholism and Substance Abuse, Dept. of Human Services
- Diana Knaebe, Div. of Mental Health, Dept. of Human Services
- Dan Rabbitt, Heartland Alliance, Chicago, IL