Top Advocates Launch 1st of 3 Illinois Mental Health Policy Forums on August 30

(Springfield, IL) – As Governor Bruce Rauner’s Administration embarks on a “transformation” of the state’s of health and human services programs, Illinois’ top behavioral health care advocates will roll out the first of three mental health policy forums at the end of August that will aim to help shape state policies.

The Community Behavioral Healthcare Association (CBHA), the Illinois Association of Rehabilitation Facilities (IARF), and the Illinois Association for Behavioral Health (IABH), in partnership with the Behavioral Health + Economics Network (BHECON) led by the National Council for Behavioral Health, will host the first of the series of behavioral health forums on August 30 in Normal.

“The state’s planned ‘transformation’ of Illinois’ health care system prioritizes behavioral health services, which promote overall health and lower health costs,” said IABH CEO Sara Moscato Howe. “The state’s effort will align with our behavioral health policy forums, forums that we expect will provide a platform to help shape’s the Administration’s policies going forward.”

The August 30 forum in Normal, “Illinois Behavioral Health Pre-Transformation: Where Are We Now and Where Are We Going?,” will provide a scan of the current system in Illinois. Presenters will discuss Illinois’ current system of care along with future considerations, such as:

  • Range of treatment options and care settings for individuals with acute, chronic and mild needs;
  • Specialized services available to children and adolescents;
  • Services for co-occurring mental health and addiction disorders;
  • Financing and payment reforms; and
  • Policy reforms that ensure individuals access to care at all stages, including prevention and early intervention.

Speakers from a diverse array of industries will also discuss creative approaches to integrating care, the impact and cost savings of a housing-first approach, how early intervention and prevention programs could be implemented across the state, and how available resources drive capacity, according to Howe.

“In Illinois, the burden of untreated mental health conditions and lack of access to substance use prevention and treatment falls on hospital emergency departments, jails, prisons, child welfare systems, schools, communities, and families,” said Howe. “That burden and the policy solutions will be the centerpiece of the forum series.”

This initial forum is expected to lead discussion towards fundamental questions:

  • What is our vision for a comprehensive, high-performing delivery system in Illinois?
  • Where are current gaps in care that create poor health outcomes and increase expenditures in the system?

The next planned forum in Normal will be on October 6.

“Throughout the three forums, participants will hear from experienced executives and clinicians from community clinics, state agency representatives, legislators, and educators,” said Howe. “They will share innovative approaches to address the continuum of care and share data from economic research on the impact of community-based care.”

The date of the third forum in Normal remains to be determined.

sara@ilabh.org

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Cash Reserves Exhausted, Hispanic Drug Treatment Agency Closure Looms

Illinois’ budget impasse is driving a suburban non-for-profit substance abuse treatment agency, which serves mostly Hispanic residents, to close all offices by July 1.

Without payment from the state on the $59,326 owed, the Elgin-based Latino Treatment Agency will begin to shut down two agency facilities by June 15 and the final office by July 1.

“Given the State’s inability to release the $59,326 owed to the Latino Treatment Agency from our state grant, we will be unable to provide services to our clients, mostly from the Hispanic community, if we do not receive these State funds by July 1,” said agency executive director Adriana Trino. “More than 160 clients will be terminated from services by July 1.”

Trino says that the agency, which has been in operation for more than 30-years, has cut salaries and exhausted bank lines of credit and cash reserves in order to maintain services to its 160 Hispanic clients spread through out Cook, DuPage, and Kane counties.

“We have cut our expenses; we have accumulated debt; and we have reduced salaries of every staff member,” Trino said. “We have exhausted cash reserves and our line of credit in order to remain afloat.”

The $59,326 owed to agency is on top of $60,690 cut from the group’s $273,008 budget by the Rauner Administration in August 2015.

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Op-Ed: Proposed Rauner Budget Fails to Meet Mental Health, Addiction Health Care Needs

OP-ED: Illinois has a staggering behavioral healthcare challenge and it needs a budget to meet that challenge.

Recent data from the federal Substance Abuse and Mental Health Services Administration underscores the need for a strong, well-funded community-based system of addiction and mental health services in Illinois.

Between 2010 and 2014, the behavioral healthcare challenges, such as depression, suicide risk, drug and/or alcohol abuse, for Illinois men, women, and children have mounted.

  • About 105,000 adolescents’ ages 12-17 report having at least one major depressive episode, while only 38% received treatment for their depression.
  • 355,000 adults 18 and over report ‘serious thoughts of suicide’; while ~363,000 qualified for a Serious Mental Illness (SMI) diagnosis.
  • Of the 1.53 million Illinois adults having ‘any mental illness’ (AMI) in the previous year, more than 55% did not receive mental health treatment.
  • Similarly, only 11.7% of the estimated 267,000 individuals 12 and older dependent on or abusing illicit drugs received treatment for their substance use disorder.

While behavioral problems and needs are clear, funding for addiction and mental illness prevention and treatment has been continually reduced by the Illinois General Assembly. In the past five years, the legislature has slashed state funding for addiction prevention, cut addiction treatment by 40% and mental health treatment by nearly 25%.

Meanwhile, an epidemic of heroin and non-medical use of prescription drugs has exploded across the state, forcing Illinois’ jails and correctional centers to become ill-equipped triage centers for individuals with mental illnesses and/or substance use disorders. Cook County Sheriff Tom Dart has repeatedly stated that the Cook County Jail is now the ‘largest mental health institution in the country’, and a majority of the individuals under his care are also there as a result of untreated addiction.

Over the past several years, Illinois has witnessed an expansion of mental health and addiction parity, the implementation of the Affordable Care Act, and a shift from state General Revenue Funds and Medicaid funding to a system of Managed Care funding, all of which has been implemented by providers in the trenches. At the same time, providers have borne uncompensated, additional expenses associated with implementation of Electronic Health Records and electronic billing. These changes have occurred while the legislature has almost annually imposed funding reductions on community providers, refused to raise historically low reimbursement rates, and left unresolved a Fiscal Year 2016 budget impasse that threatens to undermine our system of community-based care at its core.

While the staggering challenges to Illinois behavioral healthcare community providers continue to bear down, the policy prescription in the form of Governor Bruce Rauner’s proposed FY 2017 falls, let us say, short. In fact, the Governor’s budget proposal continues to move Illinois in the wrong direction, threatening to decimate the already-weakened safety net for Illinois’ most vulnerable citizens.

At a time when the need to prioritize state dollars for the maximum return on investment, reductions to the community behavioral health system are short-sighted and ill-conceived.

Data from national studies have concluded that addiction and mental health treatment not only produces measurable, positive outcomes, but also yields substantial savings to states. A 2014 actuarial study by Milliman found that $26-$48 billion could be saved nationally through effective integration of medical and behavioral services.

Additionally, several studies underscore the positive impact of addiction and mental health services:

  • A 2004 randomized trial studying employer costs found that ‘consistently-employed patients in an enhanced depression management program had 8.2% greater productivity and 28.4% less absenteeism over two years than employees receiving ‘usual care’.
  • The reduction in absenteeism and increase in productivity had an estimated annual value of $2,601 per full-time equivalent employee.
  • The state of Washington compared disabled Medicaid enrollees receiving SU treatment with the untreated population, finding that average monthly medical costs were $414 higher for those not receiving treatment, and with the cost of the treatment added in, there was a net cost offset of $252 per month or $3,024 per year. For individuals with opiate-addiction, cost offsets rose to $899 per month for those who remain in methadone treatment for at least one year.
  • The same study also found that prior to their SUD treatment expansion initiative, healthcare costs for Medicaid disabled clients with SUD problems were rising at a rate of 11% per year. Under the SUD treatment expansion initiative, the growth in healthcare costs was slowed to just 2.8% per year.

The solution is clear.

The Illinois General Assembly and the Governor must prioritize funding for addiction and mental illness prevention, treatment, and recovery support. Lawmakers and the Governor need to end the funding reduction cycle. Now. Instead, Lawmakers and the Governor need to close the gap between those needing behavioral healthcare and those receiving it. Lawmakers and the Governor need to invest in behavioral healthcare.

The governor’s proposed FY 2017 budget fails to do that.

The budget needs a do over.

Sara Moscato Howe, CEO, Illinois Alcoholism and Drug Dependence Association

showe@iadda.org

OP-ED: “Unbalanced Budget Response Act” Would Undermine Illinois Behavioral Healthcare

Eric_Foster_Hearing

Eric Foster, Vice President for Substance for Policy, Illinois Alcoholism and Drug Dependence Association

OP-ED: Illinois behavioral healthcare providers are faced with many daunting, financial problems uncertainties as they struggle to deliver quality mental health and addiction treatment services to fathers, mothers, and children in need.

The “Unbalanced Budget Response Act” would make their job worse.

First, since Fiscal Year 2009 through Fiscal Year 2015, Illinois eliminated state funding for addiction prevention, cut addiction treatment by 40% and mental health treatment by nearly 25%. In Fiscal Year 2016, Governor Bruce Rauner cut behavioral health providers by another 25%.

Second, over the past several years, behavioral healthcare providers have had to shoulder the vast implementation expansion requirements for the Parity of Mental Health and Substance Abuse Act, the implementation of the ACA, and the shift from state GRF/Medicaid to Medicaid Managed Care. Moreover, non-profit providers have had to absorb the additional expense associated with implementation of Electronic Health Records and electronic billing.

These herculean bureaucratic demands had to be implemented while simultaneously being hit by the legislature and governor with budget reductions in overall funding for services and no meaningful increase in reimbursement rates to actually cover the growing costs of doing business, such as implementing new mandates.

A recent report from the Illinois Partners for Human Services has found that stagnant reimbursement rates have had significant negative impact on the provider’s ability to cover basic operation costs. Low rates contribute to high employee turnover. Low rates blunt the expansion services to meet the growing needs of Illinois citizens. Low rates leave Illinois exposed to each new drug crisis.

The report also shows that in order to be current with cost of living, reimbursement rates for substance abuse treatment would need to increase by 27% and rates for community mental health services would need to increase by 16%.

Meanwhile, the “Unbalanced Budget Response Act”, Senate Bill 2789, would grant the governor the power to reduce rates unilaterally and without appeal. That authority to gut the last remaining financial life-line that has helped to keep Illinois’ limping behavioral healthcare system function would be an abrogation of the legislature’s own authority and of its own responsibility to the constituents to whom they serve.

Behavioral healthcare providers will be unable to sustain a service if they cannot cover the costs of rendering that service. Granting authority to arbitrarily reduce provider reimbursement rates would be a fatal blow to an already crumbling mental health and substance abuse treatment system.

The Illinois Alcoholism and Drug Dependence Association vigorously opposes this legislation.

Eric Foster, Vice President for Substance Abuse Policy, Illinois Alcoholism and Drug Dependence Association

Illinois Snags Chunk of $22.9 Million Federal Community Behavioral Health Grants

Memory loss, conceptual artwork

(Springfield, IL) – The federal government last Tuesday awarded $22.9 million to boost community-based mental and substance use disorder treatment in 24 states, including Illinois.

The Substance Abuse and Mental Health Services Administration (SAMHSA), in conjunction with the Centers for Medicare & Medicaid Services (CMS), announced yesterday that the money in the form of planning grants will support states, including Illinois whose Department of Human Services is to receive $982,373, to begin a long-term process that would certify community behavioral health clinics as federally qualified operations.

“The planning grants will help states strengthen payment for behavioral health services for Medicaid and CHIP beneficiaries, and will help individuals with mental and substance use disorders obtain the health care they need to maintain their health and well-being” said Vikki Wachino, deputy administrator of CMS, and director, Center for Medicaid and CHIP Services.

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70,000 to Lose Drug Treatment, Mental Health Services by End of July

IADDA CEO Sara Moscato Howe (seated, second right) testified before Illinois House on Wednesday.

IADDA CEO Sara Moscato Howe (seated, second right) testified before Illinois House on Wednesday.

(Springfield, IL) – Behavioral healthcare advocates today warned that a Illinois government shutdown would end drug treatment and mental health care services for 70,000 by the end of July.

The head of Illinois’s top behavioral healthcare group today testified before Illinois House lawmakers and said that the lack of a fiscal year 2016 budget means that by end of July approximately 60,000 men, women, and children would lose their mental health care and 10,000 would lose access to drug treatments services.

“If there is no money flowing to non-profit providers to pay for services by the end of July, there will be service shutdowns for 70,000 and layoffs,” said IADDA C.E.O Sara Moscato Howe. “There is no mystery here. The only question is only when, not if.”

Howe said that years of state budget cuts have financially weakened community social service providers.

“Among our community providers, after seven years of budget cuts totaling 40%, some providers are better prepared financially than others to absorb the financial shock of 90 to 95% of their income being indefinitely suspended,” said Howe. “However, unless that income is restored within a reasonable time frame, even the financially strongest operation will eventually cease to operate.”

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Gov. Rauner Budget Cuts to Mental Health Jeopardize Jobs, Jails

Springfield resident Tim Mercier interviewed before he testified before the House Human Services Appropriations Committee on April 1 against Gov. Bruce Rauner's proposed budget cuts to Illinois mental health services, explaining how those services helped turn his life around.

Springfield resident Tim Mercier interviewed before he testified before the House Human Services Appropriations Committee on April 1 against Gov. Bruce Rauner’s proposed budget cuts to Illinois mental health services, explaining how those services helped turn his life around.

(Springfield, IL) – Governor Bruce Rauner’s proposed budget cuts to Illinois mental health care services would be a blow to job seekers and aggravate the burden on local and state law enforcement officials, says a top mental health advocate.

In Fiscal Year 2016, Rauner is aiming to slice $82 million out of the $459 million in state dollars for the Illinois Department of Human Service’s Division of Mental Health, a 18% cut, according to Illinois Alcoholism and Drug Dependence Association C.E.O Sara Moscato Howe.

“Governor Rauner’s budget would cut Illinois’ community mental health services budget for the seventh time in eight years,” said Howe. “After seven years of cuts, an 18% reduction will further shred the safety net, undermining individuals’ efforts to secure and maintain stable employment while continuing to convert Illinois prisons and county jails into mental health clinics with bars.”

Statewide, the Governor’s proposed budget cut would mean 7,473 individuals would lose access to mental health care, according to Illinois Alcoholism and Drug Dependence Association.

Funding for Illinois mental health care has been cut 32% by the legislature since fiscal year 2009.

Howe says that by further cutting mental health care funding even more Illinois residents will go without needed care. Of the 1.53 million Illinois adults having ‘any mental illness’ in the previous year, more than 57% did not receive mental health treatment, she noted.

Howe also warned that the reduction in funding for mental health care services treatment services would undermine employment opportunities.

“Cutting mental health care compromises a person’s opportunity to maintain a job or to be productive,” said Howe. “Any good, modern businessman knows that healthy employees are productive employees. It’s economics 101.”

Howe pointed out that a 2004 randomized trial studying employer costs found that consistently-employed patients in an enhanced depression management program had 8.2% greater productivity and 28.4% less absenteeism over two years than employees receiving ‘usual care’. Moreover, the reduction in absenteeism and increase in productivity had an estimated annual value of $2,601 per full-time equivalent employee.

Howe also said that youth in Illinois are at high risk for mental illness and suicide and more than a third are going untreated.

“Each year between 2009 and 2013, about 88,000 Illinois adolescents’ ages 12-17 report having at least one major depressive episode, while only 37% received treatment for their depression,” said Howe. “More disturbingly, Illinois has more youth, 12.4%, reporting a suicide attempt than a depressive episode, and given that the governor’s budget cuts $200,000 for teen suicide prevention, this problem only worsens.”

Meanwhile, Howe also spotlighted the alarm bells once again set off by Cook County Sheriff Tom Dart who said on April 7 in a media interview that jails are becoming “dumping grounds” for those struggling with mental illness.

“If for some reason people doubt what I’ve been saying about how the jails throughout the country — prisons as well — if they doubt that they have not become dumping grounds for the mentally ill, then I would suggest they come here,” said Dart. “They would see that the divisions for people without mental illnesses are either empty or half-filled. The ones for people with mental illness are filled to capacity, and the areas where we have the most acutely mentally ill people are always over capacity.”

Dart estimates that roughly 30 percent of the 9,000 inmates at the Cook County jail have some form of mental illness.

The sheriff is also warning that the $82 million budget cut to state mental health service proposed by Governor Bruce Rauner will only aggravate the problem.

“I don’t know how the system could sustain that. I mean, the providers that I deal with, the people that I hand folks off to who leave the jail, with the notion that we put a plan together for them to have them leave here and to have a support network in the community so they don’t come back,” said Dart. “Those providers, I don’t know how they’re going to be able to survive. They don’t have any money.”

IADDA Warns at Hearing of Rauner Prevention, Treatment Budget Cuts

Eric Foster, IADDA's VP of Substance Abuse Services and Chief Operating Officer, testified at the senate hearing.

Eric Foster, IADDA’s VP of Substance Abuse Services and Chief Operating Officer, testified at the senate hearing.

(Chicago) – At a Monday hearing of the Illinois Senate Appropriations Committee, human service advocates weighed in on budget cuts proposed in Governor Bruce Rauner’s FY 2016 Budget.

Advocates explained to the bi-partisan group of lawmakers about the devastating impact of the proposed human service cuts. Dozens of clients and family members also attended the hearing and spoke out about the positive impact of services, underscoring the need to maintain the social safety net in Illinois communities.

Rauner is aiming to slice $27.6 million next year from the current $127 million budget of the Illinois Department of Human Service’s Division of Alcoholism and Substance Abuse for alcohol and drug treatment, a 22% cut. A cut of that magnitude would eliminate addiction healthcare treatment for 7,871 individuals next year out of the 47,000 currently receiving care this year or a 17% overall decrease.

Eric Foster, IADDA’s VP of Substance Abuse Services and Chief Operating Officer, testified at the hearing, noting the significant gap in those in Illinois currently needing critical behavioral health services and those actually receiving them.

Foster noted that funding for addiction prevention is eliminated in this budget at a time when binge drinking and marijuana use continues to escalate. He also stressed that cost savings for both addiction and mental health treatment are significant, and that cutting these programs will raise costs elsewhere in the budget.

A client of Rosecrance and Pillars agency, Catrice, a 17-year-old student at Argo High School, spoke of the impact of trauma on her young life and her desire to numb the pain through drugs and alcohol. She stressed that until she went into residential and outpatient treatment, she questioned her own desire whether to even continue living. Once in treatment, Rosecrance helped her create a path to recovery. Her story is like that of so many youth and adults whom drug treatment providers see daily in their agencies.

Haymarket Center’s Dr. Dan Lustig outlined the impact of the proposed $27 million budget cut on local treatment service providers. Dr. Lustig also emphasized the reduction in funding that has occurred since FY 2009.

Since 2009, the state has slashed $39.7 million from treatment, denying care to 8,941 individuals.

The Department of Human Services pushed back on advocate testimony and claimed that they believe that the Affordable Care Act will cover many of the proposed DASA and DMH reductions.

However, Committee chair State Senator Heather Steans (D-Chicago) reminded DHS officials that not all services are covered by the ACA and providers are still working through managed care issues. Moreover, she urged DHS Secretary Greg Bassi to quickly learn more about the impact of the federal IMD exclusion on residential substance abuse treatment, noting that relying on federal funding to make up the cost of services is not a realistic solution.

Next up is the House Human Services Appropriations Committee on Thursday at the capitol in Springfield.

showe@iadda.org

Rauner Budget Axes 7,871 from Drug Treatment

(Springfield, IL) – Governor Bruce Rauner’s proposed FY 2016 budget cuts would eliminate substance treatment for 7,871 Illinois residents, dealing a blow to employment opportunities, say advocates.

Rauner is aiming to slice $27.6 million out of the $127 million budget of the Illinois Department of Human Service’s Division of Alcoholism and Substance Abuse for alcohol and drug treatment, a 22% cut.

A cut of that magnitude would eliminate addiction healthcare treatment for 7,871 individuals next year out of the 47,000 currently receiving care this year or a 17% overall decrease, according to Illinois Alcoholism and Drug Dependence Association Vice President for Substance Abuse Policy Eric Foster, who noted that funding for addiction health care has been cut 24% since fiscal year 2009.

“Tossing 7,871 people out of treatment means tossing them out of any meaningful opportunity to get a job,” said Foster. “Any good, modern businessman, especially a small businessman, knows that healthy employees are productive employees. It’s economics 101.”

According to 2014 data from the Illinois Department of Human Services’ Division of Alcoholism and Substance Abuse, 35% of individuals entering outpatient treatment services are employed at admission, and, thanks to treatment, that number grows to 42.6% employed at discharge. For those who receive treatment at Halfway House Recovery Homes 13.3% are employed at admission and, as a result of treatment, a whopping 38.7% are employed at discharge.

“These numbers demonstrate the immediate impact on employability of individuals who have access to treatment,” said Foster. “These numbers also demonstrate the folly of cutting treatment if politicians are trying to help people get jobs.”

Since fiscal year 2009, the state has been hacking away at substance abuse treatment services, and Rauner’s proposed budget cut is “business as usual,” says Foster.

“Since 2009, the state has slashed $39.7 million from treatment, denying care to 8,941 individuals in order to solve annual, chronic budget problems,” said Foster. “The cutting of addiction health care by Governor Rauner is just Springfield business as usual. There’s no ‘shaking up Springfield. Simple-minded cutting is what Blagojevich and Quinn did each year.”

“Shaking up Springfield” would mean fully funding programs that help people reduce drug and alcohol use and that help them get back to work, not slashing funding, says Foster.

“A 2005 study by Bloomington-based Chestnut Health Systems of more than 800 Illinois adults reported that treatment produced a 58% decrease in drug and alcohol use and a 69% increase in employment engagement,” said Foster. “Cutting a program that delivers results and that helps low-income workers, minorities, and women is not “thinkin’ anew”, it’s just the same old Springfield playbook.”

In addition, Foster cited a 2006 study that revealed the substantive and dramatic effect that substance abuse treatment has on reducing Illinois crime and recidivism.

“A 2006 study of prisoners completing the Illinois Sheridan reentry prison treatment program revealed that 21% were less likely to be re-arrested for a new crime and 44% were less likely to return to prison,” said Foster. “The creation of the Sheridan program was a symbol of innovation, and the Rauner Administration needs to expand treatment for offenders if it is serious about reducing Illinois’ prisoner population.”

efoster@iadda.org

Quinn Aide Jumps to Top Substance Abuse Treatment, Mental Health Advocacy Group

(Springfield, IL) – A key aide to Governor Pat Quinn at the Illinois Department of Human Services has accepted a new post at a top substance abuse treatment, mental health advocacy group.

The current Director of Legislative Affairs for the Department of Human Services, Randy Wells, has been appointed to a newly created position of Vice President for Mental Health Policy at the Illinois Alcoholism and Drug Dependence Association the group announced on Wednesday.

“As the behavior health field has evolved in the wake of the Affordable Care Act, IADDA’s investment in its mental health policy agenda has evolved,” said IADDA CEO Sara Moscato Howe. “That evolution includes expanding the reach of our mental health policy agenda, and Randy will be vital to that expansion.”

In addition to his role under DHS Secretary Michelle Saddler, Wells previously led the National Alliance on Mental Illness (NAMI) for Illinois for eight-years, Howe noted.

“Randy brings to the Association membership a long history and leadership experience in mental health policy, particularly at NAMI-Illinois,” said Howe. “Randy will be charged with tracking mental health legislation, working with the legislature and the new Administration, and devising recommendations and policy positions.”

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