Individual Care Grant Program - Illinois Department of ... Health/yolandalinares...an ICG Coordinator located in the family’s geographic area is notified when a family requests an

Individual Care Grant Program

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Illinois River in Fall

Department of Human Services Division of Mental Health

Child and Adolescent Services

Contents

1.0 Fiscal Year 2012 Program Staff 1

2.0 Introduction 2 3.0 History 4

4.0 Role of the ICG Coordinator 5

5.0 ICG Services 6

5.1 Residential ICG Services 6

5.1.1 Residential Reporting 7 5.1.2 Annual Costs per Client 8 5.2 Community-Based ICG Services 8

6.0 Application and Appeal 10

7.0 Clients Served 11

8.0 Demographics 11

7.1 Gender 11 7.2 Race 12 7.3 Age 12 7.4 Residence 12

9.0 Diagnoses 13

10.0 Adoption Status of ICG Recipients 14 11.0 Annual Review 15

11.0 Fiscal History 15

APPENDICES:

Appendix 1 SASS Agencies by LAN and County Served 17

Appendix 2 DHS/DMH County and LAN Map 20 Appendix 3 Residential Treatment Centers Contracted by DHS/DM 22

Fiscal Year 2012 Individual Care Grant Program Staff Associate Deputy Clinical Director: Constance Y. Williams, Ph.D. Administrative Assistant: Carmen Montenegro Community Service Coordinator: Sandra Calhoun Community Service Coordinator: Vacant Financial Analyst: Jesus Tapia ICG Consultant: Vacant ICG Grant Manager: Vacant ICG Information Consultant: Vacant ICG Office Assistant: Vacant ICG Specialist: Vacant Management Operations Analyst II: Alan Dietrich, M.S.W Program Director: Dessie Trohalides, M.S. Source of data The State of Illinois contracts with Value Options, an independent behavioral health and wellness company providing outsourced administrative functions for the Division of Mental Health’s Individual Care Grant Program. In Illinois, Value Options is the Illinois Mental Health Collaborative for Access and Choice, or the “Collaborative”. The information for the fiscal year 2012 annual report was collected by the Collaborative. The Collaborative is responsible for preparing reports for the ICG Office for the purpose of program review and monitoring.

INTRODUCTION The Individual Care Grant (ICG) is governed by Illinois Title 59: Mental Health Chapter I: Department of Human Services Part 135 Individual Care Grants for Mentally Ill Children. Rule 135 defines criteria for eligibility, provision of services, funding, annual reviews and reporting requirements. The State provides a financial subsidy to assist parents or guardians to obtain residential treatment services or intensive community-based mental health services for a child with a serious, chronic, mental health condition with symptoms of psychosis. This Fiscal Year 2012 report provides data about the applicants for the ICG and the youth determined eligible for program.

The Individual Care Grant program embraces the System of Care Philosophy that honors child-centered and family-focused treatment for youth with a serious mental illness. The system of care philosophy is built upon three core values and guiding principles. The System of Care is:

1. Family driven and youth guided, with the strengths and needs of the child and family determining the types and mix of services and supports provided.

2. Community based, with the locus of services as well as system management resting within a supportive, adaptive infrastructure of services, processes, and relationships at the community level.

3. Culturally and linguistically competent, with agencies, programs, and services that reflect the cultural, racial, ethnic, and linguistic differences of the populations they serve to facilitate access to and utilization of appropriate services and supports and to eliminate disparities in care (Stroul, B., Blau, G., & Friedman, R. 2010).

Table 1. Fiscal Year 2012 Application Data Number of Applications Requested and Number of Applications Returned Number of Applications

Requested Number of Applications

Returned to the State Number of Applications

Not Returned 701 199 502

Number of Incomplete Applications and Applications in Review

Number of Incomplete Applications Submitted*

Number of Applications In Review **

78 9 *An incomplete application is missing information and/or missing documentation. ** Applications in Review were received at the end of FY12 and were reviewed in FY13.

Number of Applications Approved or Denied

Number of Applications Approved for an ICG

Number of Applications Denied

(not eligible for an ICG)* 15 97

* 97 applicants did not meet the eligibility criteria. See page 3 Denied Applications that were Appealed and Overturned

Number of Appeals for Denied Applications

Number of Appeals Overturned

29 1

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50

100

150

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ICG Application Data for Fiscal Year 2012

Applications 199 78 9 112 15 97

# Submitted

# Incomplete

# In Review*

# Reviewed # Approved # Denied

Figure 1. ICG Applications submitted, reviewed, approved, and denied. * In review: applications received at the end of FY12 and reviewed in FY13. Eligibility Criterion To be eligible for the ICG, a youth must meet each of the six eligibility criteria in Section 135.20 Eligibility criteria, Title 59: Mental Health Chapter I: Department of Human Services Part 135 Individual Care Grants for Mentally Ill Children. The criteria are summarized below:

1. Parent/guardian must be a resident of the State of Illinois,

2. The child must have a severe mental illness. Symptoms must include severely impaired reality testing and may include hallucinations, delusions, avoidance, or withdrawal from human contact, marked affective instability, apathy, and bizarre behavior, deficient or unusual forms of communication, agitation, and/or danger to self or others. The course of the illness should indicate that the symptoms do not represent an acute episode from which rapid and substantial remission is likely,

3. There has been an appropriate trial of inpatient, outpatient, and/or community-based treatment efforts, and subsequently residential services are required,

4. The child must not be under the guardianship or legal custody of a State agency,

5. The child must be enrolled in an Illinois State Board of Education approved educational program at the elementary/high school level,

6. The youth must be under the age of 17 years and 6 months when applying. ICG Application Data Seven hundred and one applications were requested by parents/guardians during Fiscal Year 2012, an increase of 30 application requests from the previous fiscal year. Five hundred and two (72%) of the applications were not returned. Of the 701 applications requested, 199, (28%) were returned by the parent/guardian. Of the 199 applications returned, 78 (39%) were incomplete due to missing information and/or documentation. One hundred twenty one of the applications

returned, (61%) were complete and were reviewed for eligibility. Of the 121 applications reviewed, fifteen applications met each of the 6 eligibility criterion. (Table 1 and 2). Incomplete applications were returned to the family with a list of item(s) that were missing from the application. Families are encouraged to seek assistance from the ICG Coordinator (see ICG Coordinator page 3) when gathering application materials and preparing the application. With the family’s consent, an ICG Coordinator located in the family’s geographic area is notified when a family requests an application. The ICG Coordinator will contact the parent/guardian to offer their assistance in gathering the required information and documentation for the ICG application.

HISTORY Illinois Legislation The ICG program was established by Illinois State legislation in 1969. Administrative Rule, Title 59 of the Illinois Administrative Code, Part 135, (Rule 135) was adopted on July 31, 1987 to govern the administration and operation of the ICG program. The ICG provides funding for residential treatment or intensive community-based mental health services to severely mentally ill children and adolescents. Division of Mental Health, Child and Adolescent Department The ICG program was placed under the management of the Division of Mental Health’s Metropolitan Child and Adolescent Network in 1998. Seven years later, the Child and Adolescent Network expanded from administering children’s mental health services for the Metropolitan Chicago eight county area to administering children’s mental health services for the entire state. In 2005, the ICG program was placed under the administration of the Statewide Child and Adolescent Service System which serves all five Comprehensive Community Service System Regions in the State of Illinois (see Appendix II Region Map). Administrative Rule Revised In January of 1999, Rule 135 was revised. The revisions included an extension of the age a youth remains eligible for the program, a change in the application review process, and the option for a youth to receive ICG services while living at home in their community. Youth enrolled in high school may remain in the ICG program until age 21. The eligibility review process was changed from a panel of three individuals reviewing ICG applications to one individual reviewing initial applications. Secretary-level appeals are also reviewed by one reviewer. The community-based service option was formally added to Rule 135 to provide for community-based services that match the child’s service needs provided before, after and in lieu of residential treatment. Additionally, all ICG placements are reviewed annually to determine continued eligibility for funding. Illinois Mental Health Collaborative On April 1, 2008, the Division of Mental Health contracted with the Illinois Mental Health Collaborative for Access and Choice to assume administrative and procedural functions for the residential treatment portion of the ICG program. The Collaborative processes application requests, receives applications, and evaluates the applications for eligibility. The Collaborative also reviews Quarterly Reports and conducts Annual Eligibility Reviews.

Illinois Children’s Mental Health Act of 2003 Mandate The Illinois Children’s Mental Health Act of 2003 mandated the Department of Healthcare and Family Services, formerly the Department of Public Aid, to secure federal financial participation (Medicaid) for ICG expenditures. During 2008, four residential providers: Allendale, Children’s Home and Aid Society of Illinois, BHC Streamwood and Children’s Home of Illinois assisted the State with the transition process to begin billing Medicaid for ICG services. Administrative Rule 132 Applied to ICG On April 1, 2009, the Illinois Administrative Code Rule 132 was applied to ICG program billing functions for residential and community-based services processed through the Collaborative’s billing system, “ProviderConnect.” At this time, the Collaborative assumed responsibility for the community-based ICG program. With the transition to Rule 132 services, providers were required to bill treatment encounters consistent with the State of Illinois Community Mental Health Services Service Definition and Reimbursement Guide. Providers registered ICG youth with ProviderConnect. Nights of stay were authorized every ninety days after a review of the ICG recipient’s quarterly report. Further, residential providers were required to facilitate Medicaid eligibility in accordance with Medicaid Category 94R, which waives family income as a requirement for eligibility on the ninety-first day of residential treatment. To facilitate this transition, training events were conducted through webinars, face-to-face trainings, and weekly technical assistance calls. Submission of ICG Claims Beginning in Fiscal Year 2012, providers submitted all claims to the Department of Healthcare and Family services (HFS) for processing. Payment was made contingent on the provider’s delivery of services documented in an accepted bill on the basis of the rate, unit cost, or allowable cost incurred. Providers seeking reimbursement for both Medicaid-funded and non-Medicaid mental health services from the Illinois Department of Human Services – Division of Mental Health (DHS-DMH) are required to comply with all DHS-DMH rules and policies and with HFS rules and policies, including Chapters 100, Chapter 200 and Chapter 300.

ROLE OF THE ICG COORDINATOR At the time a youth is found eligible for the ICG, the youth and family are referred to an ICG Coordinator for case management and other support services. ICG Coordinators are employed by Screening, Assessment and Support Services (SASS) agencies. SASS agencies are located throughout the State and are responsible for providing community-based ICG services in the Illinois County they serve. SASS agencies are listed in Appendix I. The ICG Coordinator provides support, advocacy, case management and other assistance to the child and family. Parents/guardians receive information, and guidance to determine the type of services best suited for their child. The ICG Coordinator is responsible for developing an individual service plan, providing care coordination, and assisting families to gain knowledge about treatment programs and services provided by Illinois approved residential facilities. The ICG Coordinator works with the parent/guardian to facilitate placement at a residential facility. If the parent/guardian elects the community-based option for ICG services, and these services meet the child’s clinical needs, the ICG Coordinator works with the family to devise a plan for the provision of intensive community-based services.

The ICG Coordinator provides ongoing case coordination services while the youth receives either residential treatment services or community-based ICG services. Community-based ICG services include regular home visits, collaboration with service providers, and transition planning. Case coordination for youth in residential treatment includes preparing periodic progress reports, attending staffings, maintaining regular communication with the residential facility, and providing support to the child and family.

ICG SERVICES During Fiscal Year 2012, 263 youth received ICG services. Of the 263 youth, 151 youth (57%) received mental health treatment services in residential facilities and 112 (43%) youth received community-based treatment services. One youth was incarcerated during the fiscal year. The ratio of youth receiving community-based services and residential services has remained stable (Figure 2).

Ratio of Youth Receiving Community-Based vs. Residential Services During FY12

Residential ICG57%

Community-Based ICG 43%

Figure 2. Ratio of youth receiving community or residential treatment services during Fiscal Year 2012

1. Residential ICG Services The parent/guardian of an ICG recipient may choose residential treatment for their child or they may choose community-based services. The decision to place a child in a residential facility is contingent upon the child’s mental health treatment needs. Residential treatment services are available in a 24-hour supervised residential facility. The State of Illinois contracts with residential facilities to provide mental health treatment services in a live-in facility. All residential facilities must meet the standards for licensed private facilities as defined in Title 59: Mental Health, Part 135, Section 135.10. The school programs ICG recipients attend at the residential facilities must be approved by the Illinois State Board of Education.

The ICG program strives to serve children and adolescents in the most clinically appropriate, culturally competent, least restrictive treatment setting located as close to the youth’s home as possible. During Fiscal Year 2012, Illinois contracted with 28 mental health residential treatment providers. Twenty of the 28 residential facilities were located in the State of Illinois. Seven were out-of-state facilities located in the bordering states of Wisconsin,

Indiana and Missouri. One of the out-of-state facility is located in Montana; however, no Illinois youth were placed in the Montana facility during Fiscal Year 2012.

Eighty one percent of the total ICG recipients receiving residential treatment were placed at facilities within Illinois, and 19% were placed in residential facilities out of state. Of the 19% of ICG recipients in out-of-state facilities, all were placed in the adjacent states of Wisconsin, Indiana and Missouri. Parents are encouraged to be active participants in their child’s treatment. Placement in Illinois, close to the child’s home community, is preferred and makes parental and family participation and involvement possible. At the time a youth is found eligible for an ICG, the ICG Coordinator holds an individual service planning meeting with the child’s parent/guardian. Potentially appropriate facilities that may meet the youth’s treatment needs are reviewed with the parent/guardian. The facilities reviewed are selected on the basis of the child's age, gender, mental health treatment needs, the treatment program available at the facility and the location of the facility. Also discussed at the meeting are the requirements for parental involvement during the placement. At the parent/guardian's direction and with the parent/guardian’s authorization to release treatment information, the ICG Coordinator prepares clinical referral packets for each of the facilities chosen. A list of approved residential facilities for Fiscal Year 2012 is in Appendix III.

Residential facilities contracted by the State of Illinois are required to: 1. Meet the standards for licensed private facilities, and 2. Maintain current certification of Medicaid Mental Health services for each specific service site location, and 3. Be accredited by a National Accreditation body recognized by the Illinois Department of Human Services, and 4. Have an educational program approved by the Illinois State Board of Education, and 5. Have a per diem rate that includes residential services, such as room and board, and 6. Have entered into a contract with the Department of Human Services to provide residential services during the current fiscal period, and 7. Register with the Secretary of State, and 8. Be enrolled with the Department of Healthcare and Family Services, (HFS), and 9. Register with ProviderConnect using an online application to complete service

requests. At the time a child is placed at a residential facility, a summary statement is formulated by the ICG Coordinator in collaboration with the residential facility staff. The summary statement describes the expected duration and outcomes of the placement. The summary statement is derived from the clinical issues presented at the time of the eligibility determination. The residential facility staff also prepare an individual service plan for the child. The plan is prepared within 30 days after placement. The service plan is written in consultation with the parent/guardian and the child. The child’s service plan is reviewed and updated annually. Residential Reporting Residential providers complete quarterly reports to document the youth’s current diagnosis, treatment plan, current medications, target symptoms, types of therapy used, family involvement, discharge plans, and progress toward treatment plan goals. ICG utilization staff review the quarterly reports. The eleven criteria reviewed are: (1), reason for admission, (2), discharge

criteria, (3). treatment plan goals, (4), individual therapy provided, (5), family therapy provided, (6), discharge plan, (7), specialized treatment, (8), diagnosis, (9), family involvement, (10), justification for continued treatment and (11), the overall quality of the report. Residential nights of stay are authorized every 90 days based on the results of the quarterly report. Annual Costs per Client Residential Per Diem Rates for FY2012 (Figure 3): Highest rate: $397.51 daily or $145, 091 annually Lowest rate: $194.61 daily or $71,032 annually Mean rate: = $296.06 daily or $108,062 annually Figure 3. Per Diem Rates 2. Community-Based Service Option The parent/guardian of a child with an ICG is invited to participate in a Placement/Service Determination meeting within 10 days of grant approval. The purpose of the meeting is for the parent/guardian to consider available residential options or to consider alternative in-home community-based services for their child. Community-based services are recommended when these services are determined to meet the clinical and mental health needs of the child. The ICG Coordinator is responsible for developing a service plan for the child in collaboration with the child and family. The service plan identifies services that match the child’s clinical needs. One hundred fifty eight children/adolescents received community-based ICG services during fiscal year 2012. The average cost for community-based ICG services during fiscal year 2012 was $5,020 for each ICG recipient (see Fiscal History). It is important to note that the average cost for community-based care is substantially lower than residential care because the cost of room and board is included in the per diem rate for residential treatment but it is not a factor for community-based treatment. Figure 4 below shows the DMH Region of residence for youth who received ICG services in their community while living at home.

01020304050

Num

ber o

f You

th

Community-Based ICG and Region of Residence

# Youth 45 45 17 3 2

Region 1 Region 2 Region 3 Region 4 Region 5

Figure 4: Community-Based ICG Region of Residence The services that are available through the community-based ICG option are:

Per-Diem Rates for FY2012

$0.00

$100.00$200.00$300.00

$400.00

Per Diem $397.51 $194.61 $296.06

Highest Per-Diem Lowest Per-Diem Mean Per-Diem

• Behavior Management: A time-limited, child and family training/therapy intervention focused toward amelioration or management of specific behaviors that jeopardize the child's functioning in the home/family setting. This intervention typically teaches/models techniques and skills that can be used by the parent/guardian and other family members.

• Child support services: Time-limited funding to cover costs that would otherwise be prohibitive to the parents for the child to participate in community activities when those activities are related to objectives in the child's current individual services plan.

• Community Support Individual or Group: An array of Rule 132 services for the purpose of facilitating age appropriate, normalizing activities for the child.

• Client-Centered Consultation, Case Management, Transition, Linkage, and Aftercare: Services provided to assist in the effective transition in living arrangement consistent with the child’s welfare and development.

• Case Management-Mental Health: Assessment, planning, coordination and advocacy services for clients who need multiple services and require assistance in gaining access to and in using mental health, social, vocational, education, housing, public income entitlements and other community services to assist the client in the community.

• ICG Child Support Services: Child support services include funding activities that are intended to facilitate integration into the community.

• Crisis Intervention: Activities or services provided to a person who is experiencing a psychiatric crisis that are designed to interrupt a crisis experience. The services include assessment, brief supportive therapy or counseling and referral and linkage to appropriate community services. The services are designed to avoid more restrictive levels of treatment with the goal of symptom reduction, stabilization, and restoration of a previous level of functioning.

In July 2004, support services were instituted for youth receiving community-based ICG services provided by or coordinated by a SASS agency. Support services are designed to:

• Provide families with information that will help in the decision of applying for an ICG. • Assist families with the documentation compilation necessary to apply for an ICG. • Assist families in submitting a completed ICG application. • Compile application packets for those families seeking residential services. • Collaborate with parent/guardian, ICG youth, and residential treatment providers to

develop, implement, and evaluate the individual treatment plan. • Provide clinical services in accordance with Rule 132. • Maintain ongoing facilitative relationships with families, schools, and the child’s

community in order to support the service plan. • Provide at least quarterly meetings with the family and the residential case manager for

those youth receiving residential services. • Provide monthly contact with the client’s family for those youth receiving intensive

community-based services. • Have bi-annual face-to-face contact with the staff and youth placed in an Illinois

residential facility. • Provide quarterly and annual review reports to ICG Office. • Assist parents/guardian with completing forms necessary for the Annual Review process. • Assist with the discharge and transition planning when an ICG recipient transitions out of

the ICG program to adult services. • Facilitate Medicaid eligibility for youth in residential treatment for more than 90 days.

In addition to the above services, the ICG Coordinator participates in Department of Mental Health training events and Individual Care Grant Office training and meetings specific to residential or intensive community-based care.

APPLICATION AND APPEAL Application: To apply for an ICG, the parent/guardian places a toll free telephone call to the Collaborative at 866-359-7953. The Collaborative staff will conduct a telephone in-take and send an application to the parent/guardian via U.S. mail. Each application is assigned a number so that the status of the application can be systematically monitored. With the family’s consent, the ICG Coordinator located in the family’s geographic area is notified that a family in their service area has requested an ICG application. The ICG Coordinator works with the family and provides any assistance needed in compiling the required application information for submission to the ICG Program. During Fiscal Year 2012, 701 applications were requested by parents/guardians. The number of applications requested increased by 30 (4.5%) from the previous fiscal year’s 671 requests for applications. Of the 701 applications requested by families, 112 (16%) were completed and returned to the ICG program. There were 78 incomplete applications received from parents/guardians (Table 1). The completed applications were reviewed to determine eligibility for ICG program services. Fifteen youth met the eligibility requirements for the Individual Care Grant during Fiscal Year 2012. (Table 1 and Figure 1). When an application is approved, the Collaborative sends a Letter of Eligibility Determination to the parent/guardian and to the ICG Coordinator. The ICG Coordinator provides information about the treatment services provided by residential facilities and provides information about the community-based services that are available under the ICG grant. Coordinators provide support to the family in making a decision about whether to use the ICG for residential or intensive community-based services. ICG Coordinators further assist the child and family in locating an appropriate residential treatment facility or arranging intensive community-based services. Appeal: When an application is denied, parents/guardians have the option of submitting an appeal. The parent/guardian must send their appeal to the Secretary of the Department of Human Services at 401 South Clinton, 7th Floor Chicago, Illinois 60607. The appeal must be in writing, and must be received by the Department within 40 days after the date of the denial letter sent by the ICG Program Office. The written appeal must provide in detail each basis on which the appeal is being made. The appeal must specifically state each reason that the denial of eligibility is alleged to be improper. The Secretary level review of the appeal is completed within 30 days. The reviewer of the Secretary’s level appeal is a board-eligible licensed physician in child psychiatry from the American Board of Psychiatry and Neurology. The Secretary makes the final administrative decision as to whether the child is eligible for an ICG. The Secretary’s decision is the Department’s final administrative decision. This decision is sent in writing to the parent/guardian within 40 days after the receipt of the parent/guardian's written appeal.

Of the 112 application materials and documentation reviewed for Fiscal Year 2012, 15 youth met the eligibility criteria for the grant. Ninety seven youth did not meet the eligibility criteria for the grant. Twenty nine appeals were submitted to the DHS Secretary. Of the 29 appeals, 1 decision regarding the initial application was overturned (Figure 5).

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Appeal Decisions for Initial Applications FY12

Appeals 97 29 1

Denied Appealed Overturned

Figure 5. Appeal decisions for initial applications.

CLIENTS SERVED The number of open and active cases fluctuates during the course of the year as children enter and exit the ICG program. The number of open and active ICG clients receiving services can also change as a child moves from one service type to another during the year. One Hundred and twelve (43%) youth with an ICG received services in their community and 151 (57%) received ICG services at a residential treatment facility where a more intensive level of services were provided. The level of service may change for some clients as they improve or in some cases as they require more intensive services. When determining the number of clients served during the fiscal year, it is necessary to compare the number of clients served during the fiscal year to the number of active cases at the close of the fiscal year. Throughout fiscal year 2012, there were 263 active Individual Care Grants.

DEMOGRAPHICS

1. Gender: A total of 15 youth were found eligible for an Individual Care Grant during Fiscal Year 2012. Eight (53%) of the recipients were males and 7 (47%) were females. (Figure 6).

44%46%48%50%52%54%

Gender Ratio of ICG Recipients Fiscal Year 2012

Percentage 53% 47%

Male (8) Female (7)

Figure 6. Gender ratio of youth awarded an ICG during Fiscal Year 2012. 2. Race: Seven (47%) Caucasian youth, 5 (33%) African American youth, and 3 Hispanic

(20%) youth were found eligible for an ICG during Fiscal Year 2012.

01234567

Race of Fiscal Year 2012 Recipients

Number 7 5 3

Caucasian (47%) African American Hispanic (20%)

Figure 7. Race of Recipients

3. Age: During fiscal year 2012, youth who were found eligible for an ICG ranged in age from age 11 to 17.5. The age distribution of ICG recipients for Fiscal Year 2012 are charted below in Figure 8.

0123456

Num

ber

of Y

outh

Age of Youth Awarded an ICG During FY12

Number 2 6 2 1 2 1 1

age 17.5

age 17 age 16 age 15 age 14 age 13 age 11

Figure 8. Age of Youth receiving an ICG during Fiscal Year 2012

4. Residence: The State of Illinois is divided into 5 DHS Regions (see Appendix II).

Region 1 includes all of Cook County. Region 2 includes 17 counties in Northern Illinois excluding Cook County, Region 3 includes 23 counties in North Central Illinois, Region 4 includes 28 counties in Central Illinois, and Region 5 includes 33 counties in Southern

Illinois. The number of youth found eligible for the ICG in each DHS Region is shown in Figure 10. During Fiscal Year 2012, Region1 had the highest number of youth found eligible for the ICG (7) followed by Region 2 (6) and Region 3 (2). (Figure 10). Six incomplete applications were submitted from Region 4 and 8 incomplete applications were submitted from Region 5. Incomplete applications are missing necessary documentation and cannot be reviewed for eligibility. A checklist for the required documents and information to be sent in with the application is included in each application packet. In Residential Treatment:151 youth received residential treatment services during Fiscal Year 2012. Region 1 had the highest number of youth in residential treatment There were 68 youth from Region 1 and 57 youth from Region 2 receiving ICG services in a residential treatment facility during FY12. Region 3 had 23 youth in residential treatment. There were no youth from Region 4, and Region 5 had 3 youth receiving residential treatment services (Figure 9).

Residential Placement by Region

020406080

# Youth 68 57 23 0 3


Figure 9. Residential Placement by Region

Community-Based Treatment: One hundred and twelve youth received intensive ICG treatment services in their community during Fiscal Year 2012. Forty five youth were served by agencies in Region 1, 45 youth were served by agencies in Region 2, Region 3 served 17 youth, Region 4 served 3 youth, and Region 5 served 2 youth.

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s

FY 2012 ICG Grant Awards by Region

Number 7 6 2 0 0


Figure 10. Number of ICG Grants Awarded from each DHS Region during Fiscal Year 2012 Figure 11. (below) lists the population for each of the Illinois DHS Regions (U.S. Census of Population and Housing, 2000: Summary Population and Housing Characteristics: Illinois. Washington: Government Printing Office, 2001). Figure 10 shows the number of ICG grants awarded by Region. The number of ICGs allocated to youth in each Region is proportional to the number of youth residing in each Region.

Age 0-18 Illinois Youth Population Fiscal Year 2012 by Region

Figure 11. Illinois Residents Age 0-18 during Fiscal Year 2012

CLINICAL CHARACTERISTICS: DIAGNOSIS Youth eligible for the Individual Care Grant must have a severe mental illness which is defined by the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association as a mental or emotional disorder which substantially impairs thought, perception of reality, emotional process, judgment, behavior, and the ability to cope with the ordinary demands of several life domains. Symptoms must include severely impaired reality testing and may include hallucinations, delusions, avoidance, or withdrawal from human contact, marked affective instability, apathy, and bizarre behavior, deficient or unusual forms of communication, agitation, and/or danger to self or others. The course of the illness should indicate that the symptoms do not represent an acute (a short and severe) episode with rapid and substantial remission. Of the youth found eligible for the ICG program during Fiscal Year 2012, the most prevalent occurring diagnoses were bipolar disorder (35%) and schizophrenia (35%) followed by psychotic disorders (12%). Bipolar disorder is a mood disorder defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or more depressive episodes. Severe manic episodes can sometimes lead to delusions and hallucinations. Bipolar disorder involves extreme mood swings that typically occur more frequently in children than in adults. The onset of full symptoms of Bipolar disorder generally occurs in late adolescence or young adulthood. Schizophrenia is a severe mental illness that affects the way a person feels, behaves, the way they perceive reality, and interacts with others. Symptoms commonly appear between the ages of 15 and 35, although sometimes it manifests in younger children. Some of the signs and symptoms of the disorder include seeing or hearing things that don't exist (hallucinations), having beliefs not based on reality (delusions), lack of emotion or emotions that are inappropriate for the situation, social withdrawal, decreased ability for self-care, incoherent speech, and illogical thinking. A psychotic disorder is an impairment in perception and understanding of reality. Symptoms may include fixed but untrue beliefs (delusions), seeing visions or hearing voices

1,231,138

1,094,635

324,632204,521

272,549

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000


(hallucinations), confusion, disorganized speech, exaggerated or diminished emotions, or bizarre behavior. The child’s level of functioning may be severely impaired with social withdrawal and inability to attend to school, relationships, or even basic personal care. Individuals generally have little awareness of the mental abnormalities associated with their illness.

ADOPTION STATUS OF ICG RECIPIENTS Four (24%) of the 15 youth receiving an ICG during fiscal year 2012, lived with adoptive parents. Information on adoption status is collected during the intake call which is the first point of contact between a parent/guardian and the ICG office. (Figure 12).

Adoption Ratio for Youth Awarded an ICG Fiscal Year 2012

Adopted (4)27%

Not Adopted

(11)73%

Figure12. Adoption ratio for ICG applicants.

ANNUAL REVIEW AND QUARTERLY REVIEW The Annual Review process was initiated in February 2000. Quarterly and annual reviews are required under DHS Rule 135 (Section 135.135). The annual review includes a determination for continued eligibility made on the annually recurring date of the initial eligibility determination. Continuing eligibility is based on parent participation in the treatment, continued need for intensive community or residential treatment, and clinical progress reports received from the provider. Each youth enrolled in the ICG program for one year or more received an annual review in Fiscal Year 2012. Quarterly reviews were conducted for youth who received an ICG on their 3 month anniversary and each quarter year thereafter. Quarterly reviews are conducted to monitor the progress of ICG recipients in their treatment program. Each quarterly review results in an authorization of ninety nights of stay.

FISCAL HISTORY Table 2 shows the history of appropriations and expenditures for the ICG program over the last 14 fiscal years. During the fiscal year, the appropriation is adjusted to meet the expenditure obligation. The final appropriation may be higher or lower depending on actual costs. Table 2 shows that ICG expenditures have increased over the last10 year period by slightly over 4%. The number of youth receiving ICG treatment services in a residential treatment setting has decreased, and the number of youth receiving ICG treatment services in their community has increased. During FY11, 38% of the total number of youth with an active ICG were served in their community. In FY12, the number of youth served in their community increased to 43% of the total number of youth with an ICG.

It is important to note that the average cost for residential treatment is substantially more than community-based treatment because the cost of room and board is included in the per diem rate for residential treatment but it is not a factor for community-based treatment. The total amount for the expenditures in Fiscal Year 2012 are partial figures. The total amount is likely to be higher than reported at this time. Providers encountered substantial billing issues during fiscal year 2012 which delayed a final report of expenditures.

Table 2. Fiscal history of appropriations and expenditures for the ICG program. * Partial year figure

Fiscal Year Appropriation Expenditure Percent Over/Under Appropriation

1998 $19,062,800 $18,448,500 -3.22% 1999 $19,634,600 $19,212,800 -2.15%

2000 $20,465,200 $18,051,300 -11.80%

2001 $20,976,800 $19,736,400 -5.91%

2002 $18,976,800 $24,428,300 28.73%

2003 $18,976,800 $24,760,600 30.48%

2004 $22,594,800 $22,180,600 -1.83%

2005 $23,735,855 $24,854,890 4.71%

2006 $26,256,348 $30,155,139. 14.84%

2007 $25,805,377 $33,927,375 31.47%

2008 $25,613,188 $30,943,088 20.81%

2009 $25,841,548 $27,688,476 7.15%

2011 $23,850,500 $25,401,576 6.50%

2012 $21,860,000 $17,144,334 * -7.8% *

Appendix I

Screening, Assessment and Support Services. (SASS) Agencies by LAN* and County Served (LANs are not numbered consecutively)

* Illinois is divided into 62 Child and Adolescent Local Area Networks (LANs). A LAN is a geographical area consisting of one or more counties. Each LAN is served by a SASS agency under Contract with DHS/DMH. SASS agencies employ staff in the position of an ICG Coordinator. The ICG Coordinator provides case management and other support services to a youth and their family residing in a LAN served by a SASS agency. For youth receiving intensive community-based ICG services, the ICG Coordinator provides services to the youth in their youth community (see ICG Coordinator, page 3). LAN 1: Family Counseling Center

408 East Vine Vienna, IL 62995

Counties Served: Alexander, Hardin, Johnson, Massac, Pope, Pulaski, Union

LAN 9: One Hope United 1901 South 4th Street Suite 212 Effingham, IL 62401 Counties Served: Effingham, Jasper, Clay

LAN 2: Egyptian Public & MH Center 1412 U.S. 45 North Eldorado, IL 62930 Counties Served: Gallatin, Saline, White

LAN 10: Southeastern IL Counseling Center 504 Micah Drive

Olney, IL 62450 Counties Served: Crawford, Edwards, Lawrence, Richland, Wabash

LAN 3: The H Group (merged with Southern Il Regional Social Services) 902 W. Main Street West Frankfort, IL 62896 Counties Served: Franklin, Williamson

LAN 12: WellSpring Resources (formerly Community Counseling Center N. Madison County) 2615 Edward Street Alton, IL 62002 Counties Served: Madison

LAN 4: The H Group (merged with Southern Il Regional Social Services) 604 East College Carbondale, IL 62901 Counties Served: Jackson, Perry

LAN 13: Locust Street Resource Center 100 North Side Square Carlinville, IL 62626 Counties Served: Calhoun, Greene, Jersey, Macoupin, Montgomery

LAN 5: Human Support Services P.O. Box 146 988 N. Illinois Route 3 Counties Served: Monroe, Randolph

LAN 14: Lifelinks P.O. Box 1307 1300 Mattoon, IL 61938 Counties Served: Clark, Coles, Cumberland, Douglas, Edgar, Moultrie, Shelby

LAN 6: Comprehensive Mental Health Center of St. Clair County 3911 State Street East St. Louis, IL 62205 County Served: St. Clair

LAN 15: Mental Health Centers of Central Il 901 North 1st, Suite 101 Springfield, IL 62702 Counties Served: Christian, Logan, Mason, Menard, Sangamon

LAN 7: Chestnut Health Systems Chestnut Health Systems 50 Northgate Industrial Drive Granite City, IL 62040 Counties Served: Bond, Clinton, East St. Clair, Washington

LAN 16: Schuyler County MH Services 233 N Congress Street Rushville, IL 62681 Counties Served: Brown, Cass, Morgan, Schuyler, Scott

LAN 8: One Hope United 1901 South 4th Street Suite 212

LAN 17: Transitions of Western Illinois 4409 Maine Street

Effingham, IL 62401 Counties Served: Hamilton, Jefferson, Wayne, Washington

Quincy, IL 62306 Counties Served: Adams, Hancock, Pike

LAN 18: Bridgeway 2323 Windish Drive Galesburg, IL 61401 Counties Served: Fulton, Henderson, Henry, Knox, McDonough, Warren

LAN 31: Freeport Health Network 1133 W. Stephenson Street, Suite 401 Freeport, IL 61032 Counties Served: JoDaviess, Stephenson

LAN 20: Children’s Home Association of Il 511 E. Madison Street Peoria, IL 61603 Counties Served: Peoria, Tazewell, Woodford

LAN 32: Rosecrance Berry Center 526 W. State Street Rockford, IL 61101 Counties Served: Boone, Winnebago

LAN 21: Children’s Home Association-Il 511 E. Madison Street Peoria, IL 61603 Counties Served: Peoria, Tazewell, Woodford

LAN 33: Ben Gordon MH Center 12 Health Services Drive DeKalb, IL 60115 County Served: DeKalb

LAN 22: Heritage Behavioral Health Center P.O. Box 710 Decatur, IL 62525 Counties Served: DeWitt, Macon, Piatt

LAN 34: McHenry County Health Board 620 Dakota Street Crystal Lake, IL 60012 Counties Served: Mc Henry

LAN 23: Catholic Charities 603 N. Center St. Bloomington, IL 61701 County Served: Mclean

LAN 35: Lake County Health Department 820 Greenwood Ave. Waukegan, IL 60087 County Served: Lake

LAN 23A: Institute for Human Resources 310 E. Torrance Avenue Pontiac, IL 61764 County Served: Livingston

LAN 37A: Community Counseling Centers of Chicago (C4)

2452 W. North Avenue Chicago, IL 60647 County Served: Cook

LAN 24: Crosspoint Human Services: A Division of Aunt Martha’s 210 Avenue C Danville, IL 61832 Counties Served: Champaign, Ford, Iroquois

LAN 38A: Leyden Family Services 10001 Grand Avenue Franklin Park, IL 60132 County Served: Cook

LAN 25: Center for Children’s Services 1801 Fox Drive Champaign, IL 61820 Counties Served: Vermillion

LAN 39: DuPage County Health Department 800 W. Roosevelt Road, Suite 406 Glen Ellyn, IL 60137 County Served: DuPage

LAN 26: Helen Wheeler Center 275 East Court Street Suite 102 Kankakee, IL 60901 County Served: Kankakee

LAN 40: Community Counseling Centers of Chicago (C4)


LAN 27: North Central Behavioral Health 737 Etna Road Ottawa, IL 61350 Counties Served: Bureau, LaSalle, Marshall, Putnam, Stark



LAN 29: Robert Young Center 2200 Third Avenue Rock Island, IL 61201 Counties Served: Mercer, Rock Island

LAN 42: Kenneth Young Center 1001 Rohlwing Road Elk Grove Village, IL 60007 County Served: Cook

LAN 30: Sinnissippi Centers, Inc. LAN 45: Leyden Family Services

325 Illinois Route 2 Dixon, IL 61021 Counties Served: Carroll, Lee, Ogle, Whiteside

10001 Grand Avenue Franklin Park, IL 60132 County Served: Cook

LAN 46: Kenneth Young Center 1001 Rohlwing Road Elk Grove Village, IL 60007 County Served: Cook

LAN 75: Mt. Sinai Hospital California Ave @ 15th Street Chicago, Il 60608

County Served: Cook LAN 47: Family Service Association of Greater Elgin Area 1140 North McLean Boulevard, Suite I Elgin, IL 60123 Counties Served: Cook, Kane, Kendall

LAN 76: Community Counseling Ctrs- Chicago 2452 W. North Avenue Chicago, IL 60647 County Served: Cook (part of LAN 76)

LAN 49: Will County Health Department 501 Ella Joliet, IL

Counties Served: Grundy, Will

LAN 76: Ada S. McKinley Community Services 8704 S. Constance Chicago, IL 60617 County Served: Cook (part of LAN 76)

LAN 53: Grand Prairie Services 19530 Kedzie Avenue Tinley Park, IL 60477

Counties Served: Cook, Will

LAN 77: Ada S. McKinley Community Services 2659 W. 59th Street Chicago, IL 60629 County Served: Cook

LAN 56: Metropolitan Family Services 13136 S. Western Avenue Blue Island, IL 60406

County Served: Cook


LAN 57: Pillars 1010 W. Lake Street Oak Park, IL 60302

County Served: Cook


LAN 58: Pillars 1010 W. Lake Street Oak Park, IL 60302

County Served: Cook


LAN 60: Leyden Family Services 10001 Grand Avenue Franklin Park, IL 60132 County Served: Cook


LAN 61: Leyden Family Services 10001 Grand Avenue Franklin Park, IL 60132

County Served: Cook

LAN 86: Metropolitan Family Services 13136 S. Western Avenue Blue Island, IL 60406 County Served: Cook

LAN 63: Lutheran Social Services of Illinois 6321 N. Avondale, Suite A101 Chicago, IL 60632 County Served: Cook






2452 W. North Avenue Chicago, IL 60647

County Served: Cook

Appendix II

Illinois Department of Human Services County, Region and LAN Map

(Counties are labeled, Regions are color coded, and LANs are numbered)

Illinois Department of Human Services Cook County LAN Map

Region 1 Cook County

Region 1 LAN Areas:

LAN 53: Bloom, Bremen, Rich, Thornton Townships LAN 56: Calumet, Lemont, Orland, Palos, Lower Stickney, Worth Townships LAN 57: Lyons, Riverside Townships LAN 58: Berwyn, Cicero, Oak Park, River Forest, Upper Stickney Townships LAN 60: Proviso Township LAN 61: Leyden Township LAN 63: Albany Park, Belmont-Cragin, Dunning, Edison Park, Forest Glen, Hermosa, Irving Park, Jefferson Park, Montclare, North Park, Norwood Park Township, O'Hare, Portage Park LAN 65: Edgewater, Lake View, Lincoln Park, Lincoln Square, Loop, Near North Side, North Center, Rogers Park, Uptown, West Ridge LAN 67: Austin, Avondale, East Garfield Park, Humboldt Park, Logan Square, Near West Side, North Lawndale, West Garfield Park, West Town LAN 75: Lower West Side, South Lawndale LAN 76: Armour Square, Douglas, Near South Side, Oakland LAN 77: Archer Heights, Bridgeport, Brighton Park, Chicago Lawn, Clearing, Gage Park, Garfield Ridge, McKinley Park, New City, West Elsdon, West Lawn LAN 79: Englewood, West Englewood LAN 80: Fuller Park, Grand Boulevard, Hyde Park, Kenwood, Washington Park, Woodlawn LAN 82: Avalon Park, Burnside, Chatham, Greater Grand Crossing, South Shore LAN 84: Auburn Gresham, Washington Heights LAN 85: Ashburn, Beverly, Mount Greenwood LAN 86: Morgan Park, Pullman, Riverdale, Roseland, West Pullman LAN 87: Calumet Heights, East Side, Hedgewisch, South Chicago, South Deering

Appendix III

Residential Treatment Centers Contracted by Illinois During Fiscal Year 2012 Allendale Association Grand Avenue & Offield Rd. P.O. Box 1088 Lake Villa, IL 60046

Cunningham Children’s Home 1301 North Cunningham Urbana, IL 61802

Babyfold (The) 612 Oglesby Normal, IL 61761

Kemmerer Village 941 North 2500 East Road Assumption, IL 62510

BHC Streamwood Behavioral Health Center (3 locations)

Larkin Children’s Center 1213 Larkin Avenue Elgin, IL 60123-6042

1. John Costigan Center 1360 East Irving Park Road Streamwood, IL 60107

Lutheran Child & Family Services of IL 343 West Lake Street Addison, IL 60101

2. Rock River Academy 308 East 21st Avenue Rockford, IL 61101

Maryville Academy Casa Salama 1150 North River Road Des Plaines, IL 60016

3. Riveredge Hospital 8311 West Roosevelt Road Forest Park, IL 60130

Mental Health and Deafness 614 Anthony Drive Northbrook, IL 60062

Center on Deafness 3444 Dundee Road Northbrook, IL 60062

Nexus / Indian Oaks Academy 101 Bramble Manteno, IL 60950

Children’s Home Association of Illinois 2130 Knoxville Peoria, IL 61603

Nexus / Onarga Academy P.O. Box 107 110 North Locust Onarga, IL 60955

Children’s Home & Aid Rice Children’s Center 1101 Washington Street Evanston, IL 60202

Northern Illinois Academy (Parent Company Sequel Schools) 1150 North River Road Des Plaines, IL 60016

Clinicare (3 locations in Wisconsin) 1. Eau Claire Academy 550 North Dewey Street Eau Claire, WI 54703

Oconomowoc Developmental Training Center 36100 Genesee Lake Road Oconomowoc, WI 53066

3. Wyalusing Academy 941 North 2500 East Road Prairie du Chien, WI 53821

Phoenix Care Systems, Inc. (2 locations) 1. Willowglen Academy-Wisconsin 3903 West Lisbon Milwaukee, WI 53208

2. Milwaukee Academy 9501 Watertown Plank Road Wauwatosa, WI 53213

2. Willowglen Academy-Indiana 308 East 21st Avenue Gary, Indiana 46407

Continued on next page Sonia Shankman Orthogenic School 1365 East 60th Street

Chicago, IL 60637 Thresholds 4219 North Lincoln Avenue Chicago, IL 60618

United Methodist Children’s Home 2023 Richview Rd. Mt. Vernon, IL 62864

Yellowstone Boys and Girls Ranch 1750 Ray of Hope Lane Billings, MT 59106

Documents

Individual Care Grant Program - Illinois Department of ... Health/yolandalinares...an ICG Coordinator located in the family’s geographic area is notified when a family requests an