Bill Text: IL HR0422 | 2019-2020 | 101st General Assembly | Introduced

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Bill Title: Directs the Auditor General to conduct a performance audit of the Department of Children and Family Services to review and assess the Department's ability to meet the placement needs of the children in its custody and compliance with its obligations to place children in its care in placements consistent with their best interests, and to make recommendations regarding how the Department can develop a responsive behavioral health continuum of care process that produces good outcomes for children and families in Illinois.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2019-07-02 - Rule 19(b) / Re-referred to Rules Committee [HR0422 Detail]

Download: Illinois-2019-HR0422-Introduced.html

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HOUSE RESOLUTION
WHEREAS, The Department of Children and Family Services is
required by the Children and Family Services Act [20 ILCS
505/7] to place children in its care in safe and adequate
placements consistent with each child's health, safety, and
best interests; and
WHEREAS, The Department of Children and Family Services has
adopted rules, entitled "Placement Selection Criteria", [89
Ill. Adm. Code Part 301.60] that provide that "all placement
decisions will be made consistent with the safety, best
interests and special needs of the child" and that
consideration shall be given to, "the least restrictive setting
appropriate for the child which most closely approximates a
family"; and
WHEREAS, The Department of Children and Family Services has
adopted procedures, entitled "Psychiatric Hospitalization,
Basic Premises Regarding Psychiatric Hospitalization" [DCFS
Procedures 301.110(b)], that provide that "a psychiatric
hospitalization is not a placement" and that "discharge and
placement planning shall begin from the moment of admission";
and
WHEREAS, The Department of Children and Family Services is

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the party to a federal court consent decree [B.H. et al., 88 C
5599, N.D. ILL] that provides that emergency shelter placements
"shall be limited to 30 days"; and
WHEREAS, Children in the custody of the Department of
Children and Family Services are being left in psychiatric
hospitals after their treatment is complete because there is
insufficient in-state capacity in the types of the programs the
children need, including residential treatment centers and
specialized and therapeutic foster homes; and
WHEREAS, The cost of leaving children in psychiatric
hospitals is significantly higher than providing the care the
children actually need and is not subject to federal
reimbursement pursuant to Title IV-E; therefore, be it
RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE
HUNDRED FIRST GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that
the Auditor General is directed to conduct a performance audit
of the Department of Children and Family Services to review and
assess the Department's ability to meet the placement needs of
the children in its custody and its compliance with its
obligations to place children in its care in placements
consistent with their best interests and to make
recommendations regarding how the Department can develop a
responsive behavioral health continuum of care process that

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produces good outcomes for children and families in Illinois;
and be it further
RESOLVED, That the audit include, but not be limited to,
the following:
(1) A review and analysis of systems issues impacting
the timely and appropriate placement of children in the
custody of the Department of Children and Family Services,
including, but not limited to:
(a) The current referral and admission process for
children and youth requiring placement in a residential
treatment center;
(b) The role of residential treatment centers in
the continuum of care;
(c) The evidence-based models currently utilized
in residential treatment settings;
(d) Identification of any gaps in the continuum of
care from psychiatric hospitalization to traditional
foster care/home settings;
(e) The status of the Department's progress toward
achieving appropriate and timely step-down placements for
children at any stage in the continuum of care; and
(f) How priorities should be changed to ensure
timely access to appropriate residential and foster care
resources;
(2) A review and analysis of how youth enter and exit

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residential treatment programs, including, but not limited
to, the following:
(a) The number of youth who entered a residential
placement in the last 10 fiscal years;
(b) The number of youth who entered residential
settings outside of Illinois;
(c) The number of planned and unplanned exits from
residential treatment by type (for example, child was
psychiatrically hospitalized, placed in a foster home,
returned to parent, etc.);
(d) A description of the current step-down process
from residential treatment;
(e) A description of how the Department determines
appropriate clinical placements for youth needing
residential care; and
(f) Recommendations regarding changes that should
be made to the process of matching children to the
appropriate clinical setting, including timeframes;
(3) A review and analysis of date tracking of outcomes
for children in psychiatric hospitals longer than
necessary, including, but not limited to:
(a) How demographic and clinical data regarding
children in psychiatric hospitals longer than necessary is
collected, made available, and utilized; and
(b) The current demographic of children in the
residential care service continuum, including youth who

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are in psychiatric hospitals longer than necessary, on
waiting lists for residential placements, and in
residential placements ready for step-down, including:
1. Ethnicity
2. Gender
3. Age
4. Geographic origin
5. Permanency goal
6. Current residential placement if applicable
7. Case management responsibilities
8. Diagnosis
9. Length of stay
10. Length of stay beyond targeted discharge
date;
(4) A review and analysis of the following contracting
and monitoring issues impacting the timely and appropriate
placement of children in the custody of the Department of
Children and Family Services, including, but not limited
to:
(a) An assessment of current residential bed
capacity and utilization; what capacity and utilization
are needed to meet the demand? Are there facilities with
unused physical capacity that could be utilized if need was
determined?;
(b) Analysis of the effectiveness of the current
funding structure, including analysis of the no-decline

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and bed hold component in contracts;
(c) How residential specialty population providers
are identified in the matching process;
(d) How community-based behavioral health
resources are identified, quantified, and evaluated; and
(e) Whether community-based behavioral health
organizations have adequate resources (funding, staff,
equipment, facilities, training, etc.) to achieve
appropriate service delivery and timely placements for
youth;
(5) A review and analysis of the following contracting
and monitoring issues impacting the timely and appropriate
placement of children in the Department's custody,
including, but not limited to:
(a) How residential programs are monitored. What
dashboards are utilized? Are the outcome measures
quantitative or qualitative? Are the measures effective?
What outcome measures should be utilized?;
(b) The current performance of Illinois'
residential continuum of care and how it compares to
generally accepted national practice standards and outcome
measures; and
(c) Residential continuum of care systems in other
comparable jurisdictions in terms of costs of staff by
type, overall costs and other cost centers; and be it
further

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RESOLVED, That the Department of Children and Family
Services shall cooperate fully and promptly with the Auditor
General's Office in conducting this audit; and be it further
RESOLVED, That the Auditor General commence this audit as
soon as possible and distribute the report upon completion in
accordance with Section 3-14 of the Illinois State Auditing
Act; and be it further
RESOLVED, That a copy of this resolution be delivered to
the Auditor General and the Illinois Department of Children and
Family Services.