Community mental health services

Sen. Frank D. Savickas

Eloine Plaut, executive director of the Mental Health Association of Greater Chicago, told a Senate appropriations committee in April that inflation had robbed state mental health spending. She testified that between 1975 and 1988 the Department of Mental Health and Developmental Disabilities had lost $315 million in real dollar spending. Plaut told the committee the previous year's budget actions had left state institutions a little less impoverished, community programs a little more so.

Illinois cares for the mentally ill and retarded in two ways. It provides hospitals in which the sickest are treated, and it contracts with community-based agencies for care of those able to function outside the institutions. This spring the community agencies wanted two things from the Illinois General Assembly: more money for the services they provide and a state commitment to treatment in the community. They got the money, but the commitment proved elusive.

The centerpiece of their effort was H.B. 849, an effort of Rep. Andrew J. McGann (D-29, Chicago). As proposed by the Community Care Coalition, a group of advocates for the mentally ill and developmentally disabled and providers of services to those groups, it would have bolstered services provided by community-based agencies, guaranteed services and required coordination with state facilities.

The bill was imperfect. It designated local agencies as a service delivery network and required that planning be done by that network. However, it established no structure for that planning.

The bill moved out of committee, but agreement could not be reached on the House floor. Republican lawmakers were worried about costs that the Department of Mental Health and Developmental Disabilities put at $150 million to $300 million. So the bill was gutted and replaced with one that set up a study of the issue by the Citizens Council on Mental Health and Developmental Disabilities.

In that form the bill moved to the Senate, where Sen. Frank D. Savickas (D-15, Chicago) sponsored it. Negotiations continued, and at length the advocates and the department came up with new bills. But the hour was late and there were still conflicts.

Advocates fell back to the study bill that had cleared the House. Savickas removed his technical amendment. The bill was passed and sent to the governor. Rep. McGann called it "nothing of great substance." But McGann found reason for encouragement in growing recognition of the issue.

Peter E. Rinn, executive director of the Illinois Association of Community Mental Health Agencies, was pleased with the new money provided community agencies. Gov. James R. Thompson signed a 7 percent cost of living adjustment that will help make up for no increase given local agencies last year. The cost of living increase amounted to $15 million. Local agencies also got $9 million in new programs, something Rinn called a down payment on the $300 million estimated for need.

Rinn says the push for H.B. 849 helped keep the needs of community mental health in legislators' minds and was undertaken with the knowledge that major legislation takes more than a year to pass. "The coalition remains committed to the concept and will be working throughout this year to make it a reality," Rinn says.

Next year both state institutions and community operations will be a little less impoverished. But there will still be no comprehensive system of services.□

Michael D. Klemens

August & September 1988 | Illinois Issues | 49