Illinois Needs Substantial Reforms in Funding of
Developmental Disability and Mental Health Services 

By:  Robert Okazaki

Dr. Elizabeth Powers and an economic research team at the University of Illinois in Champaign was commissioned by the Illinois Senate Appropriations I  and House Human Services Appropriations Committees to conduct a study on our state's funding of developmental disability and mental health funding.     

In a report titled “State Funding of Community Agencies for Services Provided to Illinois Residents with Mental Illnesses and/or Developmental Disabilities” Dr. Powers concludes:  “Illinois needs to proceed with substantial reforms in order not only to preserve but to enhance the role of its community providers”. 

Avenues to Independence, along with other disability support organizations, has warned state officials that Illinois’ poor funding record jeopardizes the health, welfare and safety of individuals with autism, cerebral palsy, Down’s syndrome, mental retardation and other developmental disabilities.   The report from Dr. Powers substantiates what we have been telling the governor and legislature for more than a decade.  Community organizations are barely able to preserve services.  Since 1980, Illinois has under-funded community providers by over 50% when compared to the increases provided to state institutional employees. 

This funding inequity becomes very evident when comparing what the state pays its own institutional employees versus what providers can pay in community programs.  According to Dr. Powers, wages in community developmental disability programs range from 28 to 64% less than comparable positions in Illinois’ state operated facilities.   Additionally, the report states that community medical and pension benefits are “substantially below” the 16.4% of compensation given to state government workers.   

The study also finds that Illinois’ funding system requires community organizations to assume tremendous financial risks when delivering services.  It was deliberately designed to not cover the costs of delivering services; therefore programs that underestimate expenses when dealing with more severe persons with disabilities are not adequately reimbursed and must fund-raise in order to help pay for services.  The state circumvents its obligation to provide needed resources and community agencies become reluctant to expand or take on more difficult and costly cases.   

It is estimated that over 10,000 persons are now waiting for state funded residential, day and/or employment services.  Additionally, there are hundreds of students with autism and other developmental disabilities who will be in need of continuing programs.   Community organizations are barely able to maintain the 45,000 individuals currently receiving services.   Illinois' reimburses less than 75% of the actual costs of services; without reforms to its system, community providers will be unable to provide services and Illinois will endanger the well-being of its citizens with developmental disabilities.   

Dr. Powers calls for three recommendations to improve Illinois’ system of disability supports:

1.      Dedicate all Medicaid related developmental disability and mental health funds to a long-term increase of 33% over and above regular cost-of-living adjustments for these respective programs;

2.      Reconfigure funding so that it enhances consumer choice, balances financial risk between the state, provider and service recipient; and promotes innovation and efficiency in the levels and mix of services;

3.      Reduce the use of institutions and focus resources on community support settings.

Avenues promotes consumer choice in developmental disability services and has long advocated for a significant reduction in our state's institutional census.  Better support of community programs such as Avenues are inherent in the recommendations from this study and long overdue. 

Avenues will work in conjunction with other statewide associations to promote the study’s findings with the Governor, Legislature and general citizenry of Illinois to produce major changes in the Illinois systems of developmental disability and mental health support.