House Bill 1872 was passed by a floor vote in the Illinois House on April 10, 2025. If the Senate passes it, this will become a state law (assuming the Governor signs it—the Democrats in the House voted for it, and so it got 75 Yeas to 35 Nays grin Republicans). It aims to amend the Children and Family Services Act. This Bill is targeting the youth who are removed from their living situations and placed into the custody of the Department of Children and Family Services. With this bill, the youth who are removed will receive a mental health screening and prevention 45 days after removal. They will also receive care for every year they are in the system after their initial screening. The only conditions under which they will not receive care are if the child is less than six months old, the child consents to denying care if they are twelve years old or above, or if the child is already receiving care from another mental health professional. If the child’s screening comes back showing signs of mental health issues, the child shall be connected to mental health resources and proper treatment by their caseworker. If the child is covered under Medicaid, the care plan they receive should guarantee that they have access to a provider within 30 days of the referral from the screening they received. Any existing care plan must also meet these conditions, granted that the child is covered in the state’s medicaid program. The overall purpose of this bill is to create a more holistic mental health system for the children under the Department of Child and Family Services.
This proposed bill will help in the ongoing fight to improve conditions for children in the foster care system. While foster care and temporary placements are meant to improve the child's situation, that is not always the case. Children will be dealing with the trauma of being removed from their parental care and placed into the home of another relative or even a stranger. This is something that they are going to carry with them the rest of their lives, and a bad situation in the system can only worsen their mental health. “Mental and behavioral health is the largest unmet health need for children and teens in foster care” (AAP). By completing these yearly screenings and guaranteeing care for the children who need it, we will be greatly improving the future lives of these children. Screening these children right after removal and again yearly will help catch any potential signs of mental health issues before it gets too late. This plan can act as a great preventative and ongoing mental healthcare for the children who need it the most.
An argument for why someone would not want this Bill to be passed is the cost it will impose on the state might be high. Since these children are under the care of the Department of Children and Family Services, any treatment they need to receive is going to be at the cost of the state, granted that they are on Medicaid. Children who are in the foster care system only represent around 3% of the total number of children on Medicaid, but they disproportionately represent the number of children using Medicaid for mental health and behavioral services. Children in foster care represent about 29% of the total expenses on child mental health and behavioral services (CHCS). This means that even though the children in foster care are not taking up a large portion of the enrollment in Medicaid, they are taking a large portion of the funds for mental health care. “Children in foster care have the highest mean behavioral health expenditures at $8,094 per year, compared to other children in Medicaid” (CHCS). Children in foster care are also more likely to use more expensive methods of treatment and are four times more likely to be prescribed some sort of psychotropic medication (CHCS). If treatment is expanded to cover all of the children in the foster care system under the conditions of care, the expenditures will only increase.
While there may be some push back against this Bill because of the cost it will incur, the state is already spending a good amount of money on these children without this bill being in effect. With some slight adjustment of the budget, the government could easily cover whatever extra expenses come out of the bill being passed. Even though we will be spending more as a whole to allow these children to receive more holistic care, it will pay off in society in the long run. If these children can receive both preventative and ongoing mental health care, they are more likely to be able to contribute more to society in their adulthood. If someone is struggling with mental health crises and trauma throughout their adulthood, they will not be able to reach their full potential. However, if the person receives care and works to heal the trauma that has piled on in their lives, they are going to become a more rounded person who can help society progress.
References
Medicaid behavioral health care use among children in ... Center for Health Care Strategies. (n.d.). https://www.chcs.org/media/Medicaid-BH-Care-Use-for-Children-in-Foster-Care_Fact-Sheet.pdf
Mental and behavioral health needs of children in Foster Care. American Academy of Pediatrics. (n.d.). https://www.aap.org/en/patient-care/foster-care/mental-and-behavioral-health-needs-of-children-in-foster-care/?srsltid=AfmBOoqC3HLu9qhleBCLkmuL1lR81ZY3bx4VrpRZHfeYohfE3dWpR
This presents your audience with a good presentation of the bill. Perhaps you might have included the information about the mental health needs of children in foster are first, before explaining the bill, or given a bit more about mental health needs of children in foster care. I'm very glad you found that statistics that the national average is slightly over $8,000 per foster care child per year spent on behavioral health services (figure 2 on the Center for Health Care Strategies fact sheet).
I think a point to emphasize in a descriptive account here is that the kids who get placed in foster care tend to be on track to having very rough lives. Their risk of ending up incarcerated, or committing suicide, or becoming homeless are way higher than almost any other group. Their rates of completing college are super low. Behavior health interventions such as therapy aren't cheap, as these rely on very skilled professionals such as psychiatrists, psychologists, and licensed clinical social workers. The medications to help these children may also be expensive.
I think we also need to consider what the costs to our society would be if we did not provide adequate mental health services to the children in foster care. I wonder if anyone has done a cost-benefit analysis on the long-term benefits in reduced court costs, incarceration, and welfare benefits paid out to adults who were in foster care. I suspect a child who is in foster care for six years or so, and gets about $60,000 in behavior health care over those years (more than the average per year because they are in foster care for a longer time, and presumably have more behavioral and mental health issues compared to infants in foster care for a year or less), is at considerable risk for ending up collecting TANF or SNAP and Medicaid as an adult, and is also at high risk for ending up in prison, where the annual cost would be close to $60,000.
I would be very curious to know how much this bill is likely to cost the State of Illinois. I noticed that Representative Haas, a social worker who runs a mental health clinic in Kankakee, voted against this bill, and I would like to know why she did so. I think the reason you give why people would vote against the bill (we do not have money to pay for it, so until we raise more revenue, we should not pass such legislation) must be the main reason it had 35 "nay" votes in the final passage of the bill, but are there are reasons to oppose it that we cannot think of?
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