Between January 1996 and June 1997, the State of Illinois Department of Children and Family Services, Springfield, Ill. carried out a project to support the development of a managed care system of services for foster care children-all of whom are wards of the state-who needed behavioral health services.

In 1994, 60,000 children in Illinois were in the custody of the Department of Children and Family Services. More than 13,000 of these children were placed in specialized residential treatment settings because of behavioral healthcare needs.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Mental Health Services Program for Youth Replication.

Key Results:

• Through screening and discharge planning based on a new clinical model and protocol, there was a net reduction of 1,000 children in residential treatment centers.
• More than 1,000 children were enrolled in wraparound plans, in which family service planning was individualized to develop unique treatment and support plans for each child and family served.
• An additional 700 wraparound plans were implemented in a separate, but related, interagency collaborative for non-wards of the state.
• John Lyons, Ph.D. of Northwestern University, Evanston, Ill. created a decision-making model that measured clinical presentation (symptomatology), behavioral risk and placement capacity.
• The Department of Psychiatry at the College of Medicine at the University of Illinois at Chicago, worked with the Department of Children and Family Services to develop provider profiles, standards for residential treatment and a system of managing psychotropic medications.
• The Department of Children and Family Services in partnership with both universities and others:
  • Developed placement review protocols for both admissions and discharge planning.
  • Developed standards and credentialing for the use of psychological assessments.
  • Provided training and consultation to all of the people doing the work.