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The Case for a State Child Tax Credit

History of the Federal Child Tax Credit

While first established in 1997, the federal child tax credit in 2016 had a maximum value of $1,000 for children 16 and under. An individual had to earn more than $3,000 and the credit value phased into the maximum value. The credit was fully refundable, meaning if the value of the credit exceeded a taxpayer’s tax liability then the taxpayer could receive a refund for the difference.

The Tax Cuts and Jobs Act (TCJA) of 2017, increased the Child Tax Credit in 2018 to $2,000. The phase-in started at $2,500 and the credit refund was capped at $1,400 (an amount indexed to inflation that is worth $1,600 in 2023). Those changes now are in effect through 2025, when the tax parameters revert to the pre- TCJA guidelines.

In 2021, during the height of the pandemic, the federal government expanded the federal Child Tax Credit for but only one year. The maximum credit amount increased from $2,000 to $3,600 per child under age 6 and to $3,000 per child between the ages of 6 and 17. The federal government also made the credit fully refundable to low-income households. There was no income threshold to begin receiving the credit.

Source: Tax Foundation

Source: Urban-Brookings Tax Policy Center

 Impact of the Child Tax Credit on Poverty

The 2021 enhanced federal Child Tax Credit, along with other economic supports, had a tremendous impact in lifting children out of poverty. Nationally, the supplemental child poverty rate dropped from 12.6% in 2019 to 5.2% in 2021. (Unlike the official poverty rate calculated by the Census Bureau, the supplemental poverty rate takes into account certain government benefits -such as Supplemental Nutrition Assistance Program benefits, WIC [Women, Infants and Children] benefits, the Earned Income Tax Credit [EITC], the Child Tax Credit [CTC], and housing subsidies – as well as household expenses that include childcare costs, taxes, work expenses, and medical expenses[i].)

In Illinois, the supplemental poverty measurement rate from the census bureau went from 12.7% in 2019 for children under age 18 to 5.5% in 2021 (a reduction of 56.7%)[ii]. In 2022, because of the changes in the Child Tax Credit provisions (reinstating minimum income, capping the refund amount), an estimated 664,000 Illinois children under the age of 17 became ineligible for the full credit. The number includes 217,000 Latinx children, 199,000 white children and 198,000 Black children[iii].

Number (in thousands) and Percentage of Children in SPM Poverty
Under age 18
Number Percent
Estimate M.O.E. (+/-)1 Estimate M.O.E. (+/-)1
2021 Illinois 152 15 5.5 0.5
2019 Illinois 357 18 12.7 0.7
2017 Illinois 427 18 14.8 0.6
Data are based on a sample and are subject to sampling variability.  
Source: U.S. Census Bureau, 2009 through 2019 and 2021 American Community Survey Public Use 1-year estimates.

Exactly how many children who were lifted out of poverty in 2021 but now live in poverty is unclear. The Census Bureau will release 2022 statistics later this fall. The 2019 supplemental poverty measurement of children in poverty (an estimated 357,000) gives some indication. However, impacting that number are variations in job and wage growth both at the height of the pandemic and at the end of last year.

Without accounting for the additional revenue and expenditure measurements in the supplemental poverty measurement, the Bureau’s official poverty measurement shows the following for those in poverty and those in deep poverty (or 50% of the Federal Poverty Level):

        Children under the age of 18
2021 2019 2017
Illinois children in poverty Below 50% FPL        213,584        175,016        215,972
Illinois children in deep poverty Below 100% FPL        442,261        436,327        486,196
Percentage of Illinois children in poverty 16.0% 15.7% 17.0%
Numbers reflect those for whom the poverty status is determined.  
Source: U.S. Census Bureau, American Community Survey 1-year data      

Household Needs and State Activity

It’s very likely that with a minimum income level reinstated, those in deep poverty will be most impacted by the federal Child Tax Credit changes. While inflation has decreased from the recent peak of 9.1% in June (year-to-year), food prices and rents still remain high. Data from the Census Bureau’s Household Pulse Survey (covering July 26-August 7, 2023) shows of all Illinois households with children answering the survey 12.9% either often or sometimes did not have enough to eat in the last seven days. That value rose to 38.2% for Black households with children and 19.6% for Latinx households with children. Even in households receiving assistance under the Supplemental Nutrition Assistance Program the number stood at 25.4%[iv].

The Greater Chicago Food Depository reports (based on data collected by Northwestern University) that 23% of Chicago metro area households with children were food insecure from March-April 2023[v].  The Depository also reports that of its network of more than 800 partner pantries and meal program sites across Cook County served 31% more guests in May of 2023 than the same month last year.

A previous blog post noted not only the racial disparities in poverty (and the fact that poverty for Latinx and Black children grew from 2019 to 2021) but also the fact that most two-adult/two-child households need closer to 3 times the official poverty level to meet household expenses and attain a modest standard of living.

The noted reduction in child poverty with the enhanced federal Child Tax Credit combined with the failure of Congress to continue that enhancement beyond one year calls for the need for a state Child Tax C\credit to help reduce child poverty. Utah, Oregon, and Minnesota adopted state Child Tax Credits this year and join 11 other states. In all except four states the credit will be refundable for 2023 tax year.  (In addition, Arizona adopted a one-time child tax rebate.) Minnesota Governor Tim Walz predicts the state’s new Child Tax Credit will cut child poverty in Minnesota by one-third[vi].

It is more than just the short-term economic infusion of cash.

Child Welfare Prevention

Research shows social determinates of health (including poverty, housing instability, and food insecurity are associated with child maltreatment[vii]. Additional research documents that with increasing county child poverty rates, total and type-specific official maltreatment rates increased in all race/ethnicity groups[viii].

Increased economic supports are associated with a decreased risk for neglect and physical abuse[ix]. A study published of cross-sectional study of 3,169 emergency department visits related to child abuse or neglect found fewer child abuse and neglect-related visits in the four days following expanded Child Tax Credit payments in 2021[x]. Another study found the Earned Income Tax Credit (EITC) and federal Child Tax Credit (CTC) are associated with a 5% reduction in child maltreatment reports in the four weeks following families’ receipt of the tax credit.

Children’s Health

Poverty, and associated factors such as inadequate nutrition, can negatively impact the development of a child’s body, including the brain. Children who directly or indirectly experience risk factors associated with poverty have higher odds of experiencing poor health problems as adults such as heart disease, hypertension, stroke, obesity, certain cancers, and even a shorter life expectancy[xi].

Research on the EITC (refundable on both the state and federal levels) shows increases in the credit have led to improvements in birth weight and lowered premature births[xii].  Contributing factors may be improved access to prenatal care and reduced maternal stress[xiii].

Education

According to the Urban Institute, persistently poor children (children poor at least half of the years from birth through age 17) are 13% less likely to complete high school by age 20 and 43% less likely to complete college by age 25 than other poor children[xiv]. Contributing to lower academic achievement is residential instability due to poverty.

Research suggests that an additional $1,000 in in the EITC for a household with children when a child is 13 to 18 years old increases the likelihood of completing high school by 1.3% and completing college by 4.2%[xv].

Economic Benefits

The economic benefits from the ETIC or CTC accrue not just to recipients of the credits but state and local economies as well. For low-wealth households, the marginal propensity to consume (that is how much more a person spends when their income increases) is 10 times larger than it is for wealthy households[xvi]. A state will recoup part of the spending through sales taxes and the economic activity may generate more jobs. One Congressional report estimates that the expanded federal CTC created significant benefits for local economies with $1.25 generated for each $1 in CTC payments[xvii].  A working paper issued by National Bureau of Economic Research estimates that for households earning less than $50,000 for each $100 increase in CTC payments those households spend $85 with the top categories housing ($33.18), food ($29.50), clothing ($7.87) and transportation ($7.67)[xviii].

Unlike programs where a benefit may only be used by a recipient for food, housing, or another specific purpose, a state child tax credit provides a family the flexibility to use the new financial resources in a way that best suits the household -whether it is for food, housing, child care, transportation, or clothing.

Time to Act

There are short and long-term benefits to the state by creating a state Child Tax Credit. There are the short-term benefits of addressing food insufficiency and housing instability as well as the noted economic activity around the state. With the potential of improved health, educational attainment, and even future earnings as children move to adulthood, the credit offers potential long-term savings for the state. In addition, given the Illinois’ flat income tax provision and the regressive nature of our state and local tax systems, a state child tax credit adds greater progressivity into the system.

The 2021 federal action to expand the Child Tax Credit showed how successful government can be in taking major steps to address child poverty when it decides to do so. Unfortunately, that effort lasted for only one year. Now the state needs to step in to build on that investment and give all children the opportunity to thrive.

 

Written by Mitch Lifson


[i] U.S. Census Bureau, Measuring America: How the U.S. Census Bureau Measures Poverty, June 2022

[ii] U.S. Census Bureau, Supplemental Poverty Estimate using American Community Survey Public Use Data.

[iii] Cox, Kris, Chuck Marr, Sarah Calame, and Stephanie Hingtgen, “Top Tax Priority: Expanding the Child Tax Credit in Upcoming Economic Legislation”, Center on Budget and Policy Priorities, June 12, 2023.

[iv] U.S. Census Bureau Household Pulse Survey, Week 60

[v] Greater Chicago Food Depository , “Food for Thought”, Summer 2023

[vi] A maximum credit of $1,750 per child for households of $29,500 for single tax filers and $35,000 for joint tax filers. The credits begin to decrease after reaching those thresholds.

[vii] Hunter, Amy and Glen Flores, “Social determinants of health and child maltreatment: A systematic review”,

Pediatric Research, 89, 269–274, 2021.

[viii] Kim, Hyunil, and Brett Drake, “Child maltreatment risk as a function of poverty and race/ethnicity in the USA”, Oxford University Press 2018.

International Journal of Epidemiology, 47, 780–787.

[ix] Monahan, Emma Kahle, Yasmin Grewal-Kok, Gretchen Cusic, and Claire Anderson, “Economic and concrete supports: An evidence-based service for child welfare prevention”, Chapin Hall, April 2023

[x] Bulinger, Lindsey Rose, and Angela Boy, “association of Expanded Child Tax Credit Payments with Child Abuse and Neglect Emergency Department Visits, JAMA Network, February 16, 2023.

[xi] https://www.all4kids.org/news/blog/poverty-and-its-effects-on-children/

[xii] Marr, Chuck, Chye-Ching Huang, Arloc Sherman, and Brandon Debot, “EITC and Child Tax Credit Promote Work, Reduce Poverty, and Support Children’s Development, Research Finds”, Center on Budget and Policy Priorities, October 1, 2015.

[xiii] Evans, Willian and Craig Garthwaite, “Giving Mom a Break”, American Economic Journal: Economic Policy, vol. 6, no. 2, May 2014 ; Anna, Aizer, Laura Stroud, and Stephen Buka, “Maternal Stress and Child Well-Being: Evidence from Siblings,” 2009, http://www4.gsb.columbia.edu/filemgr?file_id=6296; and

Adriana Camacho, “Stress and Birth Weight: Evidence from Terrorist Attacks,” American Economic Review, vol. 98,

  1. 2, pp. 511–515, May 2008.

[xiv] Ratcliffe, Caroline, “Child Poverty and Adult Success”, Urban Institute, September 2015

[xv] Bastian, Jacob, and Katherine Michelmore, “The Long-Term Impact of the Earned Income Tax Credit on Children’s Education and Employment Outcomes”, SSRN, 2017

[xvi] Fisher, Jonathan, David Johnson, Timothy Smeeding, and Jeffrey P. Thompson, “Estimating the Marginal Propensity to Consume Using the Distributions of Income, Consumption, and Wealth.” Federal Reserve Bank of Boston Research Department Working Papers No. 19-4, 2019. https://doi.org/10.29412/res.wp.2019.04

[xvii] Joint Economic Committee Democrats, “The Expanded Child Tax Credit Dramatically Reduced Child Poverty in 2021”, November 30, 2022.

[xviii] Schild, Jake; Sophie M. Collyer, Thesia Garner, Neeraj Kaushal, Jiwan Lee, Jane Waldfogel, and Christopher T. Wimer, “Effects of the Expanded Child Tax Credit on Household Spending: Estimates based on U.S. Consumer Expenditure Survey Data”, National Bureau of Economic Research, Working Paper 31412, June 2023

August 30, 2023
https://childrensadvocates.org/wp-content/uploads/2023/09/Child-Tax-Credit.png 544 816 Mitch Lifson https://childrensadvocates.org/wp-content/uploads/2022/03/childrens-advocates-change-logo.png Mitch Lifson2023-08-30 09:13:192024-08-07 08:33:58The Case for a State Child Tax Credit
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Needing Just the Basics

Many Illinois households with children are just trying to pay the rent and put three full meals on the table. Even with government assistance, it remains a struggle for them. In 2021, nearly 1 in 6 Illinois (15.8%) children (or more than 440,000) were in poverty. Although this is an improvement from 2017 (18.8%), the data shows stark racial and ethnic disparities remain regarding child poverty. The child poverty rate decreased at a faster rate for Black and Latinx children from 2017 to 2021 (4.9% and 5.9% respectively), however it has been increasing recently for Black and Latinx families with the poverty rate for Black children at 35.5%, Latinx children at 19.2%, and white, non-Hispanic children at 9.1%.

Source: U.S. Census Bureau, American Community Survey

Source: U.S. Census Bureau, American Community Survey

Child poverty impacts every region in the state, but the picture differs depending on whether you look at the percentage of children in poverty versus the actual number of children in poverty. While Cook, Lake, and Winnebago counties (all in northern Illinois) have the highest numbers of children below the poverty level, Alexander, Pope, and Perry counties (all in southern Illinois) have the highest percentages of poverty for children.

Five Illinois counties that have the greatest percentage of children below 100% of the Federal Poverty Level.
Alexander County 35.8%
Pope County 35.0%
Perry County 31.2%
Vermilion County 29.1%
Jackson County 25.5%

Source 2021, 5-year American Community Survey

Five Illinois counties that have the greatest number of children below 100% of the Federal Poverty Level.
Cook County 210,002
Lake County 17,608
Winnebago County 16,652
Kane County 16,182
Will County 15,608

Source 2021, 5-year American Community Survey

Children’s Advocates for Change has examined the data by counties, race, and ethnicity. You can find fact sheets for each Illinois county on our website. When looking at the data by race and ethnicity, care needs to be taken in interpreting the data because of sample sizes and margins of error. For example, Richland County shows 98.1% of Black children in poverty. Yet, the estimated population of black children is 53 with a margin of error at +/- 65. However, when examining  several counties with 250 or more Black children, you can still see the disparities in child poverty rates.

Source: 2021-2017 American Community Survey, U.S. Census Bureau

More populous counties:

Source: 2021-2017 American Community Survey, U.S. Census Bureau

Looking at either the composite state child poverty rate or a composite county child poverty rate can be misleading because it does not illustrate the existing disparities by race and ethnicity. This can misinform lawmakers such that the public policies adopted to address child poverty may not get at barriers specific to each demographic group. Yet, even these numbers do not tell the whole story. Many academics have looked at what income is really required to meet basic household needs. In 2022, the federal poverty level for a family of four was $27,750. The Economic Policy Institute has examined the income level a two-adult/two-child household needs to attain a modest yet adequate standard of living. The calculations take into account household expenses that include housing, food, transportation, health care, child care and taxes. By that gauge, the average for all Illinois counties is $81,591 or 2.94 times the official poverty level.

Economic Policy Institute : The income a family needs to attain a modest yet adequate standard of living.
[In 2020 dollars].
Census figures show more than one million Illinois children were below 250% FPL in 2021.

Source: 2021-2017 American Community Survey Data pulled from IPUMS USA.

Thus, nearly 2/3 of Black and Latinx children and more than 40% of all Illinois children are in households below an income considered necessary to meet basic household needs and maintain an adequate standard of living. Furthermore, where the percentages below 100% FPL were 9.1% for white, non-Latinx children and 35.5% for Black children (or a difference of 26.4%) at below 250% FPL the percentage is 30.3% for white, non-Latinx children and 69.0% for Black children (or a difference of 38.7%). Not only do disparities remain but they widen.

While the difference between white, non-Latinx children and Latinx children goes from 9.1% and 19.2% respectively at below 100% FPL to 30.3% and 62.8% at below 250% FPL respectively, that may not tell the entire story. The U.S. Census Bureau does not make regular adjustments to the American Community Survey to account for undercounts in census data. They do release reports on undercounts after the decennial census .

In 2022, the Census Bureau reported the Hispanic or Latino population had a statistically significant undercount rate of 4.99%[i]. Consequently, reported situations of poverty, income, and all other statistics might be off, and much worse than displayed.

The most recent Household Pulse Survey from the Census Bureau (April 26-May 8, 2023) shows many Illinois households still struggle to meet basic needs such as food security and housing even with existing state and federal programs.Census data shows the poorest Illinois residents are paying the most in rent. Housing is a necessity; it is not a luxury item. To be rent burdened means to be paying more than 30% of monthly income on rent. Currently, 44% of Illinois renters are rent burdened. Renters with the lowest income are also paying the most out of their pockets for rent. For Illinois households earning less than $20,000, 88.2% are rent burdened. For those households earning more $75,000 or more, just 5.3% are rent burdened. The numbers also differ by region, which is a factor of income as well as the stock of affordable housing. In Kendall County,  99.5% of those making under $20,000 are rent burdened.

High housing costs are a direct driver of poverty. Families facing high housing costs must restrict their expenditures on other basic necessities[ii]. Data from the National Equity Atlas shows that in 2020 35% of Black households renting were severely rent burdened (spending more than 50% of income on housing) versus 22% of white households[iii].

Source: U.S. Census Bureau

Public Assistance
Cycles of poverty cannot be broken without adequate food and health care. Children cannot go to school, focus, and learn if they are hungry or sick.

SNAP provides households with extra funds to spend on food each month. Census data shows about 20% of Illinois households with children are recipients of SNAP. About 36% of Illinois children are on public health insurance .

Source: U.S. Census Bureau

Additional Economic Assistance
In 2021, during the height of the pandemic, the federal government expanded the federal child tax credit. The maximum credit amount increased from $2,000 to $3,600 per child under age 6 and to $3,000 per child ages 6-17. The federal government also made the credit fully refundable to low-income households. Combined with other federal relief efforts, the child tax credit expansion cut the nation’s child poverty rate almost in half.  Columbia University estimates the federal child tax credit alone (without other federal benefits) cut child poverty by close to 30%[iv] and more than 90% of households used the credit for food, utilities, housing costs, clothing, or education[v]. However, that expansion lasted for just one year and as the data above shows, many households are still far short of the income level necessary to meet basic household needs and an adequate standard of living. With a divided Congress, the nation may not see a reinstatement of the enhanced federal child tax credit any time soon.

As of 2022, 11 states had some form of a child tax credit[vi].  Children’s Advocates for Change was part of a larger coalition that pushed this spring for an Illinois child tax credit. While the legislature did not include that provision in the Fiscal Year 2024 budget, CAFC will continue to push for the measure. CAFC also worked with Illinois legislators on an income tax credit for renters. Current Illinois law allows homeowners to take a portion of their property tax bill as a credit against any state income tax liability. While the measure received a legislative hearing, the General Assembly did not act on it. CAFC will continue its work on this effort as well to see that all Illinois children have the necessary resources to thrive.

Written by Helen R. Weigle Fellow Fran Delacey and Mitch Lifson


[i] https://www.census.gov/newsroom/press-releases/2022/2020-census-estimates-of-undercount-and-overcount.html
[ii] Kimberlin, Sara, Laura Tach, and Christopher Wimer. 2018. “A Renter’s Tax Credit to Curtail the Affordable Housing Crisis.” RSF: The Russell Sage Foundation Journal of the Social Sciences 4(2): 131–60.
[iii] https://nationalequityatlas.org/indicators/Housing_burden?geo=02000000000017000&houseburd01=2
[iv] Zachary, Parolin, Sophie Collyer, Megan Curran. 2022. « Sixth Child Tax Credit Payment Kept 3.7 Million Children Out of Poverty.” Columbia University Center on Poverty and Social Policy. Vol. 6, No. 1. f
[v] https://www.cbpp.org/blog/9-in-10-families-with-low-incomes-are-using-child-tax-credits-to-pay-for-necessities-education
[vi] Waxman, Samantha, and Iris Hinh,  March 3, 2023, “States Can Enact or Expand Child Tax Credits and Earned Income Tax Credits to Build Equitable, Inclusive Communities and Economies”, Center on Budget and Policy Priorities.

June 14, 2023
https://childrensadvocates.org/wp-content/uploads/2023/06/aaron-doucett-liOAS02GnfY-unsplash-scaled.jpg 1707 2560 Mitch Lifson https://childrensadvocates.org/wp-content/uploads/2022/03/childrens-advocates-change-logo.png Mitch Lifson2023-06-14 11:27:492024-08-07 08:33:58Needing Just the Basics
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Proposed Fiscal Year 2024 State Budget

Governor J.B. Pritzker presented his proposed Fiscal Year 2024 (FY24) budget to the Illinois General Assembly with an emphasis on education and measures to address a state workforce shortage.

The proposed budget of $49.6 billion in General Revenue Funds (GRF) is slightly lower than anticipated FY23 expenditures once supplemental appropriations for the year are included[i]. The FY24 introduced budget also includes for FY23 a proposed $490 million in GRF supplemental appropriations, an additional $200 million transfer to state pension funds, and a supplemental appropriation of $100 million for Early Childhood Capital Projects.

Because some FY24 anticipated expenditures are for FY23 outstanding bills (and some FY24 bills are expected to carry over to FY25), the net FY24 operating General Revenue Funds operating appropriations total $48.3 billion. The largest categories are:

  • 26.5% for education
  • 20.5% for human services
  • 20.4% for pensions and
  • 18.8% for health care.

The remaining 13.8% is allocated for other expenditures GRF which includes public safety, economic development, environment and culture, and other government services (such as employee group health insurance). When including designated federal funds and non-state GRF funds, health care makes up the largest proportion of state state expenditures at 31.3% followed by education at 18.5%.

In addition, to the proposed FY24 expenditures noted above, the state is looking at a transfer of $138 million to the Budget Stabilization Fund[ii].

Revenue

In the past two years, the state saw a large influx of revenue from direct federal state payments and grants of COVID-19 relief funds as well as increases in income tax revenue due partly to federal pandemic relief funds made directly to individuals.

The Governor’s Office of Management and Budget (GOMB) estimates base revenues and transfers from other state funds for FY24 to total $49.9 billion for FY24. That is a decrease of $652 million from the projected final FY23 revenues which were, since passage of the initial FY23 budget, significantly revised upward by more than $4.9 billion. That revision was due to, in part, to better-than-expected sales and income tax revenues, a larger than anticipated transfer from the Income Tax Refund Fund to the General Revenue Fund, and increased federal funding (largely a transfer into the General Revenue Fund of federal COVID-19 relief funds received by the state).

Looking at the FY24 projected revenues, part of the revenue calculation involves an increased annual transfer of motor fuel tax revenue into the state’s Road Fund (as required under state law), the fact that in FY23 there was a one-year suspension of the 1% sales tax on groceries (which will be reinstated for FY24), the first repayment to the General Revenue Fund from the state’s Unemployment Insurance Trust Fund of a portion of the state’s FY23 $450 loan the UI Trust Fund, and the anticipation of a mild recession during 2023.

Expenditures

FY23 estimated expenditures have a number of one-time appropriations and transfers. This includes transfers of just under $1.2 billion to the Budget Stabilization Fund and $1.8 billion to the Unemployment Insurance Trust Fund and appropriations for a number of COVID-19 relief measures. During FY23, the state also transferred $200 million above the required certified amounts into the state pension funds and appropriated $400 million to the Large Business Attraction Fund, which state statute outlines partly as a “fund designed to finance large firms considering the location of a proposed plant in the state” (30 ILCS 750/10-6).  In addition to the noted expenditures, there was approximately $1.16 billion in income tax and property tax rebate checks approved in the spring of 2022 that were sent to Illinois residents with the expenditures charged to FY22. The state lists another $50 million in tax rebate checks under FY23 expenditures.

A portion of that increase seen in FY23 GRF expenditures is now being replaced by Medicaid GRF cost increases and increased education funding. In addition to examining those areas, this blog posts reviews some of the programs and services impacting children and their families.

Department of Healthcare and Family Services

Medicaid is a federally authorized program providing health care coverage to low-income adults, children, pregnant women, and elderly people with disabilities[iii]. It is authorized by the federal government, jointly funded by states and the federal government, and to a large degree run by states. The federal government matches an amount of state funds spent on Medicaid services and programs. Currently, Medicaid covers approximately 3.9 million Illinois residents or about 30% of the state’s population. Prior to the pandemic, Medicaid covered approximately 2.9 million residents.

The Federal Medical Assistance Percentage (FMAP) is based on a formula that considers state per capital incomes. Under federal law, while a federal declaration of a public health emergency existed (that declaration ends on May 11th), the state received an enhanced matching Medicaid funding of 6.2%. Beginning later this year, the federal government will begin to phase-out the enhanced percentage. Consequently, the Department of Healthcare and Family Services budget calls for a $709 million GRF increase to deal with the enhanced FMAP phase-out.

As part of the measures for additional Medicaid funding to a state during the pandemic, Congress required “continuous coverage”. This required Medicaid enrollees would not lose coverage during the pandemic unless they moved out of state, requested cancellation, or passed away. Within the budget Congress approved at the end of 2022 was a sunset date of March 31, 2023,for continuous coverage. That does not mean individuals will lose coverage on that date. According to HFS, the first time anyone will get a renewal notice in the mail is the start of May. That will be just for people whose coverage is due for renewal by June 1st. Other enrollees will receive notices one month before their redetermination month. To help residents maintain Medicaid coverage or (if their income has increased since enrollment making them no longer eligible) transition to other health insurance, the budget includes $8 million dollars for a “Ready to Renew Campaign”.

Also, within the HFS budget is $100 million for Medicaid reimbursement rate increases starting January 1st of next year. HFS has indicated it is targeting increases to facilitate health equity with respect to:

  • Improved birth outcomes and lowering rates of maternal mortality
  • Behavioral health (with a portion of the emphasis on therapy delivered by a state Licensed Practitioner of the Healing Arts at Community Mental Health Centers[iv]), and
  • Dental services

The agency is proposing to work with the dental community on a new assessment to allow further dental rate increases and expand access to dental services.

According to the budget, HFS plans to reinvest $450 million over several years to preserve and grow the healthcare workforce. According to GOMB, in the event the state overpays Managed Care Organizations (MCOs) for the actual level of Medicaid services provided to patients, the refunds from the MCOs to HFS would be used for the healthcare workforce investments.

Education

Early childhood

A centerpiece of the Governor’s proposed budget is his “Smart Start Illinois” early childhood initiative. In total, the Governor is proposing in this FY24 budget an additional $250 million (in some instances through the State Board of Education and in others through the Department of Human Services) to:

  • Minimize child care deserts
  • Raise child care worker wages
  • Increase the quality of child care
  • Stabilize the state’s early intervention program to ensure children with developmental delays and disabilities receive needed services and
  • Sustain and expand the state’s home visiting program to help promote child development and readiness for school, improve maternal and child health, prevent child abuse and neglect, and prevent domestic violence

Specifically, the budget calls for:

  • An additional $75 million for the Early Childhood Block Grant Program to create 5,000 new preschool slots in the next year
  • An additional $40 million for Early Intervention Programs to handle expected increases in caseloads and provide a 10% wage increase for providers
  • An additional $5 million to expand the Home Visiting Program under DHS and
  • An investment of $130 million in state funds (with additional federal dollars) to begin funding Childcare Workforce Compensation Contracts. Based on recommendations from the Governor’s Commission on Equitable Early Childhood Education and Care Funding, the contracts are designed to provide a base funding level for child care providers allowing them to increase child care worker salaries and attract others to the field

Within the DHS budget is $20 million to upgrade the state’ s child care payment management system and $50 million to cover an expected increase in children participating in the state’s Childcare Assistance Program as well as rate increases for providers.

The Governor envisions Smart Start Illinois as a multi-year effort that would in each successive year add additional funding for the Early Childhood Block Grant, Early Intervention Rate Increases, Workforce Compensation Contracts, and the Home Visiting Program.

K-12 Education

The K-12 budget increases funding for the state’s evidence-based school funding formula by $350 million (for a total of $8.3 billion). This formula was revised in 2017 with the goal of adding $3.5 billion into state school funding over the next ten years to help reduce inequities in school funding. The budget also includes a $86.4 million increase for mandated categorical special education and transportation grants.

The state has received more than $8 billion in federal COVID-19 relief funds elementary and secondary schools with 90% of the funds designated for districts with the highest low-income populations. To date, it has distributed $4 billion of the amount with an additional $4 billion to be distributed to schools through September of 2024.

According to the Governor’s office, the state has approximately 3,500 unfilled teaching positions across the state. To help address this issue, the FY24 budget includes $70 million to start a three-year pilot program (with the intention of also spending $70 million in both FY25 and FY26) to improve the teacher pipeline. Specifically, the plan calls for allocating 80% of the funds to 170 of the state’s school district experiencing some of the most significant difficulties in attracting and retaining teachers. The proposal calls for flexibility in how districts could spend the funds through measures such as signing bonuses, housing stipends, tuition and assistance, and help with student loans and licensure fees.

Higher Education

Within the proposed FY24 state budget is a $100 million, or 7% increase, for public universities and community colleges.

The proposed FY24 budget also includes (within the budget for the Illinois Student Assistance Commission [ISAC]) a $100 million increase for the Monetary Award Program (MAP), which assists Illinois residents with tuition and fees at Illinois colleges and universities (including community colleges). According to the Governor’s office, this will allow nearly all community college students and 40% of public university students at or below median income levels to have their tuition and fees covered through MAP and federal Pell Grants.

The ISAC FY24 budget also includes an additional $2.8 million for the Minority Teachers of Illinois Scholarship Program (bringing the total to $7 million). According to ISAC, the scholarships (which went up to $7,500 in the 2022-23 academic year and can be used for tuition, fees, room and board, or commuter allowances) are for “African American/Black, Hispanic American, Asian American…Native American or…qualified bilingual minority” applicants, planning to “teach at a nonprofit Illinois public, private, or parochial preschool, elementary school, or secondary school, for which the Illinois State Board of Education (ISBE) has determined that no less than 30 percent of the enrolled students are African American/Black, Hispanic American, Asian American, or Native American”.

Department of Children and Family Services

The Department of Children and Family Services (DCFS) general funds line item for personal services and fringe benefits increases by $18.3 million in the proposed FY24 budget. With the funding, the agency is planning on increasing its staffing by 192 people to help address an increasing number of calls to the agency hotline as well as anticipated increases in the number of child abuse and neglect investigations (from an estimated 95,912 in FY23 to an anticipated 97,613 in FY24.)

Including other state and federal funds, DCFS has an overall proposed budget of $2 billion for FY24, which represents an 11% increase from FY23. The overall proposed budget includes $41 million for the rollout of a modernized child welfare information system to replace the previous case management system. The Comprehensive Child Welfare Information System is designed to provide a unified case management system for all DCFS child welfare data and allow for faster case processing. Also within the budget is $30 million for additional Level of Care Support Services to increase the capacity for youth placement in “the most clinically appropriate settings through capital grants and workforce support”[v].

According 2021 news reports, in 343 foster children — some as young as seven — were housed in psychiatric hospitals in 2021 after doctors cleared them for release because DCFS could not find suitable homes for them. [vi]. In 2022, the agency reported the number of youths hospitalized beyond medical necessity was down by 80%[vii].

Department of Human Services

Detailed above in the Smart Start Illinois provisions, was funding set aside for increases in the DHS Home Visiting Program, upgrading the child care payment management system and the Child Care Assistance Program.

TANF

The federal Temporary Assistance for Needy Families (TANF) program provides grant funds to states to assist pregnant women and families with one or more dependent children. TANF funding helps pay for food, shelter, utilities, and expenses other than medical[viii].  (For qualifying families, the benefits can run up to 60 months. Under certain circumstances, an individual may receive TANF benefits for an additional period of time.) The proposed FY24 budget includes an additional $50 million in TANF funding to handle caseload increases and increase the monthly grant payment from 30% of the Federal Poverty Level (FPL) to 40% of FPL. (For an Illinois family of three, the monthly benefit at 30% of FPL in 2022 was just under $550.)

Housing

In 2021, Governor Pritzker issued an executive order to fight homelessness in Illinois. Under the order, he established a State Homeless Chief at DHS to coordinate the state’s efforts to decrease homelessness, improve the health and human service outcomes for people who experience homelessness, and strengthen the safety nets for housing stability.

The proposed FY24 budget establishes under DHS the “Home Illinois” program to target the prevention of homelessness and expand housing supports. In doing so, the Governor switches Illinois Housing Development Authority (IDHA) budget line items from IDHA’s prior fiscal agent (the Department of Revenue) to DHS. The budget calls for a $45 million increase for shelter diversion, emergency and transitional housing, and scattered site supporting housing.

Behavioral Health

In March of 2022, Governor Pritzker established the Children’s Behavioral Health Transformation Initiative with the goal of seeing that young people with significant behavioral health needs receive needed community and residential services. At that time, he appointed Dr. Dana Weiner to head the effort. Dr. Weiner is set to release her report later this month. The DHS proposed FY24 budget includes $1.5 million for the development of a Children’s Behavioral Health Portal. It also increases GRF funding for Comprehensive Community Based Youth Services by $10 million.

A few other programs to note:

  • To further help address food insecurity and grocery store deserts in underserved communities, the Department of Commerce and Economic Opportunity (DCEO) proposed FY24 budget includes $20 million for a n Illinois Grocery Initiative to incentivize the opening or expansion of grocery stores by independent grocers or local governments.
  • The DCEO budget also includes $10 million for a Clean Energy Career and Technical Education Initiative to assist high schools in developing curricula that supports electric vehicle manufacturing technical education.
  • The Department of Public Health’s proposed FY24 budget includes $2 million to support frontline pediatric care providers with the training and resources to provide integrated mental health services and treatment.

In the coming weeks, Children’s Advocates for Change (CAFC) will be taking a closer look at the proposed FY24 budget and following legislative hearings on it. At the same time, CAFC will continue to work for further economic supports for working families with legislative measures establishing a state child tax credit (SB 1444) as well as a state income tax credit for renters (SB 1836, HB 2429).  We also hope the final budget will include additional funding for the provision of mental health services to Illinois students.

CAFC also believes that while the Governor notes throughout the proposed FY24 budget education expenditures, community investments, and other grant and loan programs to promote equity, there should be a statement or section in the budget that specifically reviews how the overall proposed expenditures on state programs and services will address outstanding racial and ethic disparities in the state. CAFC will be working with members of the General Assembly this session for passage of HB 3748. The bill requires (starting with the introduction of the FY25 state budget) that the Governor included an explanation within the document of the manner in which provisions of the budget further the Governor’s efforts ensure equity in the State. Such a statement will help focus attention on existing inequities and further the discussion of how to eliminate them.

The Illinois General Assembly has scheduled May 19th as its adjournment date for the spring legislative session.

Written by Mitch Lifson

______________________________________________________________________________________________________

[i] In addition to state general revenue funds there are state special funds (such as revenue collected and specifically designated for health insurance, financial regulation or medical assistance), state highway funds, and federal trust funds.

[ii] The Illinois Budget Stabilization Fund, often called the rainy day fund, is “a special fund in the State treasury established for the purpose of reducing the need for future tax increases, maintaining the highest possible bond rating, reducing the need for short term borrowing, providing available resources to meet State obligations whenever casual deficits or failures in revenue occur, and providing the means of addressing budgetary shortfalls”. (30 ILCS 122/5)

[iii] Definition from Medicaid.gov

[iv] According to the Illinois Administrative Code, a Licensed Practitioner of the Healing Arts is a Illinois licensed healthcare practitioner who, within the scope of State law, has the ability to independently make a clinical assessment, certify a diagnosis and recommend treatment for persons with a mental illness and who is one of the following: a physician; an advanced practice nurse with psychiatric specialty license, a clinical psychologist,

a licensed clinical social worker, a licensed clinical professional counselor, or a licensed marriage and family therapist.

[v] Proposed FY2024 Illinois State Budget”, p. 266

[vi] https://illinoisanswers.org/2022/05/26/foster-children-held-in-jails-shelters-workers-threatened-attacked-a-state-agency-in-crisis/

[vii] ttps://wgntv.com/news/wgn-investigates/dcfs-reports-progress-after-hundreds-of-kids-hospitalized-longer-than-necessary/

[viii] Illinois Department of Human Services

February 18, 2023
https://childrensadvocates.org/wp-content/uploads/2023/02/FY24-Budget-Cover.png 2079 1604 Mitch Lifson https://childrensadvocates.org/wp-content/uploads/2022/03/childrens-advocates-change-logo.png Mitch Lifson2023-02-18 11:36:372024-08-07 08:33:58Proposed Fiscal Year 2024 State Budget
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Forum on Maternal Health Disparities

On December 9th at 12:00 p.m. Central Time, Children’s Advocates for Change will host a Helen R. Weigle Policy Forum on racial and ethnic disparities in maternal mortality rates.

In 2020, the maternal mortality rate nationally for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women.[1] Furthermore, the rates have been increasing between 2018 and 2020.

In Illinois, 2016-2018 data shows a death rate of 47 per 100,000 for Black women and 16 per 100,000 for white women.[2]

 

Among the topics to be discussed during the forum:

  • Awareness among pregnant women of pre-natal nutrition steps, the impact of smoking and drinking, and the need for regular medical check-ups. How is the information conveyed to women?
  • Access to regular medical care during pregnancy.
  • Treatment by health care professionals during pregnancy – the impact of

Children’s Advocates for Change President Dr. Tasha Green Cruzat will moderate a panel discussion on these topics. Panelists include:

Vernice Davis Anthony, BSN, MPH, CEO of VDA Health Connect whose career has included working as the City of Detroit Public Health Department’s director and the director of the Michigan Department of Public Health.

Kylea Laina Liese, PhD, CNM, of the University of Illinois Chicago whose current research focuses on health system structures and obstetric racism that drive disparities in maternal health and mortality

Another of the items to be examined is how the state should build and maintain its public health system going forward. The pandemic illustrated health care deserts where the lack of care, in part, precipitated greater health risks due to COVID-19.

You can register for the event by clicking here: https://bit.ly/maternalhealthforum.

 

[1] https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/E-stat-Maternal-Mortality-Rates-2022.pdf

[1] IDPH Office of Women’s Health and Family Services, May 2021

 

 

 

 

 

November 30, 2022
https://childrensadvocates.org/wp-content/uploads/2022/11/marcelo-leal-6pcGTJDuf6M-unsplash-scaled.jpg 1707 2560 Mitch Lifson https://childrensadvocates.org/wp-content/uploads/2022/03/childrens-advocates-change-logo.png Mitch Lifson2022-11-30 10:13:452024-08-07 08:33:58Forum on Maternal Health Disparities
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Meeting Youth Mental Health Needs

School is underway for K-12 students, variants of COVID-19 continue, and many students still face mental health challenges brought on by or increased due to the pandemic. Following the U.S. Surgeon General’s Advisory on Children’s Mental Health, Children’s Advocates for Change (CAFC) undertook a closer look at the subject this summer. We talked to state and national experts, school social workers, and students. In our latest policy paper, CAFC outlines the data, state programs underway, and further steps the state of Illinois can take to best meet the mental health needs of our youth.

At Home and Isolated

In the early part of the pandemic, schools shutdown in-person learning and switched to remote learning via computers. School is generally where students meet their friends, and when school closed, so did many of their doors to socialization, social development, and ability to interact outside of a screen, leading to a significant increase in isolation. The physical isolation, combined with job losses by parents and caregivers, illnesses, and deaths brought about increased levels of anxiety and depression for many young people. All of this came on top of other factors impacting youth mental health that include poverty, violence, and negative social media messages.

Two self-report surveys help capture the state of youth both during the pandemic and the time leading up to it. A January–June 2021 survey by the Centers for Disease Control and Prevention (CDC) of 7,705 public and private high school students showed 37.1% of responding high school students experienced poor mental health most of the time or always during the pandemic. More than 44% of the total respondents reported persistent feelings of sadness or hopelessness.[1]

The CDC also conducts a national survey, and state departments of health and education conduct statewide surveys, that feed into the Youth Risk Behavior Surveillance System (YRBSS) which helps monitor health behaviors and social problems among youth.[2] Asked in 2009 if a student felt sad or hopeless for two or more weeks in the year before the survey, 27.8% of Illinois students surveyed said “yes”. Ten years later 36.3% said “yes”….an increase of more than 30%. Data reflecting whether a student seriously considered attempting suicide also increased.[3]

What School Social Workers Saw

Children’s Advocates for Change surveyed 76 school social workers from around the state of Illinois regarding student mental health at their school. This was a self-reported survey in August of 2022 gathering the perspectives of school social workers about students from various grade levels, some as young as pre-kindergarten, all the way through high school.

  • Over 86% of respondents agreed that student mental health was currently a concern at their school.
  • Over three-quarters of school social workers stated there were not enough resources to meet the needs of the students in their school.
  • An overwhelming response of almost 82% of school social workers indicated there were barriers to the ability for students to receive mental health services at their school.

The National Association of Social Workers (NASW) recommends schools maintain a ratio of one school social worker for 250 students (.004). Under Illinois law (105 ILCS 5/34-18.58) the state recommends the noted NASW standard but does not require the ratio be maintained.

A February 2022 report by the entity Inseparable put the Illinois social worker to student ratio at one to 741 students and the ratio of counselors to students at one to 626. [4]

Telehealth

Our policy paper also looks at school use of telehealth to deliver mental health services to youth. While it holds promise for addressing access issues in urban and rural areas, issues remain with inequities in access to broadband services and needed electronic devises such as laptops, desktop computers, tablets, and cell phones.

Poverty, trauma and inequities

Poverty, education, neighborhood violence, and other factors affect the likelihood of a youth’s exposure to an adverse childhood experience (ACE), and ACEs have a significant impact on youth developing mental health conditions.[5] In many cases poverty may be the main driver, impacting housing stability, food sufficiency, and the safety of a neighborhood in which a family resides.

While business shutdowns and slowdowns increased the economic needs in many households, particularly Black, Hispanic, and Latino households, economic inequalities existed before the pandemic. For example, U.S. Census Bureau numbers show the percentage of Illinois Black children in poverty versus white non-Hispanic children was more than three and a half times higher in 2019 (pre-pandemic).

The data on children exposed to adverse childhood experiences show differences by race and ethnicity – particularly with regards to exposure to one adverse childhood experience.


What Students Are Saying
Children’s Advocates for Change also spoke to more than 75 young people across the state from Chicago, the Chicago suburbs, East St. Louis, and Moline to hear from them what issues are impacting their communities. When we spoke with them about the issues affecting youth mental health, racism and homophobia were two of the top issues they felt were problems within the schools. Youth have expressed that it often feels as if there is not adequate intervention from the administration regarding reported concerns about these issues.

Delivering mental health services in a school setting can improve access to such care for many students. In poorer communities, whether it is due to insurance coverage, proximity of a community provider, use of a primary care physician versus a specialist, or a stigma families feel about mental health treatment, youth may not receive needed mental health treatment outside of school.

In our conversations with students about available mental health resources in school and whether it was easy to access help, one common theme that came up was that students felt there was an initial barrier to being able to leave the classroom. Another frequent topic was parents not understanding or invalidating the kids’ mental health challenges.

“Many people find it hard to access the help because they have to go out of their way just to ask/receive it and when they do, they only get it on certain days.”
                                                                                                Chicago Student

What Is Being Done

With pandemic relief legislation in 2020 and 2021, Congress approved approximately $190 billion for state education departments and local school systems to deal with COVID-19 related issues including learning loss, mental health needs, health protocols, and related modifications to buildings for health and safety improvements.[6]

Most of the federal COVID-19 relief money used for student mental health services came through the Elementary and Secondary School Emergency Relief Fund (ESSER). From ESSER federal funding, Illinois received a total $7.54 billion. Of that amount it kept, $476 million for state-directed programming with the remaining funds allocated to local school districts across the state.[7]

Some of the state efforts underway include Project Reach and Project AWARE:

Project REACH
In 2020, the Illinois State Board of Education established a partnership with the Center for Childhood Resilience (CCR) at Lurie Children’s Hospital to offer training and support to staff at seven social emotional learning hubs established across the state. Staff at these hubs then work with local school districts in training on student trauma evaluations, trauma-informed responses, and development of action plans to address issues identified in the evaluations.

Project AWARE
In 2020, the Substance Abuse and Mental Health Administration within the U.S. Department of Health and Human Services launched Project AWARE (Advancing Wellness and Resiliency in Education), which made funding available through federal grants up to $1.8 million per proposed budget to support youth mental health needs in schools and in the community.[8] Currently, the only three Illinois school districts are participating: Chicago School District #299, Eldorado CUSD #4, and Bloomington School District #87.[9]

In addition to the federal pandemic relief funding provided to schools, recently approved federal gun safety legislation provides the potential of even more funding for the state to address student mental health needs. The bill contains the following funding sources:[10]

  • $80 million for a pediatric mental health care access program, which allows pediatricians to provide mental health services via telehealth.
  • $60 million over four years for training primary care clinicians to provide mental health services to young people.
  • $250 million to increase the Community Mental Health Services block grants to states to help fill in blanks in a state’s mental health system.
  • $240 million over four years to be added to Project AWARE, which provides grants to mental and behavioral health organizations, community groups, and schools to raise students’ awareness of and connect them to mental health services in schools.
  • $150 million for the new 988 National Suicide Prevention Lifeline.

Recommendations for the state of Illinois

After examining not just Illinois’ efforts to address youth mental health needs but also efforts underway in other states, CAFC recommends Illinois legislators consider undertaking the following measures:

Conduct regular mental health assessments for students and use the data to establish grant programs for school districts:
Require Illinois schools to conduct a mental health and wellness assessment of students at least once per school year to determine needs for student population within each school district in Illinois.

Mandate school mental health staff to student ratios
As noted earlier, state law currently suggests but does not mandate a ratio of one school social worker for every 250 students for Illinois schools. This is not sufficient to address the youth mental health needs present in schools. CAFC recommends the state establish an appropriate ratio of school mental health personnel per student based on need as determined by the mental health assessment discussed above. Some schools may need a higher ratio (one social worker per fewer than 250 students). Additionally, the ratio, once established, needs to remain as a requirement to ensure students have access to the necessary resources.

Establish and expand school-based health resources with additional staff and telehealth
School-based mental health care is a positive solution to addressing youth mental health care by bringing the services to students. Increasing mental health staff (social workers, therapists, psychologists, and other behavioral health professionals) within the schools is critical to addressing youth mental health needs. While it should not be considered a long-term substitute for full-time social workers and counselors in school, telehealth does represent a means for a school to increase access to mental health treatment for youth in the short-term and it can then serve as a complement to in-person counseling.

However, increasing telehealth services needs to occur in conjunction with the state taking further action to increase the availability of broadband service (both in urban and rural areas) and ensuring students have access to a laptop, desktop computer, tablet, and/or smart phone to adequately utilize telehealth services.

Adopt a state child income tax credit
Illinois low- and moderate-income families could benefit from a state child tax credit to help them address economic needs that include housing, food security, and/or clothing and help mitigate the negative influence of poverty in a child’s mental health.

Enhance required mental health literacy training and/or mental health first aid programs for educators and parents through Illinois school districts
While it is important for school personnel, it is equally important for parents to have access to similar resources. Often, parents are not aware of the signs and symptoms of a mental health issue.

Related to our recommendations are continuing efforts to address the social determinants of mental health that include addressing food deserts, lack of affordable housing in some communities and regions of the state, and lack of access (or difficulty in access) to medical care providers.

On September 14, 2022, Children’s Advocates for Change held an online public policy forum on meeting the mental health needs of our youth. You can view the video on our YouTube Channel that includes a panel discussion on many of the issues noted here as well as portions of interviews from youth themselves.

Written by Sarah Stolarski-Galla and Mitch Lifson
 ____________________________________________________
Endnotes

[1] Jones SE, Ethier KA, Hertz M, et al. Mental Health, Suicidality, and Connectedness Among High School Students During the COVID-19 Pandemic — Adolescent Behaviors and Experiences Survey, United States, January–June 2021. MMWR Suppl 2022;71(Suppl-3):16–21. DOI: http://dx.doi.org/10.15585/mmwr.su7103a3external icon.

[2] https://www.cdc.gov/healthyyouth/data/yrbs/index.htm

[3] Centers for Disease Control and Prevention [CDC]. (n.d.-b). Disparities in mental health and suicide indicators among U.S. high school students, 2009-2019. U.S. Department of Health & Human Services. Retrieved July 20, 2022, from https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/mental-health-data-table.pdf

[4] Inseparable, America’s School Mental Health Report Card, February 2022. (Referenced data from the U.S. Department of Education Civil Rights Data Collection [2015-2016] and the U.S. Department of Education, National Center for Education Statistics [2018-2019].) https://hopefulfutures.us/wp-content/uploads/2022/02/Final_Master_021522.pdf

[5] Colizzi, M., Lasalvia, A. & Ruggeri, M. (2020). Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care? International Journal of Mental Health Systems, 14(23). https://doi.org/10.1186/s13033-020-00356-9

[6] Lieberman, Mark, and Andrew Ujifusa, “Everything You Need to Know About Schools and COVID Relief Funds”, Education Week, September 10, 2021, https://www.edweek.org/policy-politics/everything-you-need-to-know-about-schools-and-covid-relief-funds/2021/09

[7] Information provided by the Illinois State Board of Education

[8] Substance Abuse and Mental Health Services Administration [SAMHSA]. (2020). FY2020 Project AWARE (advancing wellness and resiliency in education) state education agency grants. Department of Health and Human Services. https://www.samhsa.gov/sites/default/files/grants/pdf/fy-2020-aware-foa.pdf

[9] Illinois State Board of Education. (n.d.). Illinois AWARE. https://www.isbe.net/Documents/SWC21-IL-AWARE-ppt.pdf

[10] Knight, Victoria, Gun Safety ‘Wrapped in a Mental Health Bill”: A Look at Health Provisions in the New Law, Kaiser Health News, July 7, 2022, https://khn.org/news/article/gun-violence-mental-health-legislation-suicide/

September 22, 2022
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