The Power of a Job: Thresholds Supported Employment
Jobs transform lives. They provide purpose, routine, and financial freedom – all of which play a key role in recovery from mental illnesses. As Area Director for Little Caesars Pizza, Quizhpe Luz is one of the many employers who partner with Thresholds to provide competitive career opportunities to our clients through our supported employment services. “I believe in giving people a chance,” Quizhpe said, “that’s why I decided to work with Thresholds.”
In 2011, Quizhpe was introduced to Zekkina, a member of Thresholds Deaf Program who was working with supported employment to find a job, and invited her to join the Little Caesars team. Hiring Zekkina proved to benefit them both, filling an open position with an excellent employee and giving Zekkina a feeling of connection and empowerment. Reflecting on her life before employment, Zekkina shared “I was bored and had bad mood swings at home. Now I enjoy working, keeping busy – and no more mood swings.”
Quizhpe emphasized the importance of equality on her team in both respect and responsibility. “The team doesn’t treat Zekkina any differently,” she said, “they hold her accountable just like everybody else.” While Little Caesars training already incorporated multiple learning and communication styles, Quizhpe says working with Zekkina inspired her to seek out American Sign Language worksheets to better communicate with her.
Zekkina’s strong work ethic and positive contributions to Little Caesars have motivated Quizhpe to hire several more Thresholds clients and provide them with the same chance to succeed. “It feels wonderful to give someone a job. You’re making a difference in someone’s life, seeing their smiles as they start their career is payback for anything.”
Thresholds supported employment services provide clients with opportunities to build skills, prepare for interviews, match clients with employers based on their unique interests, and provide ongoing support both before and after the hiring process. To learn more about Thresholds supported employment services, visit thresholds.org/employment.
Advocacy: Raising Our Voices to Move Mental Health Forward
By Amber Kirchhoff
On May 1, Thresholds kicked off Mental Health Awareness Month by convening people with lived experience, health care and human service providers, and policymakers from across the state for our annual Mental Health Policy Forum. The Policy Forum served not only as an opportunity to learn from national experts and experienced state leaders, but as a chance to reimagine ourselves as advocates for the reforms and investment needed to transform the mental health system.
During the Policy Forum, several members of Illinois’ mental health community spoke of commonly faced challenges to accessing the care and supports needed to manage mental health conditions. Because of stigma and a general lack of information about mental illnesses, often many years go by before receiving a diagnosis. Even with an awareness of a mental health condition, accessing treatment and housing can be extremely difficult because of the underfunded, overly complex system of care that is currently in place. As a result, far too many spiral into disability, begin to self-medicate, cycle in and out of the hospital, or find themselves entangled with the justice system.
These tragedies are avoidable and Illinois can and must do better. We as advocates play an important role in bringing about needed changes and ensuring that no one is allowed to continue to fall between the cracks. Like most other health conditions, mental illness is treatable. In order to build a system that works, we must strengthen early identification and treatment, build service capacity so everyone who needs care gets it, ensure affordable housing as a foundation for treatment, grow the mental health workforce, and improve insurance coverage for proven treatments. Together this package of policy solutions represent the bedrock of our Road Map to Mental Health Reform.
Mental Health Awareness Month provides an important opportunity to challenge stigma and to start conversations about the critical need for treatment that works. At Thresholds, we work to advance those conversations and inspire mental health advocates all year round. As a community, we know what works; and together change is possible.
Amber Kirchhoff is an experienced public policy professional who has worked both in state government and with non-profit organizations. Currently, she holds the role of Policy Associate at Thresholds, supporting the agency’s government relations and advocacy efforts. Prior to joining Thresholds, Amber served as a Policy Analyst under the administration for former Illinois Governor Pat Quinn. She previously earned a Master’s of Political Science through the Civic Leadership Program at the University of Illinois at Urbana-Champaign.
We are deeply disappointed that in spite of the hard work of our advocates, and the urging of millions across the country, the U.S. House voted today to pass the American Health Care Act (AHCA), putting the health coverage of 24 million Americans in jeopardy. Millions will lose access to affordable healthcare if this bill makes it to the President’s desk. The House vote on the AHCA is a vote to slash Medicaid – the primary payer of mental health and substance use treatment – by $880 billion, weaken protections for pre-existing conditions, and undercut the Essential Health Benefits requirement, which guarantees that benefits like mental illness and substance use treatment are covered.
That said, the fight is NOT over. In order to become law, the bill will need to pass the Senate and then be signed by the President. We must not let this happen.
Thank you for making countless calls, showing up to town halls, and posting on social media to stop the AHCA. We must continue this fight in the Senate, and we hope that you will join us.
Throughout this next phase, we will share important updates and opportunities to take action. Both Senator Dick Durbin and Senator Tammy Duckworth of Illinois have been outspoken supporters of the Affordable Care Act and we thank them for their leadership on this critical issue.
Thresholds remains committed to preserving health coverage and access to treatment, and we know you do too. Onward, together.
Press Contact: Emily Moen, Director of Public Relations and Marketing, 773-572-5172
Donor Spotlight – The Martin Foundation, Inc.
Thresholds is proud to feature The Martin Foundation, Inc. in our Donor Spotlight. Established in 1953 by Lee and Geraldine Martin, The Martin Foundation, Inc. has created a legacy of philanthropy, making transformative gifts that support a range of issues, including: education, women and children, the arts, and the environment.
Since 1983, The Martin Foundation, Inc. has been a generous partner to Thresholds, most recently supporting our Homeless Services Program. Our Homeless Services Program provides a variety of innovative programs that engage and empower individuals experiencing homelessness and mental illness on their journeys to recovery. Our Mobile Assessment Units (MAUs) are a key component of our Homeless Services Program, acting as the vital link that connects individuals to services and resources. Each MAU canvasses streets, shelters, CTA lines, and other areas where homeless individuals congregate. After meeting immediate needs and completing the intake process, MAU’s refer these individuals to the most appropriate Thresholds program, which link them to housing and comprehensive support services. Today, Thresholds has eight Mobile Assessment Units. Last year, they engaged nearly 3,000 homeless individuals.
We are grateful to The Martin Foundation, Inc. for their long-time partnership. In their more than 30 years of support, they have donated over $200,000 to Thresholds, giving hope to thousands of individuals experiencing serious mental illness.
Evaluation Department Field Notes
Here at Thresholds, the Evaluation Department is helping to drive improvements in our programs by providing relevant, timely data to staff across our 100 treatment teams. In the process, the department is also documenting Thresholds’ performance as we move to value-based care in an increasingly competitive health care market.
Behavioral Health Providers Poised to Lead
Specialty behavioral health providers like Thresholds historically have utilized person-centered, trusting relationships and done whatever is needed to support individuals with complex social and health needs. These providers have served a valuable function within the healthcare system for many years by disrupting the cycle of high-cost and inappropriate institutional care like emergency rooms, hospitals, and jails. Our approach helps people with serious mental illnesses live successfully in the community. Community behavioral health care providers like Thresholds are poised to take the lead in the shift to value-based care by continuing to improve outcomes and document value, two activities that depend on harnessing data.
As calls increase to transform the health care delivery system from one designed to treat acute conditions to one that is also able to treat chronic conditions, including behavioral health conditions, community behavioral health providers have a lot to offer as both partners and leaders. Evidence increasingly shows that health outcomes are improved by employing intensive, evidence-based practices to activate patients to work toward health goals and lifestyle modifications.
Data Helps You Stand Out in a Competitive Healthcare Market
As insurers and hospitals are encouraged to work towards better outcomes, increased efficiency, and better quality care, they are looking to behavioral health providers for guidance and partnerships, and Thresholds is positioned to play that role. One way to prepare for and attract such healthcare partnerships is to identify the most complex patients and examine operational and care processes. We gathered data to identify those who were experiencing frequent inpatient re-admissions for reasons like unmanaged diabetes, blood pressure, or schizophrenia, targeting groups whose improvements would impact both social and health sector systems. While re-admissions and volume of services used is not the only way to define high need, it allows providers to start with a small, high acuity group (4% in Thresholds’ case) who with better support in managing their illness would also reduce costs for the larger health system.
Data Improves Quality of Care
To help our teams work most effectively with high-need patients and to measure our performance in doing so, Thresholds Evaluation Department created interactive dashboard reports that merge Medicaid claims data with Thresholds electronic health care data so that we can track outcomes over time for clients who are struggling with managing their multiple conditions. These semi-automated reports allow teams to better manage their caseloads based on need, ask different questions about the most high-need patients, and make decisions about clinical intervention effectiveness over time by tracking frequency of emergency room visits, hospitalizations, and incarcerations.
Doing this improves outcomes, orients staff to value-based care, and will contribute to a generation of new best-practices in engaging and supporting individuals with the most complex needs. Behavioral health specialty providers have a long history of addressing the social determinants of health as the first and most important step in engaging and treating serious mental health conditions. Indeed, such providers have incredible skill in building trusting relationships, linking individuals to and helping them maintain housing, and providing care management to those who have not been able to access or have not been well engaged in other healthcare settings. Through the use of data to inform front-line practice and client care, Thresholds is making strides in demonstrating our commitment to helping the most high-need clients who are shared across social and health sectors. Thresholds’ Evaluation Department is happy to discuss the design of these interactive dashboards – and will continue to partner with Thresholds clinical staff to refine and optimize them for clinical use.
Kristin Davis, PhD, is the Director of Evaluation at Thresholds, where she leads information-based decision making and uses data to improve organizational performance. She has also designed and led grant-funded research studies for Thresholds, with a focus on integrated healthcare and wellness.
We are encouraged by the Trump Administration’s announcement yesterday on the creation of the Commission on Combating Drug Addiction and the Opioid Crisis aimed at addressing the nation’s growing opioid epidemic. In 2015, opioid overdoses claimed the lives of more than 33,000 Americans. We must tackle this epidemic with a full commitment to evidence-supported treatment.
However, the Administration’s plan to gut Medicaid (the primary payer in the U.S. for substance use and mental health treatment) by $880 billion over the next ten years, along with its proposal to cut $5.8 billion from the National Institute of Health (the federal agency charged with research on new treatment approaches), hardly squares with a commitment to addressing the opioid epidemic. An estimated 24 million Americans would lose healthcare coverage (and access to substance use treatment) under the Administration’s recent push to repeal and replace the Affordable Care Act.
We urge the Commission to build upon the bipartisan support for the 21st Century Cures Act which was signed into law last year to strengthen research on innovative and evidence-based therapies and treatments. We also invite the Commission to work from the Surgeon General’s most recent report, which explores in detail substance use and addiction in America and what can be done in policy and practice to address it. And lastly, we call upon the Administration to appoint a director to lead the White House Office on National Drug Control Policy, a critical partner to the Commission as it embarks on its charge.
While we are encouraged by the President’s willingness to establish a commission dedicated to addressing the opioid epidemic, in order to make a real difference the Administration must also demonstrate its commitment to access to health coverage and evidence-supported treatment for the millions of people across our country living with an opioid addiction.
Donor Spotlight – Otho S.A. Sprague Memorial Institute
Thresholds is excited to feature the Otho S.A. Sprague Memorial Institute in this month’s Donor Spotlight. The Sprague Institute, established in 1911, is committed to investigating the cause of disease and pursuing the prevention and relief of human suffering throughout Chicago. Among their many early achievements, medical researchers from the Sprague Institute were involved with early trials of insulin, treatments for schizophrenia, and discovering the cause of scarlet fever.
More recently, the foundation has helped launch city-wide health initiatives like The Chicago Asthma Consortium, the Consortium to Lower Obesity in Chicago Children (CLOCC), and Healthy Chicago 2.0.
In addition to remaining at the forefront of medical research, the Sprague Institute is committed to supporting social services throughout the City of Chicago.
Thresholds is grateful to the Sprague Institute Board for their generous grant that will help implement an agency-wide call service center. Currently, individuals seeking to reach Thresholds have hundreds of phone numbers to choose from, representing our many sites, programs, and staff members. This new call center will be the single point of entry for all inquiries related to clinical, business, or operational services. Set to launch in October 2017, this updated, state-of-the-art call service center will improve our ability to meet the needs and requests of our diverse stakeholders more efficiently and effectively—enhancing service delivery to our more than 15,000 clients.
Thanks to the Sprague Institute’s generosity, Thresholds has the resources needed for this transformative improvement. We could not do this work without the support of funders like the Otho S.A. Sprague Memorial Institute!
Chicago, IL – Thresholds has stated that we oppose any national healthcare legislation that reduces the number of insured individuals or reduces Medicaid funding and benefits. More than 5,000 of our 15,000 clients gained coverage through Medicaid Expansion under the Affordable Care Act (ACA or Obamacare), all of whom are living with serious mental illnesses and complex medical needs.
Yesterday, many of our fears about the repeal of the ACA were confirmed. According to the analysis produced by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT), non-partisan governmental units, if the House Republicans’ plan (American Health Care Act, or AHCA) is passed an estimated 24 million Americans will lose health coverage by 2026. This will push the total number of uninsured Americans to 52 million. In the first year alone, 14 million Americans will lose coverage. The analysis from the CBO and JCT makes it clear that the biggest losers under the AHCA are older, sicker, and poorer Americans.
The analysis also shows a major federal disinvestment in Medicaid, the largest payer for mental health and substance use treatment, totaling $880 billion in cuts over a 10-year period. Federal cuts of this magnitude would result in hundreds of thousands of Illinoisans losing access to treatment and healthcare. Illinois would be hamstrung in its ability to address the opioid epidemic and undertake significant mental health reforms.
This is unacceptable. The proposed repeal of the ACA will be devastating to Illinois.
Last week House Republicans pushed a package of bills through Congressional committees in spite of the CBO and JCT not yet having completed their analysis. The premature passage of these bills out of committee puts us one step closer to the loss of health care coverage for millions living with mental health and substance use conditions.
Before the ACA, far too many living with mental health and substance use conditions were unable to access treatment until their illness had become debilitating. We can’t go back. Our elected officials must do better.
Mental health and substance use conditions are treatable and recovery is possible. Significant progress toward expanding access to treatment was made under the ACA. Now is not the time to pull the rug out from under those who are working to reclaim their lives.
As it stands, the AHCA is fundamentally flawed. We join advocates, providers, and those with lived experience across the country in calling upon the President and Congress to uphold their commitments to ensuring that all Americans have affordable coverage and access to the care they need.
To stay up to date on this and other public policy matters, please sign up for our mailing list. You can share your ACA story and get involved with our statewide coalition ProtectOurCareIL for additional updates and information on protecting health coverage and Medicaid.
MEDIA CONTACT – Emily Moen, Director of Public Relations and Marketing, 773-572-5172
Thresholds Joins Statewide Coalition Calling on Elected Officials to “Protect Our Care” and Stand Against Healthcare Repeal and Medicaid Caps
CHICAGO, IL – Today, Thresholds is pleased to be among the more than 50 organizations launching Protect Our Care Illinois, a statewide coalition of healthcare providers and advocates dedicated to preserving healthcare coverage and preventing caps to Medicaid. Protect Our Care Illinois is calling on our members of Congress to ensure that all Illinoisans have access to the care they need.
Earlier this year Congress took initial steps to repeal the Affordable Care Act (ACA), also known as Obamacare. As one of Illinois’ largest and longest serving community-based mental health and substance use treatment providers, Thresholds recognizes what an historic step forward the ACA has been for those living with mental health and substance use conditions. The landmark legislation did not simply expand healthcare coverage – it also established critical protections that ensure coverage for life-saving mental health and substance use treatment.
The repeal and replacement plan released by House Republican leadership last week not only jeopardizes the healthcare coverage of some 1.2 million Illinoisans newly insured under the ACA, including an estimated 348,000 living with mental health and substance use conditions, it also rolls back the clock on countless other critical protections. Among the protections at stake for those living with mental health and substance use conditions if Congressional Republicans continue to pursue repeal:
- Coverage for low-income individuals through Medicaid
- Prohibition on the denial of coverage because of a pre-existing condition
- Elimination of lifetime and annual limits
- Mandatory coverage of treatment by all insurance plans
Protect Our Care Illinois coalition members urge Illinois’ Representatives in Congress to publicly oppose a repeal of the ACA and any Medicaid block grant or per capita cap proposal. Both would disrupt access to care for millions and cause a devastating ripple effect throughout the healthcare system. Either block grants or per capita caps will result in federal spending cuts to Medicaid, limiting access to care and leaving Illinois unprepared to address the heroin and opioid epidemic as well as the unmet need for mental health treatment.
Illinoisans deserve better.
Thresholds is a lead organization for the Protect Our Care Illinois coalition along with: Access Living, ACLU of Illinois, AIDS Foundation of Chicago, Chicago Coalition for the Homeless, EverThrive Illinois, Health & Medicine Policy Research Group, Heartland Alliance, Illinois Coalition of Immigrant and Refugee Rights, Legal Council for Health Justice, SEIU Healthcare Illinois Indiana, and the Sargent Shriver National Center on Poverty Law.
For more information on the coalition, visit www.protectourcareil.org and follow the conversation on Twitter (@ProtectILCare) and Facebook (@ProtectOurCareIL). Use the hashtag #ProtectOurCareIL to join in the discussion.
Press Contact: Emily Moen, Director of Public Relations and Marketing, 773-572-5172
Chicago, IL – The annual budget address serves as an opportunity for the governor to present his financial plan for our state for the year ahead. Today, Governor Rauner gave his third budget address since taking office in 2015. While we too are encouraged by the Senate coming together on a bipartisan basis to build cooperation and achieve a balanced budget, unfortunately, much uncertainty remains.
For nearly two years, Illinois has not had a complete budget. As a result, Thresholds, like dozens of other healthcare and human service providers, has been forced to tap into reserves, extend lines of credit, and lay off staff in an effort to stay afloat and preserve access to life-saving treatment.
This is unacceptable. No other state in the nation operates in such an unsustainable fashion. Illinois deserves better.
With each passing day, our state’s fiscal stability becomes increasingly more tenuous and providers’ ability to deliver care, housing, and so many other critical services becomes more at risk. The budget crisis cannot be allowed to continue. The livelihood of too many hangs in the balance.
Not only do we as healthcare and human service providers ensure that Illinoisans get what they need to live their best lives, but we generate an estimated $4.5 billion in spending annually and employ tens of thousands in communities across the state. Of 429 social services agencies surveyed statewide by the United Way last summer, 45% of respondents have been forced to lay off staff, up from 24% in January 2016. This trend will continue until a fully-funded budget is passed and providers are paid on time and in full. Until then, our state will continue to lose vital jobs in an industry that employs thousands of Illinoisans who work to support the elderly, the disabled, and those living with mental health and substance use conditions, among others.
The budget crisis must end. We join countless others from Chicago to Carbondale and from Macomb to Urbana imploring the Governor and members of the General Assembly to act responsibly and in the best interest of those they represent by passing a full budget along with the revenue necessary to support vital public investments, today and in the years to come.
During this incredibly difficult time, the leadership of the Governor and state legislature is needed now more than ever. We agree that the Governor and state lawmakers “have a moral obligation to work together to bring change… [and] return Illinois to hope, opportunity, and prosperity,” as the Governor said today. The future of the state rests in their hands and we are all counting on them to do what is needed to right the course.
MEDIA CONTACT: Emily Moen, Director of Public Relations and Marketing, 773-572-5172