- PNC is proud to support Business Forward, where community leaders discuss the issues confronting business in Central Illinois.

(exciting music) - Welcome to Business Forward.

I am your host, Matt George, joining me tonight, Debbi Smith.

Debbi is the Executive Director of the Community and Residential Service Authority for the State of Illinois.

Welcome, Debbi.

- Thank you.

- Well, let's start off with you and then we're gonna get into what CRSA does.

But are you from Illinois?

Have you been here your whole life?

- Pretty much, yes.

Pretty much born and raised here, I love Illinois.

- I've volunteered on the past few years in a committee and board capacity with CRSA, and knowing what you do and your team does for all communities of Illinois is admirable, but I wanna start off with the mental health field.

You being in this position for many years as a clinician.

How long have you been in the business?

- Well, gosh, over 30, about 35 years in the mental health field.

- [Matt] Did you always have the passion to want to help others?

Is that what drove you to get into this field?

- I think so.

I think, you know, looking at, just looking at the state of affairs for children, I think initially when I was to college, I was really interested in working in business management.

That was when participative management was real big and quickly learned that my heart was with social services.

So I kind of found a way to blend my passion for organizing things with being able to serve, I kind of focused on children, and been able to focus at that point on doing social services for kids, but also being in administrative positions to help guide services for those children.

- You know, CRSA is kind of a hidden gym, even though it's been around a while.

And why don't you as executive director, I know you made a big announcement recently.

You're actually retiring and you're gonna be training a replacement.

And so, first of all, all those years, thank you for your service.

We need more people like you.

- You're so welcome.

- So as the executive director of CRSA, what does the community and residential services authority do?

- Well, we are an inter agency group.

It's made up of different agencies within the State of Illinois.

We serve children who are kind of stuck in the service systems, the ones that need help, but can't quite find a way to get the right services for them.

So 1985, CRSA was created, which is the Community and Residential Services Authority.

It originally started looking at youth that weren't able to get access to residential care, which residential care means services that are therapeutic in nature, that they would have to live away from home for a while in order to get 24/7 interventions to get better so they can go home.

And at that time there were some glitches and there still are quite honestly in the system.

And so the state legislature said, you know, there are way too many, way too many avenues for youth to get help, but there's also a lot of avenues where they get lost in the shuffle.

So they created the community and residential services authority to do that.

And it's an active board.

I'd be glad to tell you more about that if you wanna know more about the board, the makeup of the board and what the mission of the community and residential services has become.

- Yeah, let's talk about mission and then we'll go to the board.

- Okay.

So really our mission is to promote a network of resources for kids in Illinois that have social and emotional difficulties.

They also have educational problems along with that typically.

And we really, our goal is to help them receive services in a timely fashion.

And then of course in the vision would be that this is going to help them.

It's gonna help our state.

It's gonna help our country.

It's gonna help overall just society when these kids are able to fully participate and realize their potential in society.

So we get 'em early enough and help them quick enough.

I think that's a good vision for any entity that's helping kids.

- And so from, I know you have a team and it's a mighty team, but it's a small team.

And so you have a lot of things coming at you from just about every community in the state.

How does your team handle all of the stress of being able to handle what I'm guessing are many, many cases that are coming their way?

- Yes.

We have a small team.

We have a small budget, we're tucked away, again, we were created by the state legislature to do this.

So the majority of my team are spread across the state of Illinois, have four people that serve the entire state.

We're going to serve about 350 kids this year.

And the kind of, when you talked about stress, I mean the kind of stress that families are under, and what they're facing, I think is what helps our team stay focused and interested in the mission of CRSA 'cause we have a lot of children who have physical aggression as the number one presenting issue, and then they have multiple mental health diagnoses.

So these aren't the kids that fit nicely in any one system.

So there's a lot of work on behalf of a regional coordinator, which is what we call our staff that serve the State of Illinois.

- And so they would be in the Southern region, different regions, and then they would handle that caseload, so to speak, of whatever comes their way.

- Yes, typically we divide it up to four quadrants of the State of Illinois.

Of course, Cook County is kind of an entity unto itself.

We do have some of the Northern Illinois coordinators assist with serving the Collar counties around Cook.

- Okay.

And so when you're talking about the board, there's board members that are, why don't you explain the makeup of it because I really find this piece interesting.

- It is interesting.

It's interesting that the state legislature had the foresight to develop the community and residential services authority.

Because before that, there really wasn't partly any entity that was looking into the service gaps and the glitches that families run into.

And they're trying to get the services for their kids that they need.

So the legislature said, okay, we're gonna create the CRSA and we're gonna have four representatives from the House and Senate Elementary and Secondary Education Committee.

Those are called our legislative designees.

We have six representatives on our board from the governor's office.

The attorney general has a representative, DCFS, Department of Children and Family Services has a rep, Department of Healthcare and Family Services, Illinois State Board of Ed, Department of Juvenile Justice, Department of Human Services has four divisions that serve on our board.

And that would be division of mental health, developmental disabilities, rehab services, and the division of family and community services.

So that's our board.

And then again, there's an executive director, there's support staff, and then our regional coordinators that serve the state.

So that's pretty much how we're, how we're made and what we consist of.

- Yeah.

And I think one of the things that I'll say from a positive standpoint is to get all these entities into one room is a feat, and it's so positive to hear, like when you hear the State Board of Education working in collaboration with DCFS, or whatever it may be, it's many, many combos, but I always give the teammates, the staff at each one of these entities, state entities, a lot of credit because this business is hard and there are systematic issues as you know, that are uncontrollable by many people, but the caring and that empathetic piece.

And I think that piece, and maybe I'm putting words in your mouth, but I've heard you talk about it before.

If you don't have that empathy or that care in your heart for these kids in our families, you're probably in the wrong business.

And I think there's a lot of great people that work in this business that don't get a lot of credit.

- Absolutely.

We are fortunate to have the opportunity to work with individuals through all these state agencies that are willing to roll their sleeves up and figure out how to best serve a family and a child.

I think there's a famous quote that this business isn't for sissys or, you know, getting old is not for sissys, but this business isn't for sissys either, because it takes a lot of work, a lot of dedication, and you have to follow up because I think that's where we lose it sometimes without doing the follow up.

So the individuals that we work with are always willing to have us call and say, how's this working out?

Is this child getting what they need?

What else can we do?

And come to, oftentimes CRSA staff will call meetings, multiple agency meetings, and everyone's willing to jump in and see what they can do from the school districts to the social service agencies.

We have a variety of individuals that should be getting crowns instead of the thorns that they get.

- I agree with that.

I mean, I was given a talk a couple weeks ago and I was talking about that people in the social service industry and people with that work at these entities, they really never get a pat on the back.

And it's not like Debbi Smith, you're trying, you're sitting there over to the side saying, man, I just wish people would appreciate me more.

You're not saying that at all, 'cause you wouldn't be in the business to do it, but it is nice to know that there is a group that we do understand the stresses and the crises that go on, not only in our state, but in our country and that to put everyone's minds together, it's actually a very, very good, good feeling.

- It is, and I think that, when they, again, the individuals that we will call will consult with the different agencies and usually it's more than one agency.

So out of the ones that I read and we may have juvenile justice and healthcare and family services and DCFS involved in one case all at the same time.

So because there are services that need to be blended and a lot of work to be done.

And now with not as many resources as we have had in the past, it's even becomes more and more heroic in a way for these social workers to stay involved.

We've lost from 2017 to 2019 Illinois, the loss of resources and personnel to serve kids actually increased by 215%.

So we were one of Illinois is actually one of the states in the United States that has probably the least amount of direct service, mental health workers, or, you know, I know the agencies are trying very hard to build that back up, but we've lost a lot and it's difficult for the ones that are sticking with it, staying involved and trying to get through some serious situations where children need immediately to be helped and may or may not be getting access to that help.

- Yeah, I mean, to kind of piggyback on that comment.

I just urge people that are in college that look at this business as one of the most fulfilling businesses that you can be in because at the end of the day of every day that you're in this business, your heart can be filled or torn.

But knowing that you're on that front line of helping those kids, we need more people in this business throughout the state.

- Yes, and I think there's also been some initiatives now to make it more worth their while and recognize them as professionals, that they are to be getting the compensation they need to do their job.

- So you hear thrown around a lot, a child will have an individual service plan and it, obviously, the service plan for an individual, it speaks for what it is, but what really is it?

I mean, what's that deep dive of a plan look like if a child has one of those?

- So again, our focus is the children who have complex mental health needs or educational needs that have severe emotional disabilities.

So it's most often these youth will have some type of assessment and with that assessment comes a plan.

So once the plan comes into play, then there are individuals that need to enact the plan.

So I mean, it's really just pretty common sense.

But when you hear that term, it doesn't really make sense, and families, a lot of times will ask us, what does that mean?

And well, so, well, here's a course of events.

And if you (indistinct) the experts will predict and try to help you understand that this is most likely going to be the course that will best help your child.

- Yeah.

And I say that because I had a case once where someone couldn't quite understand it and it's almost like you're mapping out the best road for this child and family to become as independent or as good as they can be as possible, whether it's education or whether it's residential services or whatever it may be.

But it's here is the plan, and then the goal is integration back into your family or into your school district or whatever it may be.

And I think people, it's hard to understand too, when your child's going through a crisis or your family's going through a crisis.

- I mean, part of that planning too, I think that what people would probably want to know is that, well, what are they actually looking, you know, looking at my family, what are they actually trying to assess here?

And, you know, some of the things I pulled, what we look at is does the child present a danger to themself and others?

I mean, that's a biggie.

You need to assess that right away.

What kind of functioning do they have?

Their role functioning at school, in the community with their peers, other relationships with family.

So those are some things that you wanna look at, you wanna look at is the family able to maintain that child?

What kind of supports do they need in order to maintain that youth?

And so that's part of an assessment that becomes part of a plan.

And how many resources has this family actually been able to have access to?

And did they even know about the local mental health center and what they could do, or did they even know what might be available through developmental disability services or whatever that child needs.

So it's a matter of trying to assess the services, the level of care, and then to come up with an ultimate plan.

- It's just like any social service agency or Red Cross or whoever, you really don't.

A lot of times if you're floating along in life and everything's okay, and then all of a sudden crisis hits, and then you need something, it's almost like all of these places are hidden gems.

And I say that about CRSA.

And that's why I wanted you on the show today is because I wanted the communities to understand that there is help out there.

And so like when you saw the past couple years coming out of COVID and seeing, have you seen an uptick or increase in mental health issues?

I mean, you hear it all the time, but does the data back up everything that you're hearing?

- We're looking at that data.

And what I have for FY21 was that we definitely had an increase in a request for youth to go into residential care, that increased by at least 20% in our caseload.

It used to be the majority of requests that we received were for educational assistance for what's called an individual education plan, or to give an assessment for a plan.

And that switched to the largest portion of our request for FY21, which includes post COVID and during COVID were for residential treatment.

- [Matt] Okay.

- Kids were at home, the kind of kids we serve aren't the ones that are gonna zoom into their classroom.

And a lot of them aren't getting the social work that they needed.

They weren't getting access to some of those other educational supports they needed.

So we saw then, and it makes sense at the other end of the pendulum would be, it's like, if I can't get access to services, I can't even actually children weren't even able to see counselors in person at that time for mental health.

So then we saw an uptick definitely in the youth that we're presenting for residential treatment.

And these youth are the ones that are usually a danger to themselves or others, or have severe depression, suicide, or homicidal ideation.

- So you have someone on your staff, Lynn Louder, who works with a lot of the legislators.

How does somebody like that in that position, other than just experience, stay on top of all of the bills that are going through and all of the laws that are being enacted, how does that position stay on top of that?

- So she knows how to grab the laws that have issues concerning children, mental health, and then our code departments.

So those will kind of, she'll red flag those.

And then what she does is disseminate that to the board and to the staff, and then ask them to pick their top 10 legislative initiatives that we would most likely be interested and want to follow.

And so the board gives her the feedback and then I do and then our staff do, and then she follows that legislation, and then gives us updates on whether it passed or whether that's stalled or whatever.

- So she's actually boots on the ground sometimes in the capital or sometimes talking to a Senator, or whoever it may be trying to figure out what's gonna be the most biggest impact to families and youth.

- Yes.

And there are times when then once we get that information, then the board will determine whether or not they will support, they'll vote to decide whether they want to support some legislative initiatives.

So we've had that as well, so that they weigh in.

And if the board can't agree on what initiative to support, we do allow staff to independently, on their own, of course, be able to weigh in with supportive letters on things that they feel personally would benefit the children that we serve.

We just can't let them at that point, use the moniker of CRSA.

But typically we, I mean, many times we've had the board weigh in on very important legislation and emergency legislation.

And I think that's helpful because we've seen recommendations from the board on legislative initiatives that actually end up in the actual legislative language.

- How do you, I don't know whether you have mentors or, but as a leader that you've been for many years, how do you stay on top of everything and have these ideas that you kind of sometimes think, I might have to ask somebody, I mean, do you have mentors maybe past directors that you rely on?

- Yes.

I mean, I think, you know, I think that CRSA has done a good job of picking excellent board chairs.

So, I mean, you are one of our chairs and the ones that I've had in the past have been most excellent mentors.

They've kind of helped guide, there's several directions that we could go.

They help guide us in understanding what our initiative should be for the year.

And then we, again, we bring that to the board and the board help set the agendas for the big picture, which we'll be doing again at the end of this fiscal year and we'll be looking at strategic planning for next fiscal year and getting into some new initiatives that most likely will be something CRSA could, could bring to the state, and maybe be helpful in some way.

But yeah, that's kind of how we do it.

I start with a mentor, I start with saying, hey, you know, what if we did this, what would that look like?

And then the board chair, all of our board chairs, Dr. Seth Harkins, you, Gary Silvack, and John, and then of course I will call some of my old, one of the previous directors, John (indistinct) who's also been a good advisor, Tim Sike, I haven't been lacking for excellent advisors.

And I'm fortunate that our field has some sages that are still around that can help me out.

- Yeah, so how do you personally, when you see some of these cases, and I get asked this question a lot, like, how do you go home at night and not just think about these kids all the time?

Like how, what do you do to cope?

- Well, when I first started, when I was new into the social work field, I brought it home with me all the time.

So I had to learn how to separate when I walked away from my desk, when I walked away from my office, there were personal things that I had to learn to do.

And I think each of us have to, if you stay in this field very long of when you shut it off, one of the best coping mechanisms that I personally, I believe other than prayer, and a personal life with making sure I'm with my family and doing fun things and realizing that, you know, there's some normal things in this world too, that I don't have to get caught up in the abnormal things that happen to people.

But really one thing that helped me a lot, and one thing I tell my staff is if you don't need, sometimes we get into too much of the awfulizing and don't need to know the entire history.

Can we just let that go and deal with what we have here in front of us today?

- Well, I have to catch you off.

Let it go.

I appreciate you.

I appreciate what you do, Debbi.

I'm Matt George, and this is another episode of Business Forward.