Like other states, Illinois’s public agencies provide services to the neediest citizens in the state. A recent study conducted by researchers at Chapin Hall suggests that comparatively few families consume the lion’s share of the state’s service resources. In other words, a relatively small number of families with multiple problems receive services of several types.

Researchers looked specifically at five services—mental health care, substance abuse treatment, foster care, adult incarceration, and juvenile incarceration—and at the records kept by the agencies administering the services. For mental health services and substance abuse treatment, the source of the data was Medicaid paid claims. The researchers also drew on state agency records in order to identify “family units.” The study population includes all families who have a substantiated case of abuse or neglect with the Illinois Department of Children and Family Services and those families with a woman aged 18-45 years who have received food stamps between January 1, 2007 and December 31, 2008 from the Illinois Department of Human Services. In this way, they identified a study population of 502,165 families. Of those families:

* 114,355 families (23%) received two or more types of services, and were called multisystem families.
* Multisystem families accounted for 292,973 (63%) of the “problems” for which services were provided.
* The 114,355 multisystem families use 86 percent of the fiscal resources.

A closer examination of the character of service overlap paints a more nuanced picture of the co-occurrence of problems among Illinois families. For example:

* Ninety-four percent of the multisystem families had received mental health services.
* Almost all (96%) of families who had experienced a juvenile incarceration also received other services; 95 percent of families receiving substance abuse treatment also received other services.
* Eighty-four percent of the multisystem families had either a substantiated report of abuse or neglect or an injury due to violence.

These findings have significant implications for the state’s overall budget and for considering how services might best be organized and provided. It is more important than ever—for all states—that resources be deployed efficiently and effectively. This type of analysis depends on having data that are linked across programs and over time. Illinois has made substantial investments in developing and analyzing this data. Yet, much work remains to be done as researchers attempt to gain a more complete understanding of the dynamics of service use.