The time period analyzed in this study spans several major policy changes that affected publicly provided services to disabled children in Illinois and nationwide. The most significant of these changes was the implementation of the Supreme Court's decision in the Zebley vs. Sullivan case. The Zebley decision, which expanded the list of disabling impairments and included a functional assessment in the disability determination for children, significantly increased the number of children receiving SSI nationwide.
Medicaid funded services in Illinois were also under going changes throughout this time period. In May of 1992, mental health services reimbursed by Medicaid were expanded in Illinois through the implementation of the Medicaid clinic/rehab option. For the first time, individuals could receive an array of Medicaid reimbursed mental health services (i.e. case management, crisis intervention, mental health assessment) from community mental health centers. Managed care was also being phased in to primary health care programs reimbursed by Medicaid. In May of 1993, the Healthy Morns/Healthy Kids Managed Care Program began in the City of Chicago after being started prior to May of 1993 in the downstate regions of Illinois. These changes are reflected in our analyst . Whenever possible, we note the policy change as well as highlight how they affected the patterns of service receipt.