Chestnut Health Systems outlines integrated care, warns Medicaid cuts would hit local patients

Randy Derek, community relations coordinator at Chestnut Health Systems, told the McLean County Board Health Committee on the organization’s November agenda that Chestnut operates 11 locations across three states and provides integrated primary care, mental health and substance-use services to a largely Medicaid population.

Chestnut “treat[s] 30,000 patients annually,” Derek said, and described the organization’s integrated “medical home” approach that coordinates behavioral health, primary care and dental care. He said Chestnut has about 820 employees and 13 service delivery sites and noted that the Chestnut Family Dental Center opened in 2024 with 10 operatories; between spring 2024 and spring 2025 the dental center treated 972 unduplicated patients.

The organization provides a full continuum of substance-use services short of local detox beds and works with drug court and recovery court programs. Derek said Chestnut serves as the statewide leadership center for the Recovery Oriented System of Care (ROSC) that offers technical assistance to county ROSCs across Illinois. “We have distributed 25,000 Narcan doses,” he added, citing the agency’s overdose-education and naloxone distribution efforts.

Derek emphasized Chestnut’s reliance on Medicaid. He said roughly 86% of patients at the Chestnut Family Health Center in ZIP code 61701 are Medicaid enrollees and noted county-level counts of about 11,000 Medicaid enrollees in 61701 and another roughly 7,300 in other Bloomington ZIP codes. When a committee member asked whether Chestnut could continue services if Medicaid funding were interrupted, Derek said the larger organization has reserve funds and other program revenue that would allow it to absorb a near-term funding gap, citing past state funding disruptions as precedent.

Committee members also asked about housing status among Chestnut clients; Derek said some unhoused clients are employed and that the health center sees clients during evening clinic hours to accommodate those who work daytime shifts.

Derek described county opioid settlement-funded naloxone vending machines and said the county map listing vending locations will be available at trustnet.org/narcan. He invited committee members to tour Chestnut facilities, including the dental clinic at 720 West Chestnut and a 50-person community meeting room at the family health center.

The committee did not take formal action on Chestnut’s presentation; the item was for information and discussion.