101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB3385

 

Introduced 2/14/2020, by Sen. Heather A. Steans

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Creates the Mental Health and Substance Use Disorder Rate Equity Act. Provides that, beginning in 2023, and every State fiscal year thereafter, the General Assembly shall appropriate sufficient funds to the Department of Human Services to ensure grants to community-based prevention organizations and providers of mental health and substance use disorder treatment under community service grant programs will be adjusted upward by an amount equal to the Consumer Price Index-U from the previous year, not to exceed 2% in any State fiscal year. Requires similar appropriations to be made to increase the reimbursement rates for certified community mental health centers and behavioral health clinics and licensed or certified community-based substance use disorder treatment providers. Amends the Substance Use Disorder Act. Requires the Department of Human Services to implement incremental rate increases for all community-based substance use disorder treatment and intervention services beginning July 1, 2020 and every State fiscal year thereafter. Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department to implement incremental rate increases for all community-based mental health treatment services beginning July 1, 2020 and every State fiscal year thereafter. Amends the Illinois Public Aid Code. Provides that, beginning on July 1, 2020, reimbursement rates, for psychiatric and behavioral health services provided by community mental health centers or behavioral health clinics shall be increased by 9%. Requires incremental rate increases beginning July 1, 2021 and every State fiscal year thereafter. Amends the Illinois Administrative Procedure Act. Permits the Departments of Human Services and Healthcare and Family Services to adopt emergency rules. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB3385LRB101 18462 KTG 67910 b

1    AN ACT concerning mental health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Mental
5Health and Substance Use Disorder Rate Equity Act.
 
6    Section 5. Findings. The General Assembly finds that:
7    (1) A March 2019 report by the USC Schaeffer Center for
8Health Policy & Economics estimates the following for the State
9of Illinois: almost 951,066 adults in Illinois experienced
10serious psychological distress in the past 12 months.
11    (2) People who experienced serious psychological distress
12in the past 12 months are more likely to abuse or be dependent
13on alcohol or illicit drugs during that same time period.
14    (3) In Illinois, 28.6% of people with serious mental
15psychological distress have an unmet need of mental health
16treatment.
17    (4) In Illinois, 33.3% of people with serious psychological
18distress and an unmet need of mental health treatment did not
19receive this treatment due to costs.
20    (5) In the Medicaid and uninsured population, a higher
21percentage of adults, 14% and 11.6% respectively, in Illinois
22reported serious psychological distress during the past year
23compared to people with Medicare, Veterans, or private health

 

 

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1insurance coverage.
2    (6) Hospital costs in the U.S. and Illinois ranged from
3$5,000 to $9,000 per stay for patients with serious mental
4illness.
5    (7) Total hospital costs in Illinois for hospitalizations
6for serious mental illness together exceeded $360,000,000 in
72014.
8    (8) Illinois' mental health agency spends a very low per
9capita amount, $77 on mental health services, compared to the
10rest of the U.S., $133.
11    (9) There are 13.8 behavioral health care professionals for
12every 10,000 residents in Illinois, which is significantly
13lower than the average, 21.4, in the U.S.
14    (10) The number of behavioral health care professionals
15needed to remove the shortage designation in Health
16Professional Shortage Areas is high in all states surrounding
17Illinois, especially in rural areas. However, Illinois has seen
18the highest increase, +215%, in these shortages between 2017
19and 2019.
20    (11) In Illinois state prisons, approximately 18% of prison
21inmates, or 7,883 inmates, have been previously diagnosed with
22a serious mental illness, compared to the overall U.S. prison
23population, 22%.
24    (12) The economic burden of schizophrenia, bipolar
25disorder, and major depressive disorder in adults in Illinois
26is estimated to be at least $1,400,000,000 for each serious

 

 

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1mental illness.
2    (13) NAMI Illinois reports that youth mental health is
3worsening. Rates of youth depression increased from 8.5% in
42011 to 11.1% in 2014.
5    (14) In 2019, the Journal of Community Health found that
6suicide rates are disproportionately higher among African
7American adolescents. From 2001 to 2017, the rate for African
8American teen boys rose 60%, according to the study. Among
9African American teen girls, rates nearly tripled, rising by an
10astounding 182%. Illinois was among the 10 states with the
11greatest number of African American adolescent suicides
12(2015-2017).
13    (15) In 2017, according to the National Institute on Drug
14Abuse, there were 2,202 drug overdose deaths involving opioids
15in Illinois - a rate of 17.2 deaths per 100,000 persons, which
16is higher than the national rate of 14.6 deaths per 100,000
17persons. The greatest increase in opioid deaths was seen in
18cases involving synthetic opioids (mainly fentanyl): a rise
19from 127 deaths in 2014 to 1,187 deaths in 2017. Deaths
20involving heroin also increased significantly in the same
213-year period: from 844 to 1,251 deaths. There were 623 deaths
22involving prescription opioids in 2017, nearly double the 343
23deaths in 2014.
24    (16) In the State Fiscal Year 2020 budget, the General
25Assembly provided a rate increase for behavioral health care
26services of 2.5%, which is insufficient to meet costs of

 

 

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1Illinois' $15 minimum wage increase alone.
2    (17) Good mental health allows people to feel good about
3life, helping people accomplish their goals and participate in
4their communities. To promote the prosperity of all
5Illinoisans, we need to invest in our State's mental health and
6addiction treatment services. When we improve programs and
7services that help all Illinoisans establish stable mental
8health and well-being, we contribute to everyone's
9prosperity-both now and in the future. Increasing our
10investments in behavioral health prevention and early
11intervention now will help ensure that we establish the
12foundation of a strong future for our State and everyone in it.
 
13    Section 10. Funding for community-based prevention
14organizations and providers of mental health and substance use
15disorder treatment. Beginning in 2023, and every State fiscal
16year thereafter, the General Assembly shall appropriate
17sufficient funds to the Department of Human Services to ensure
18grants to community-based prevention organizations and
19providers of mental health and substance use disorder treatment
20under community service grant programs for mental health and
21substance use disorder prevention will be adjusted upward by an
22amount equal to the Consumer Price Index-U from the previous
23year, not to exceed 2% in any State fiscal year. If there is a
24decrease in the Consumer Price Index-U, rates shall remain
25unchanged for that State fiscal year.

 

 

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1    For the purposes of this Section, "consumer price index-u"
2means the index published by the Bureau of Labor Statistics of
3the United States Department of Labor that measures the average
4change in prices of goods and services purchased by all urban
5consumers, United States city average, all items, 1982-84 =
6100.
 
7    Section 15. Funding for certified community mental health
8centers and behavioral health clinics. Beginning in 2023, and
9every State fiscal year thereafter, the General Assembly shall
10appropriate sufficient funds to the Department of Human
11Services to ensure reimbursement rates for certified community
12mental health centers and behavioral health clinics under
13community service grant programs for persons with mental
14illness will be adjusted upward by an amount equal to the
15Consumer Price Index-U from the previous year, not to exceed 2%
16in any State fiscal year. If there is a decrease in the
17Consumer Price Index-U, rates shall remain unchanged for that
18State fiscal year. The Department shall adopt rules, including
19emergency rules under Section 5-45.1 of the Illinois
20Administrative Procedure Act, to implement the provisions of
21this Section.
22    For the purposes of this Section, "consumer price index-u"
23means the index published by the Bureau of Labor Statistics of
24the United States Department of Labor that measures the average
25change in prices of goods and services purchased by all urban

 

 

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1consumers, United States city average, all items, 1982-84 =
2100.
 
3    Section 20. Funding for licensed or certified
4community-based substance use disorder treatment providers.
5Beginning in 2023, and every State fiscal year thereafter, the
6General Assembly shall appropriate sufficient funds to the
7Department of Human Services to ensure reimbursement rates for
8licensed or certified community-based substance use disorder
9treatment providers under community service grant programs for
10persons with substance use disorders will be adjusted upward by
11an amount equal to the Consumer Price Index-U from the previous
12year, not to exceed 2% in any State fiscal year. If there is a
13decrease in the Consumer Price Index-U, rates shall remain
14unchanged for that State fiscal year. The Department shall
15adopt rules, including emergency rules under Section 5-45.1 of
16the Illinois Administrative Procedure Act, to implement the
17provisions of this Section.
18    For the purposes of this Section, "consumer price index-u"
19means the index published by the Bureau of Labor Statistics of
20the United States Department of Labor that measures the average
21change in prices of goods and services purchased by all urban
22consumers, United States city average, all items, 1982-84 =
23100.
 
24    Section 25. Illinois Administrative Procedure Act is

 

 

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1amended by adding Section 5-45.1 as follows:
 
2    (5 ILCS 100/5-45.1 new)
3    Sec. 5-45.1. Emergency rulemaking; Departments of
4Healthcare and Family Services and Human Services. To provide
5for the expeditious and timely implementation of provisions of
6the Mental Health and Substance Use Disorder Rate Equity Act,
7Section 55-30 of the Substance Use Disorder Act, Section 75 of
8the Mental Health and Developmental Disabilities
9Administrative Act, and Section 5-5.05a of the Illinois Public
10Aid Code, emergency rules may be adopted in accordance with
11Section 5-45 by the respective Department. The adoption of
12emergency rules authorized by Section 5-45 and this Section is
13deemed to be necessary for the public interest, safety, and
14welfare.
15    This Section is repealed on January 1, 2026.
 
16    Section 30. The Substance Use Disorder Act is amended by
17changing Section 55-30 as follows:
 
18    (20 ILCS 301/55-30)
19    Sec. 55-30. Rate increase.
20    (a) The Department shall by rule develop the increased rate
21methodology and annualize the increased rate beginning with
22State fiscal year 2018 contracts to licensed providers of
23community-based substance use disorder intervention or

 

 

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1treatment, based on the additional amounts appropriated for the
2purpose of providing a rate increase to licensed providers. The
3Department shall adopt rules, including emergency rules under
4subsection (y) of Section 5-45 of the Illinois Administrative
5Procedure Act, to implement the provisions of this Section.
6    (b) (Blank) Within 30 days after June 4, 2018 (the
7effective date of Public Act 100-587), the Division of
8Substance Use Prevention and Recovery shall apply an increase
9in rates of 3% above the rate paid on June 30, 2017 to all
10Medicaid and non-Medicaid reimbursable service rates. The
11Department shall adopt rules, including emergency rules under
12subsection (bb) of Section 5-45 of the Illinois Administrative
13Procedure Act, to implement the provisions of this subsection
14(b).
15    (c) Beginning on July 1, 2020, the Division of Substance
16Use Prevention and Recovery shall increase reimbursement rates
17for all community-based substance use disorder treatment and
18intervention services by 9%. On July 1, 2021, such rates shall
19be increased by 7%. On July 1, 2022, such rates shall be
20increased by 5%. Beginning in 2023, and every State fiscal year
21thereafter, reimbursement rates for those community-based
22substance use disorder treatment and intervention services
23shall be adjusted upward by an amount equal to the Consumer
24Price Index-U from the previous year, not to exceed 2% in any
25State fiscal year. If there is a decrease in the Consumer Price
26Index-U, rates shall remain unchanged for that State fiscal

 

 

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1year. The Department shall adopt rules, including emergency
2rules under Section 5-45.1 of the Illinois Administrative
3Procedure Act, to implement the provisions of this Section.
4    For the purposes of this subsection, "consumer price
5index-u" means the index published by the Bureau of Labor
6Statistics of the United States Department of Labor that
7measures the average change in prices of goods and services
8purchased by all urban consumers, United States city average,
9all items, 1982-84 = 100.
10(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
11100-759, eff. 1-1-19; 101-81, eff. 7-12-19.)
 
12    Section 35. The Mental Health and Developmental
13Disabilities Administrative Act is amended by changing Section
1475 as follows:
 
15    (20 ILCS 1705/75)
16    Sec. 75. Rate increase. Beginning on July 1, 2020, the
17Division of Mental Health shall increase reimbursement rates
18for all community-based mental health treatment services by 9%.
19On July 1, 2021 such rates shall be increased by 7%. On July 1,
202022, such rates shall be increased by 5%. Beginning in 2023,
21and every State fiscal year thereafter, reimbursement rates for
22those community-based mental health treatment services shall
23be adjusted upward by an amount equal to the Consumer Price
24Index-U from the previous year, not to exceed 2% in any State

 

 

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1fiscal year. If there is a decrease in the Consumer Price
2Index-U, rates shall remain unchanged for that State fiscal
3year. The Department shall adopt rules, including emergency
4rules under Section 5-45.1 of the Illinois Administrative
5Procedure Act, to implement the provisions of this Section.
6Within 30 days after July 6, 2017 (the effective date of Public
7Act 100-23), the Division of Mental Health shall by rule
8develop the increased rate methodology and annualize the
9increased rate beginning with State fiscal year 2018 contracts
10to certified community mental health centers, based on the
11additional amounts appropriated for the purpose of providing a
12rate increase to certified community mental health centers,
13with the annualization to be maintained in State fiscal year
142019. The Department shall adopt rules, including emergency
15rules under subsections (y) and (bb) of Section 5-45 of the
16Illinois Administrative Procedure Act, to implement the
17provisions of this Section.
18    For the purposes of this Section, "consumer price index-u"
19means the index published by the Bureau of Labor Statistics of
20the United States Department of Labor that measures the average
21change in prices of goods and services purchased by all urban
22consumers, United States city average, all items, 1982-84 =
23100.
24(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18.)
 
25    Section 40. The Illinois Public Aid Code is amended by

 

 

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1changing Section 5-5.05a and by adding Section 41 as follows:
 
2    (305 ILCS 5/5-5.05a)
3    Sec. 5-5.05a. Reimbursement rates; community mental health
4centers.
5    (a) Notwithstanding the provisions of any other law,
6reimbursement rates, including enhanced payment rates and rate
7add-ons, for psychiatric and behavioral health services
8provided in or by community mental health centers licensed or
9certified by the Department of Human Services shall not be
10lower than the rates for such services in effect on November 1,
112017. The Department of Healthcare and Family Services shall
12apply for any waiver or State Plan amendment, if required, to
13implement the reimbursement rates established in this Section.
14Implementation of the reimbursement rates shall be contingent
15on federal approval.
16    (b) Beginning on July 1, 2020, reimbursement rates,
17including enhanced payment rates and rate add-ons, for
18psychiatric and behavioral health services provided in or by
19community mental health centers or behavioral health clinics
20licensed or certified by the Department of Human Services or
21the Department of Healthcare and Family Services shall be
22increased by 9%. On July 1, 2021 such rates shall be increased
23by 7%. On July 1, 2022, such rates shall be increased by 5%.
24Beginning in 2023, and every State fiscal year thereafter,
25reimbursement rates for community mental health centers or

 

 

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1behavioral health clinics licensed or certified by the
2Department of Human Services or the Department of Healthcare
3and Family Services shall be adjusted upward by an amount equal
4to the Consumer Price Index-U from the previous year, not to
5exceed 2% in any State fiscal year. If there is a decrease in
6the Consumer Price Index-U, rates shall remain unchanged for
7that State fiscal year. The Department of Healthcare and Family
8Services shall adopt rules, including emergency rules under
9Section 5-45.1 of the Illinois Administrative Procedure Act, to
10implement the provisions of this Section.
11    For the purposes of this subsection, "consumer price
12index-u" means the index published by the Bureau of Labor
13Statistics of the United States Department of Labor that
14measures the average change in prices of goods and services
15purchased by all urban consumers, United States city average,
16all items, 1982-84 = 100.
17(Source: P.A. 100-587, eff. 6-4-18.)
 
18    (305 ILCS 5/41 new)
19    Sec. 41. Reimbursement rates; substance use disorder
20treatment providers and facilities. Beginning on July 1, 2020,
21the Department of Human Services' Division of Substance Use
22Prevention and Recovery shall increase reimbursement rates by
239% for all community-based substance use disorder treatment
24services. On July 1, 2021 such rates shall be increased by 7%.
25On July 1, 2022, such rates shall be increased by 5%. Beginning

 

 

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1in 2023, and every State fiscal year thereafter, reimbursement
2rates for those community-based substance use disorder
3treatment services shall be adjusted upward by an amount equal
4to the Consumer Price Index-U from the previous year, not to
5exceed 2% in any State fiscal year. If there is a decrease in
6the Consumer Price Index-U, rates shall remain unchanged for
7that State fiscal year. The Department shall adopt rules,
8including emergency rules under Section 5-45.1 of the Illinois
9Administrative Procedure Act, to implement the provisions of
10this Section.
11    For the purposes of this Section, "consumer price index-u"
12means the index published by the Bureau of Labor Statistics of
13the United States Department of Labor that measures the average
14change in prices of goods and services purchased by all urban
15consumers, United States city average, all items, 1982-84 =
16100.
 
17    Section 99. Effective date. This Act takes effect upon
18becoming law.

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    New Act
4    5 ILCS 100/5-45.1 new
5    20 ILCS 301/55-30
6    20 ILCS 1705/75
7    305 ILCS 5/5-5.05a
8    305 ILCS 5/41 new