102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB2314

 

Introduced 2/26/2021, by Sen. Sara Feigenholtz

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 100/5-170 new

    Provides that the Act may be referred to as the Community Mental Health Rule and Regulatory Modernization Act. Amends the Illinois Administrative Procedure Act. Changes the text of Sections of the Illinois Administrative Code pertaining to: community-based mental health service definitions and professional qualifications; program approval for specified behavioral health services; assertive community treatment; and community support teams. Effective immediately.


LRB102 15771 SSS 21138 b

 

 

A BILL FOR

 

SB2314LRB102 15771 SSS 21138 b

1    AN ACT concerning government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. This Act may be referred to as the Community
5Mental Health Rule and Regulatory Modernization Act. The
6purpose of this Act is to make rule and regulatory changes to
7the administrative rules that govern community mental health
8services to improve access to mental health care in Illinois.
 
9    Section 5. The Illinois Administrative Procedure Act is
10amended by adding Section 5-170 as follows:
 
11    (5 ILCS 100/5-170 new)
12    Sec. 5-170.
13    (a) Title 89, Part 140, Sections 140.453 through 140.455,
14and 140.TABLE N of the Illinois Administrative Code shall be
15revised for purposes of improving access to community mental
16health and behavioral health services:
17        (1) To enable services to begin immediately upon the
18    initiation of the comprehensive Integrated Assessment and
19    Treatment plan, Section 140.453(c)(1)(B) shall be amended
20    as follows: the word "completion" shall be replaced with
21    "initiation".
22        The following sentence shall be added at the end of

 

 

SB2314- 2 -LRB102 15771 SSS 21138 b

1    the subsection: "The Integrated Assessment and Treatment
2    Plan shall be completed within 45 days of initiation."
3        (2) To eliminate the over-assessment of individuals,
4    Section 140.453(d)(1)(A)(i) shall be revised by replacing
5    "every 180 days" with "annually".
6        (3) To reduce administrative barriers for individuals
7    being deinstitutionalized, Section 140.453(d)(4)(A)(iii)
8    shall be revised by adding the following sentence at the
9    end: "Prior authorizations for any individual
10    transitioning from an institutional setting to the
11    community under a deinstitutionalization consent decree to
12    which the State of Illinois is party who initially
13    qualifies and is authorized for ACT, shall be effective
14    for one year intervals with a sufficient number of units
15    of service being approved to meet a full year of medical
16    necessity."
17        (4) To reduce staff turn-over and improve the quality
18    of care for Team-Based MRO services, Section
19    140.453(d)(4)(A)(iv) shall be revised by adding the
20    following bullet: "An individual possessing a bachelor's
21    degree in counseling and guidance, rehabilitation
22    counseling, social work, education, vocational counseling,
23    psychology, pastoral counseling, family therapy or related
24    human service field with at least two years of documented
25    clinical experience in Team Based MRO Services under the
26    supervision of a QMHP."

 

 

SB2314- 3 -LRB102 15771 SSS 21138 b

1        (5) To reduce staff turn-over and improve the quality
2    of care for Team-Based MRO services, Section
3    140.453(d)(4)(B)(i) shall be revised by adding the
4    following at the end of the second bullet: "or an
5    individual possessing a bachelor's degree in counseling
6    and guidance, rehabilitation counseling, social work,
7    education, vocational counseling, psychology, pastoral
8    counseling, family therapy or related human service field
9    with at least two years of documented clinical experience
10    in Team Based MRO Services under the supervision of a
11    QMHP."
12        (6) To reduce administrative barriers to care for
13    individuals being deinstitutionalized, Section
14    140.453(d)(4)(B)(iii) shall be revised by adding the
15    following sentence at the end: "Prior authorizations for
16    any individual transitioning from an institutional setting
17    to the community under a deinstitutionalization consent
18    decree to which the State of Illinois is party who
19    initially qualifies and is authorized for CST, shall be
20    effective for one year intervals with a sufficient number
21    of units of service being approved to meet a full year of
22    medical necessity."
23        (7) To allow time for client volume to match start up
24    expenses of CST Teams, Section 140.TABLE N, (c)(1)(B)
25    shall be revised by adding the following language after
26    the word "following" and before the colon: "within six

 

 

SB2314- 4 -LRB102 15771 SSS 21138 b

1    months of the CST team being established".
2        (8) Section 140.TABLE N, (c)(1)(D)(ii) shall be
3    revised by:
4            (A) striking the word "lead",
5            (B) replacing the words "referring LPHA" with
6        "team lead", and
7            (C) replacing the word "monthly" with "quarterly".
8        (9) Section 140.TABLE N, (c)(1)(D)(iii) shall be
9    revised by replacing the term "LPHA" with "CST team lead".
10        (10) To fully utilize treating Advance Practice Nurses
11    (APNs) and partnerships with hospitals and Federally
12    Qualified Health Clinics in a time of a profound state and
13    national shortage of psychiatrists, Section 140.TABLE N,
14    (e)(1)(C)(ii) shall be revised by striking the last
15    sentence to enable the full utilization of treating APNs
16    employed or on contract with a CMHC. The following
17    sentence shall be added to the end of the subsection to
18    maximize provider partnerships for treating APNs and
19    psychiatrists: "A CMHC may enter into a written contract
20    with a Federally Qualified Health Clinic or hospital for
21    the psychiatric resource for the CMHC's ACT team."
22        (11) To allow time for client volume to match start up
23    expenses of ACT Teams, Section 140.TABLE N, (e)(1)(C)(iii)
24    shall be revised by adding the following before the colon:
25    "within six months of the ACT team being established".
26        (12) To eliminate clinical reviews that do not have

 

 

SB2314- 5 -LRB102 15771 SSS 21138 b

1    meaningful clinical value in patient care, Section
2    140.TABLE N, (e)(1)(E)(iii) shall be revised by:
3            (A) Replacing "monthly" with "quarterly",
4            (B) Replacing "psychiatrist" with "Psychiatric
5        Resource".
6        (13) To align team member roles with fidelity and best
7    practices, Section 140.TABLE N, (e)(1)(E)(iv) shall be
8    revised by replacing "Psychiatric Resource" with "Team
9    Lead".
10        (14) For purposes of addressing the behavioral health
11    workforce shortage, Section 140.453(d)(1)(A)(iii) shall be
12    revised by replacing "an LPHA" with "the direct supervisor
13    of the individual completing the IATP".
14    (b) Title 59, Chapter IV, Part 132 of the Illinois
15Administrative Code shall be amended as follows:
16    Title 59, Chapter IV, Part 132 shall be revised to be
17consistent with the changes made to Title 89, Part 140,
18Sections 140.453 through 140.455, and 140.TABLE N of the
19Illinois Administrative Code pursuant to this Act, including
20but not limited to the following:
21        (A) Section 132.135(c)(1) shall be revised by striking
22    the language and replacing it with the following:
23    "Supervision by a licensed clinician, as defined in
24    section 132.25, or an individual possessing a bachelor's
25    degree in counseling and guidance, rehabilitation
26    counseling, social work, education, vocational counseling,

 

 

SB2314- 6 -LRB102 15771 SSS 21138 b

1    psychology, pastoral counseling, family therapy or related
2    human service field with at least two years of documented
3    clinical experience in Team Based MRO Services under the
4    supervision of a QMHP, who is the team leader."
5        (B) Section 132.135(3) shall be revised by replacing
6    the language with the following: "Program support provided
7    by a psychiatrist or an advance practice nurse. A CMHC may
8    enter into a written contract with a Federally Qualified
9    Health Clinic or hospital for the psychiatric resource for
10    the CMHC's ACT team. Program support shall also include a
11    program administrative assistant."
12        (C) To allow time for client volume to match start up
13    expenses of ACT Teams, a Section 132.135(c)(7) shall be
14    added as follows: "Minimum staffing requirements of ACT
15    teams shall be met within six months of the ACT team being
16    established."
17        (D) Section 132.145(a) shall be revised by striking
18    the language and replacing it with the following:
19    "Demonstration of the ability to meet the minimum staffing
20    requirement that each team includes a minimum of three FTE
21    within six months of a CST team being established."
22        (E) Section 132.145(b) shall be revised by striking
23    the language and replacing it with the following:
24    "Demonstration of ability to meet the requirement to staff
25    the program with a QMHP or an individual possessing a
26    bachelor's degree in counseling and guidance,

 

 

SB2314- 7 -LRB102 15771 SSS 21138 b

1    rehabilitation counseling, social work, education,
2    vocational counseling, psychology, pastoral counseling,
3    family therapy or related human service field with at
4    least two years of documented clinical experience in Team
5    Based MRO Services under the supervision of a QMHP, who is
6    the full-time team leader and functions as a practitioner
7    on the team."
8    (c) The Department of Healthcare and Family Services and
9the Department of Human Services shall file the administrative
10rule changes required pursuant to this Section by no later
11than three months following the effective date of this
12amendatory Act of the 102nd General Assembly.
 
13    Section 99. Effective date. This Act takes effect upon
14becoming law.