HB5046 103RD GENERAL ASSEMBLY

LRB103 37749 RLC 67877 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5046

Introduced 2/8/2024, by Rep. Jenn Ladisch Douglass

SYNOPSIS AS INTRODUCED:

405 ILCS 100/10
405 ILCS 100/15
405 ILCS 100/35
405 ILCS 100/45 new

Amends the Psychiatry Practice Incentive Act. Provides that the Department of Public Health shall establish a Collaborative Care Demonstration Grant program and set criteria for the program. Provides that the Director of Public Health may establish a program, and criteria for the program, to provide grants, training, and technical assistance to eligible primary health care practices to support implementation of the program. Establishes the purposes and use of the grants. Provides that grants awarded under the program shall be for a minimum amount of $100,000. Provides that the minimum award amount shall increase by $1,000 per 1% share of patients to be seen by the awardee during the applicable grant period that are expected to be enrolled in Medicaid, up to $500,000 total per award. Provides that the Director of Public Health may solicit proposals from and enter into grant agreements with eligible collaborative care technical assistance centers to provide technical assistance to primary health care practices on providing behavioral health integration services through the psychiatric Collaborative Care Model, including, but not limited to, recipients of grants under the program. Provides that the Director of Public Health may develop and implement a public awareness campaign to raise awareness about the psychiatric Collaborative Care Model. Provides that the program is subject to appropriation. Defines terms. Effective July 1, 2024.

A BILL FOR

AN ACT concerning health.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Psychiatry Practice Incentive Act is amended by changing Sections 10, 15, and 35 and by adding Section 45 as follows:

(405 ILCS 100/10)

Sec. 10. Definitions. In this Act, unless the context otherwise requires:

"Collaborative care technical assistance center" means a health care organization that can provide educational support and technical assistance related to the psychiatric Collaborative Care Model, including an academic medical center.

"Department" means the Department of Public Health.

"Director" means the Director of Public Health.

"Designated shortage area" means an area designated by the Director as a psychiatric or mental health physician shortage area, as defined by the United States Department of Health and Human Services or as further defined by the Department to enable it to effectively fulfill the purpose stated in Section 5 of this Act. Such areas may include the following:

(1) an urban or rural area that is a rational area for the delivery of health services;

(2) a population group; or

(3) a public or nonprofit private medical facility.

"Eligible medical student" means a person who meets all of the following qualifications:

(1) He or she is an Illinois resident at the time of application for assistance under the program established by this Act.

(2) He or she is studying medicine in a medical school located in Illinois.

(3) He or she exhibits financial need, as determined by the Department.

(4) He or she agrees to practice full time in a designated shortage area as a psychiatrist for one year for each year that he or she receives assistance under this Act.

(5) He or she agrees to accept medical payments, as defined in this Act, and to serve targeted populations.

"Medical facility" means a facility for the delivery of health services. "Medical facility" includes a hospital, State mental health institution, public health center, outpatient medical facility, rehabilitation facility, long-term care facility, federally-qualified health center, migrant health center, community health center, community mental health center, or State correctional institution.

"Medicaid" means the medical assistance program defined in Article V of the Illinois Public Aid Code.

"Medical payments" means compensation provided to physicians for services rendered under Article V of the Illinois Public Aid Code.

"Medically underserved area" means an urban or rural area designated by the Secretary of the United States Department of Health and Human Services as an area with a shortage of personal health services or as otherwise designated by the Department of Public Health.

"Medically underserved population" means (i) the population of an urban or rural area designated by the Secretary of the United States Department of Health and Human Services as an area with a shortage of personal health services, (ii) a population group designated by the Secretary of the United States Department of Health and Human Services as having a shortage of personal health services, or (iii) as otherwise designated by the Department of Public Health.

"Primary health care physician" means a person licensed to practice medicine in all of its branches under the Medical Practice Act of 1987 with board eligibility or certification in the specialty of family medicine, internal medicine, pediatrics, obstetrics, gynecology, or geriatrics, as defined by recognized standards of professional medical practice.

"Primary health care practice" means a medical practice of primary health care physicians, including a practice within a larger health care system.

"Psychiatric Collaborative Care Model" means an evidence-based, integrated behavioral health service delivery method, which includes a formal collaborative arrangement among a primary care team consisting of a primary care provider, a care manager, and a psychiatric consultant as defined in Section 356z.39 of the Illinois Insurance Code.

"Psychiatric physician" means a person licensed to practice medicine in all of its branches under the Medical Practice Act of 1987 with board eligibility or certification in the specialty of psychiatry, as defined by recognized standards of professional medical practice.

"Psychiatric practice residency program" means a program accredited by the Residency Review Committee for Psychiatry of the Accreditation Council for Graduate Medical Education or the American Osteopathic Association.

"Targeted populations" means one or more of the following: (i) a medically underserved population, (ii) persons in a medically underserved area, (iii) an uninsured population of this State, and (iv) persons enrolled in a medical program administered by the Illinois Department of Healthcare and Family Services.

"Uninsured population" means persons who (i) do not own private health care insurance, (ii) are not part of a group insurance plan, and (iii) are not eligible for any State or federal government-sponsored health care program.

(Source: P.A. 96-1411, eff. 1-1-11.)

(405 ILCS 100/15)

Sec. 15. Powers and duties of the Department. The Department shall have all of the following powers and duties:

(1) To allocate funds to psychiatric practice residency and child and adolescent fellowship programs according to the following priorities:

(A) to increase the number of psychiatric physicians in designated shortage areas;

(B) to increase the percentage of psychiatric physicians establishing practice within the State upon completion of residency;

(C) to increase the number of accredited psychiatric practice residencies within the State; and

(D) to increase the percentage of psychiatric practice physicians establishing practice within the State upon completion of residency.

(2) To determine the procedures for the distribution of the funds to psychiatric residency programs, including the establishment of eligibility criteria in accordance with the following guidelines:

(A) preference for programs that are to be established at locations that exhibit potential for extending psychiatric practice physician availability to designated shortage areas;

(B) preference for programs that are located away from communities in which medical schools are located; and

(C) preference for programs located in hospitals that have affiliation agreements with medical schools located within the State.

In distributing such funds, the Department may also consider as secondary criteria whether or not a psychiatric practice residency program has (i) adequate courses of instruction in the child and adolescent behavioral disorder sciences; (ii) availability and systematic utilization of opportunities for residents to gain experience through local health departments, community mental health centers, or other preventive or occupational medical facilities; (iii) a continuing program of community oriented research in such areas as risk factors in community populations; (iv) sufficient mechanisms for maintenance of quality training, such as peer review, systematic progress reviews, referral system, and maintenance of adequate records; and (v) an appropriate course of instruction in societal, institutional, and economic conditions affecting psychiatric practice.

(3) To receive and disburse federal funds in accordance with the purpose stated in Section 5 of this Act.

(4) To enter into contracts or agreements with any agency or department of this State or the United States to carry out the provisions of this Act.

(5) To coordinate the psychiatric residency grants program established under this Act with other student assistance and residency programs administered by the Department and the Board of Higher Education under the Health Services Education Grants Act.

(6) To design and coordinate a study for the purpose of assessing the characteristics of practice resulting from the psychiatric practice residency programs including, but not limited to, information regarding the nature and scope of practices, location of practices, years of active practice following completion of residency and other information deemed necessary for the administration of this Act.

(7) To establish a program, and the criteria for such program, for the repayment of the educational loans of physicians who agree to (i) serve in designated shortage areas for a specified period of time, no less than 3 years, (ii) accept medical payments, as defined in this Act, and (iii) serve targeted populations to the extent required by the program. Payments under this program may be made for the principal, interest, and related expenses of government and commercial loans received by the individual for tuition expenses and all other reasonable educational expenses incurred by the individual. Payments made under this provision are exempt from State income tax, as provided by law.

(8) To require psychiatric practice residency programs seeking grants under this Act to make application according to procedures consistent with the priorities and guidelines established in items (1) and (2) of this Section.

(9) To adopt rules and regulations that are necessary for the establishment and maintenance of the programs required by this Act.

(10) To establish a Collaborative Care Demonstration Grant program and set criteria for the program, as described in Section 45.

(Source: P.A. 96-1411, eff. 1-1-11.)

(405 ILCS 100/35)

Sec. 35. Annual report. The Department may annually report to the General Assembly and the Governor the results and progress of all programs established under this Act.

The annual report to the General Assembly and the Governor must include the impact of programs established under this Act on the ability of designated shortage areas to attract and retain physicians and other health care personnel and integration of behavioral health care into primary care settings in designated shortage areas. The report shall include recommendations to improve that ability.

The requirement for reporting to the General Assembly shall be satisfied by filing copies of the report as required by Section 3.1 of the General Assembly Organization Act, and by filing such additional copies with the State Government Report Distribution Center for the General Assembly as is required under paragraph (t) of Section 7 of the State Library Act.

(Source: P.A. 99-933, eff. 1-27-17; 100-1148, eff. 12-10-18.)

(405 ILCS 100/45 new)

Sec. 45. Collaborative Care Demonstration Grants.

(a) The Director may establish a program and criteria for the program to provide grants, training, and technical assistance to eligible primary health care practices to support implementation of the psychiatric Collaborative Care Model.

(b) Grants awarded under subsection (a) may be used for one or more of the following purposes:

(1) hiring staff;

(2) identifying and formalizing contractual relationships with other health care providers, including providers who will function as psychiatric consultants and behavioral health care managers in providing behavioral health integration services through the psychiatric Collaborative Care Model;

(3) purchasing or maintaining software and other resources needed to appropriately provide behavioral health integration services through the Collaborative Care Model, including resources needed to establish a patient registry and implement measurement-based care; and

(4) for other purposes as the Director may determine to be necessary.

(c) Grants awarded under subsection (a) shall be for a minimum amount of $100,000. The minimum award amount under this subsection (c) shall increase by $1,000 per 1% share of patients to be seen by the awardee during the applicable grant period that are expected to be enrolled in Medicaid, up to $500,000 total per award.

(d) The Director may solicit proposals from and enter into grant agreements with eligible collaborative care technical assistance centers to provide technical assistance to primary health care practices on providing behavioral health integration services through the psychiatric Collaborative Care Model, including, but not limited to, recipients of grants described in subsection (a). The technical assistance center shall provide technical assistance to primary care physicians for:

(1) developing financial models and budgets for program launch and sustainability based on practice size;

(2) developing staffing models for essential staff roles, including care managers and consulting psychiatrists;

(3) providing information technology expertise to assist with building the model requirements into electronic health records, including assistance with care manager tools, patient registry, ongoing patient monitoring, and patient records;

(4) training support for all key staff and operational consultation to develop practice workflows;

(5) establishing methods to ensure the sharing of best practices and operational knowledge among primary care physicians that provide behavioral health integration services through the Collaborative Care Model; and

(6) for other purposes that the Director may determine to be necessary.

(f) The Director may develop and implement a public awareness campaign to raise awareness about the psychiatric Collaborative Care Model.

(g) This Section is subject to appropriation.

Section 99. Effective date. This Act takes effect July 1, 2024.