97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1152

 

Introduced 02/08/11, by Rep. John E. Bradley

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 1705/71a new

    Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that the Department of Human Services shall strive to guarantee that persons, including children, suffering from mental illness, substance abuse, and other behavioral disorders have access to locally accessible behavioral health care providers who have the ability to treat the person's conditions in a cost effective, outcome-based manner. Requires the Department to designate as essential community behavioral health care providers organizations that meet certain qualifications; promote the co-location of primary and behavioral health care services centers; and work towards reducing Illinois' underserved and health professional shortage areas. Contains provisions concerning fee-for-service compensation; term limits for essential community behavioral health care providers; and other matters. Effective immediately.


LRB097 05474 KTG 45533 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB1152LRB097 05474 KTG 45533 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Mental Health and Developmental
5Disabilities Administrative Act is amended by adding Section
671a as follows:
 
7    (20 ILCS 1705/71a new)
8    Sec. 71a. Community Behavioral Health Care.
9    (a) The Department shall strive to guarantee that persons,
10including children, suffering from mental illness, substance
11abuse, and other behavioral disorders have access to locally
12accessible behavioral health care providers who have the
13ability to treat the person's conditions in a cost effective,
14outcome-based manner. To ensure continuity and quality of care
15that is integrated with the person's overall medical care, the
16Department shall:
17        (1) Designate as essential community behavioral health
18    care providers organizations that meet the qualifications
19    set forth in subsection (b) of this Section.
20        (2) Promote the co-location of primary and behavioral
21    health care services centers.
22        (3) Promote access to necessary behavioral health care
23    services in the State's Health Insurance Exchange

 

 

HB1152- 2 -LRB097 05474 KTG 45533 b

1    policies.
2        (4) Promote continuity of care for persons moving
3    between Medicaid, SCHIP, and programs administered by the
4    Department that provide behavioral health care services.
5        (5) Promote continuity of care for persons not yet
6    eligible for Medicaid or who are without insurance coverage
7    for their conditions.
8        (6) Work towards reducing Illinois' underserved and
9    health professional shortage areas.
10    (b) The Department shall designate certain community
11behavioral health care providers as essential community
12behavioral health care providers. To qualify for the
13designation an organization must be a not-for-profit
14organization under the Internal Revenue Code or a governmental
15entity that:
16        (1) Demonstrates a commitment to serving low-income
17    and underserved populations.
18        (2) Provides outcome-based community behavioral health
19    care treatment or services.
20        (3) Does not restrict access or services because of a
21    client's financial limitation.
22        (4) Is a community behavioral health care provider
23    certified by the Department, or a licensed community
24    behavioral health care provider holding a purchase of care
25    contract with the State under the State's Medicaid program.
26    An organization that is licensed or certified by the

 

 

HB1152- 3 -LRB097 05474 KTG 45533 b

1Department may apply to the Department for designation as an
2essential community behavioral health care provider.
3    (c) An organization designated as an essential community
4behavioral health care provider under subsection (b) and all
5members of the care treatment and service staff of the
6essential community behavioral health care provider shall
7agree to serve enrollees of all health insurers or health care
8service contractors operating in the area that the designated
9essential community behavioral health care provider serves.
10Health insurers shall include State programs funded under Title
11XIX and Title XXI of the federal Social Security Act, including
12the State's Medicaid program and the Covering ALL KIDS Health
13Insurance Program; other programs funded by the Department of
14Healthcare and Family Services for non-public employees; and
15programs for both the insured and uninsured funded by the
16Department of Human Services.
17    (d) An essential community behavioral health care provider
18shall be entitled to compensation on a fee-for-service basis
19within a global budget or within a risk-based incentive
20contract. Staff members and other health care providers in the
21service area of the designated essential community behavioral
22health care provider shall not be restricted from providing
23care, treatment, or services through affiliation with any other
24health insurer or health care service contractor.
25    (e) A designation of a community behavioral health care
26provider as an essential community behavioral health care

 

 

HB1152- 4 -LRB097 05474 KTG 45533 b

1provider shall end 5 years after the date the designation is
2granted. The Department, however, may terminate the
3designation for cause before the end of the 5-year period if
4the essential community behavioral health care provider fails
5to comply with the eligibility standards set forth in
6subsection (b).
7    A designated essential community behavioral health care
8provider may reapply for designation 6 months prior to the
9designation ending and shall provide documented evidence that
10the provider continues to meet all criteria for designation.
11    If the essential community behavioral health care provider
12continues to meet all criteria for designation, the Department
13shall continue the designation for an additional 5-year period.
 
14    Section 99. Effective date. This Act takes effect upon
15becoming law.