SB0476 102ND GENERAL ASSEMBLY

LRB102 15393 KTG 20756 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB0476

Introduced 2/23/2021, by Sen. Sara Feigenholtz

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, beginning in 2024, 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, 2021 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, 2021 and every State fiscal year thereafter. Amends the Illinois Public Aid Code. Provides that, beginning on July 1, 2021, 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, 2022 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.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning mental health.

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

Section 1. Short title. This Act may be cited as the Mental Health and Substance Use Disorder Rate Equity Act.

Section 5. Findings. The General Assembly finds that:

(1) The immediate and direct impact of COVID-19 has already resulted in thousands of lives lost and significant incremental cost to the healthcare system.

(2) The impact of COVID-19 on child and family well-being is intergenerational and potentially long-lasting without appropriate intervention. Research by Child Trends demonstrates that parents' health is one of the strongest predictors of a child's health, and this effect is even more pronounced for low-income families. Addressing health and well-being across the life span is essential if Illinois is to recover from the pandemic.

(3) The rates of anxiety and depression for all populations have continued to rise since early June 2020, reaching all-time highs from July 16–21, with Latinx, Asian, Black, and multiracial groups expressing higher levels of symptoms than non-Hispanic whites, according to the U.S. Census Bureau and the Centers for Disease Control and Prevention's National Center for Health Statistics.

(4) This surge of people experiencing acute behavioral health problems, both those with new symptoms and those with existing conditions, has the potential to further impact the healthcare system for years to come.

(5) Analysis shows that people with behavioral health diagnoses have around 4 times the average health care spending of those without, due to factors such as medical complications, reduced access to preventive care, and challenges with illness management.

(6) The federal Centers for Disease Control and Prevention has announced that 2020 will be a record year for drug overdose deaths due primarily to the COVID-19 pandemic with deaths due to opioids and other substances causing a dramatic and long-standing impact upon communities.

(7) The Department of Healthcare and Family Services has a standard measure that one in 5 Medicaid enrollees have behavioral health issues, a measure which yields approximately 82,100 new clients with mental health or addiction treatment needs in 2020.

(8) During the COVID-19 pandemic, the social distancing and stay-at-home orders have caused isolation, depression, and a dramatic increase in reliance upon alcohol and other substances. There is a need to address these consequences through increased focus upon prevention as well as treatment.

(9) With thousands of new behavioral clients seeking care, there is a need to increase community capacity to meet the overwhelming demand for services.

(10) The Illinois opioid crisis remains a crisis, with a record number of overdoses in 2020.

(11) According to data from the Department of Public Health, opioid overdose deaths rose 36.5% in the first 5 months of 2020 from 197 deaths in January to 269 deaths.

(12) According to data from the counties, teen suicides were up in 2020 compared to 2019, and Cook County's Black community experienced 71 suicides in the first 9 months of 2020, compared to 56 in all of 2019.

(13) COVID-19 has caused an avalanche of cases to crash into a chronically underfunded, understaffed State behavioral system further brutalized financially during the budget impasse years.

(14) Over the next 6 years, the minimum wage in Illinois will go from $8.25 to $15 per hour, an hourly rate increase of as much as $6.75 (an 82% increase) across the State. The human services sector impact is estimated to be $1,300,000,000 for the increase in mandated future costs through 2025.

(15) A robust framework for addressing behavioral health concerns will be necessary to manage demand on the system, acknowledging that the full health care impact of COVID-19 may not be known for years to come.

(16) Community-based behavioral health prevention and treatment are less expensive and more impactful than intensive hospital-based treatment or emergency responders, including Illinois' law enforcement officers, who are not as well equipped to address crisis interventions.

(17) Good mental health and substance use disorder prevention and treatment allows people to feel good about life, helping people accomplish their goals, and participate in their communities. To promote the prosperity of all Illinoisans, we need to invest in our State's mental health and substance use prevention and treatment services. When we improve programs and services that help all Illinoisans establish stable behavioral health and well-being, we contribute to everyone's prosperity, both now and in the future. Increasing our investments in behavioral health prevention and early intervention now will help ensure that we establish the foundation of a strong future for our State and everyone in it.

Section 10. Funding for community-based prevention organizations and providers of mental health and substance use disorder treatment. 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 for mental health and substance use disorder prevention 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year.

As used in this Section, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

Section 15. Funding for certified community mental health centers and behavioral health clinics. Beginning in 2024, and every State fiscal year thereafter, the General Assembly shall appropriate sufficient funds to the Department of Human Services to ensure reimbursement rates for certified community mental health centers and behavioral health clinics under community service grant programs for persons with mental illness 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

As used in this Section, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

Section 20. Funding for licensed or certified community-based substance use disorder treatment providers. Beginning in 2024, and every State fiscal year thereafter, the General Assembly shall appropriate sufficient funds to the Department of Human Services to ensure reimbursement rates for licensed or certified community-based substance use disorder treatment providers under community service grant programs for persons with substance use disorders 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

As used in this Section, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

Section 25. Illinois Administrative Procedure Act is amended by adding Section 5-45.8 as follows:

(5 ILCS 100/5-45.8 new)

Sec. 5-45.8. Emergency rulemaking; behavioral health care services rate equity. To provide for the expeditious and timely implementation of provisions of the Mental Health and Substance Use Disorder Rate Equity Act, Section 55-30 of the Substance Use Disorder Act, Section 75 of the Mental Health and Developmental Disabilities Administrative Act, and Section 5-5.05a of the Illinois Public Aid Code, emergency rules may be adopted in accordance with Section 5-45 by the respective Department. The adoption of emergency rules authorized by Section 5-45 and this Section is deemed to be necessary for the public interest, safety, and welfare.

This Section is repealed on January 1, 2026.

Section 30. The Substance Use Disorder Act is amended by changing Section 55-30 as follows:

(20 ILCS 301/55-30)

Sec. 55-30. Rate increase.

(a) The Department shall by rule develop the increased rate methodology and annualize the increased rate beginning with State fiscal year 2018 contracts to licensed providers of community-based substance use disorder intervention or treatment, based on the additional amounts appropriated for the purpose of providing a rate increase to licensed providers. The Department shall adopt rules, including emergency rules under subsection (y) of Section 5-45 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

(b) (Blank) Within 30 days after June 4, 2018 (the effective date of Public Act 100-587), the Division of Substance Use Prevention and Recovery shall apply an increase in rates of 3% above the rate paid on June 30, 2017 to all Medicaid and non-Medicaid reimbursable service rates. The Department shall adopt rules, including emergency rules under subsection (bb) of Section 5-45 of the Illinois Administrative Procedure Act, to implement the provisions of this subsection (b).

(c) Beginning on July 1, 2021, the Division of Substance Use Prevention and Recovery shall increase reimbursement rates for all community-based substance use disorder treatment and intervention services by 9%. On July 1, 2022, such rates shall be increased by 7%. On July 1, 2023, such rates shall be increased by 5%. Beginning in 2024, and every State fiscal year thereafter, reimbursement rates for those community-based substance use disorder treatment and intervention services shall 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

For the purposes of this subsection, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; 100-759, eff. 1-1-19; 101-81, eff. 7-12-19.)

Section 35. The Mental Health and Developmental Disabilities Administrative Act is amended by changing Section 75 as follows:

(20 ILCS 1705/75)

Sec. 75. Rate increase. Beginning on July 1, 2021, the Division of Mental Health shall increase reimbursement rates for all community-based mental health treatment services by 9%. On July 1, 2022 such rates shall be increased by 7%. On July 1, 2023, such rates shall be increased by 5%. Beginning in 2024, and every State fiscal year thereafter, reimbursement rates for those community-based mental health treatment services shall 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section. Within 30 days after July 6, 2017 (the effective date of Public Act 100-23), the Division of Mental Health shall by rule develop the increased rate methodology and annualize the increased rate beginning with State fiscal year 2018 contracts to certified community mental health centers, based on the additional amounts appropriated for the purpose of providing a rate increase to certified community mental health centers, with the annualization to be maintained in State fiscal year 2019. The Department shall adopt rules, including emergency rules under subsections (y) and (bb) of Section 5-45 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

For the purposes of this Section, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18.)

Section 40. The Illinois Public Aid Code is amended by changing Section 5-5.05a and by adding Section 41 as follows:

(305 ILCS 5/5-5.05a)

Sec. 5-5.05a. Reimbursement rates; community mental health centers.

(a) Notwithstanding the provisions of any other law, reimbursement rates, including enhanced payment rates and rate add-ons, for psychiatric and behavioral health services provided in or by community mental health centers licensed or certified by the Department of Human Services shall not be lower than the rates for such services in effect on November 1, 2017. The Department of Healthcare and Family Services shall apply for any waiver or State Plan amendment, if required, to implement the reimbursement rates established in this Section. Implementation of the reimbursement rates shall be contingent on federal approval.

(b) Beginning on July 1, 2021, reimbursement rates, including enhanced payment rates and rate add-ons, for psychiatric and behavioral health services provided in or by community mental health centers or behavioral health clinics licensed or certified by the Department of Human Services or the Department of Healthcare and Family Services shall be increased by 9%. On July 1, 2022 such rates shall be increased by 7%. On July 1, 2023, such rates shall be increased by 5%. Beginning in 2024, and every State fiscal year thereafter, reimbursement rates for community mental health centers or behavioral health clinics licensed or certified by the Department of Human Services or the Department of Healthcare and Family Services shall 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department of Healthcare and Family Services shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

For the purposes of this subsection, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

(Source: P.A. 100-587, eff. 6-4-18.)

(305 ILCS 5/41 new)

Sec. 41. Reimbursement rates; substance use disorder treatment providers and facilities. Beginning on July 1, 2021, the Department of Human Services' Division of Substance Use Prevention and Recovery shall increase reimbursement rates by 9% for all community-based substance use disorder treatment services. On July 1, 2022 such rates shall be increased by 7%. On July 1, 2023, such rates shall be increased by 5%. Beginning in 2024, and every State fiscal year thereafter, reimbursement rates for those community-based substance use disorder treatment services shall 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. If there is a decrease in the Consumer Price Index-U, rates shall remain unchanged for that State fiscal year. The Department shall adopt rules, including emergency rules under Section 5-45.1 of the Illinois Administrative Procedure Act, to implement the provisions of this Section.

For the purposes of this Section, "consumer price index-u" means the index published by the Bureau of Labor Statistics of the United States Department of Labor that measures the average change in prices of goods and services purchased by all urban consumers, United States city average, all items, 1982-84 = 100.

Section 99. Effective date. This Act takes effect upon becoming law.