SB2314 102ND GENERAL ASSEMBLY

LRB102 15771 SSS 21138 b

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.

A BILL FOR

AN ACT concerning government.

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

Section 1. This Act may be referred to as the Community Mental Health Rule and Regulatory Modernization Act. The purpose of this Act is to make rule and regulatory changes to the administrative rules that govern community mental health services to improve access to mental health care in Illinois.

Section 5. The Illinois Administrative Procedure Act is amended by adding Section 5-170 as follows:

(5 ILCS 100/5-170 new)

Sec. 5-170.

(a) Title 89, Part 140, Sections 140.453 through 140.455, and 140.TABLE N of the Illinois Administrative Code shall be revised for purposes of improving access to community mental health and behavioral health services:

(1) To enable services to begin immediately upon the initiation of the comprehensive Integrated Assessment and Treatment plan, Section 140.453(c)(1)(B) shall be amended as follows: the word "completion" shall be replaced with "initiation".

The following sentence shall be added at the end of the subsection: "The Integrated Assessment and Treatment Plan shall be completed within 45 days of initiation."

(2) To eliminate the over-assessment of individuals, Section 140.453(d)(1)(A)(i) shall be revised by replacing "every 180 days" with "annually".

(3) To reduce administrative barriers for individuals being deinstitutionalized, Section 140.453(d)(4)(A)(iii) shall be revised by adding the following sentence at the end: "Prior authorizations for any individual transitioning from an institutional setting to the community under a deinstitutionalization consent decree to which the State of Illinois is party who initially qualifies and is authorized for ACT, shall be effective for one year intervals with a sufficient number of units of service being approved to meet a full year of medical necessity."

(4) To reduce staff turn-over and improve the quality of care for Team-Based MRO services, Section 140.453(d)(4)(A)(iv) shall be revised by adding the following bullet: "An individual possessing a bachelor's degree in counseling and guidance, rehabilitation counseling, social work, education, vocational counseling, psychology, pastoral counseling, family therapy or related human service field with at least two years of documented clinical experience in Team Based MRO Services under the supervision of a QMHP."

(5) To reduce staff turn-over and improve the quality of care for Team-Based MRO services, Section 140.453(d)(4)(B)(i) shall be revised by adding the following at the end of the second bullet: "or an individual possessing a bachelor's degree in counseling and guidance, rehabilitation counseling, social work, education, vocational counseling, psychology, pastoral counseling, family therapy or related human service field with at least two years of documented clinical experience in Team Based MRO Services under the supervision of a QMHP."

(6) To reduce administrative barriers to care for individuals being deinstitutionalized, Section 140.453(d)(4)(B)(iii) shall be revised by adding the following sentence at the end: "Prior authorizations for any individual transitioning from an institutional setting to the community under a deinstitutionalization consent decree to which the State of Illinois is party who initially qualifies and is authorized for CST, shall be effective for one year intervals with a sufficient number of units of service being approved to meet a full year of medical necessity."

(7) To allow time for client volume to match start up expenses of CST Teams, Section 140.TABLE N, (c)(1)(B) shall be revised by adding the following language after the word "following" and before the colon: "within six months of the CST team being established".

(8) Section 140.TABLE N, (c)(1)(D)(ii) shall be revised by:

(A) striking the word "lead",

(B) replacing the words "referring LPHA" with "team lead", and

(C) replacing the word "monthly" with "quarterly".

(9) Section 140.TABLE N, (c)(1)(D)(iii) shall be revised by replacing the term "LPHA" with "CST team lead".

(10) To fully utilize treating Advance Practice Nurses (APNs) and partnerships with hospitals and Federally Qualified Health Clinics in a time of a profound state and national shortage of psychiatrists, Section 140.TABLE N, (e)(1)(C)(ii) shall be revised by striking the last sentence to enable the full utilization of treating APNs employed or on contract with a CMHC. The following sentence shall be added to the end of the subsection to maximize provider partnerships for treating APNs and psychiatrists: "A CMHC may enter into a written contract with a Federally Qualified Health Clinic or hospital for the psychiatric resource for the CMHC's ACT team."

(11) To allow time for client volume to match start up expenses of ACT Teams, Section 140.TABLE N, (e)(1)(C)(iii) shall be revised by adding the following before the colon: "within six months of the ACT team being established".

(12) To eliminate clinical reviews that do not have meaningful clinical value in patient care, Section 140.TABLE N, (e)(1)(E)(iii) shall be revised by:

(A) Replacing "monthly" with "quarterly",

(B) Replacing "psychiatrist" with "Psychiatric Resource".

(13) To align team member roles with fidelity and best practices, Section 140.TABLE N, (e)(1)(E)(iv) shall be revised by replacing "Psychiatric Resource" with "Team Lead".

(14) For purposes of addressing the behavioral health workforce shortage, Section 140.453(d)(1)(A)(iii) shall be revised by replacing "an LPHA" with "the direct supervisor of the individual completing the IATP".

(b) Title 59, Chapter IV, Part 132 of the Illinois Administrative Code shall be amended as follows:

Title 59, Chapter IV, Part 132 shall be revised to be consistent with the changes made to Title 89, Part 140, Sections 140.453 through 140.455, and 140.TABLE N of the Illinois Administrative Code pursuant to this Act, including but not limited to the following:

(A) Section 132.135(c)(1) shall be revised by striking the language and replacing it with the following: "Supervision by a licensed clinician, as defined in section 132.25, or an individual possessing a bachelor's degree in counseling and guidance, rehabilitation counseling, social work, education, vocational counseling, psychology, pastoral counseling, family therapy or related human service field with at least two years of documented clinical experience in Team Based MRO Services under the supervision of a QMHP, who is the team leader."

(B) Section 132.135(3) shall be revised by replacing the language with the following: "Program support provided by a psychiatrist or an advance practice nurse. A CMHC may enter into a written contract with a Federally Qualified Health Clinic or hospital for the psychiatric resource for the CMHC's ACT team. Program support shall also include a program administrative assistant."

(C) To allow time for client volume to match start up expenses of ACT Teams, a Section 132.135(c)(7) shall be added as follows: "Minimum staffing requirements of ACT teams shall be met within six months of the ACT team being established."

(D) Section 132.145(a) shall be revised by striking the language and replacing it with the following: "Demonstration of the ability to meet the minimum staffing requirement that each team includes a minimum of three FTE within six months of a CST team being established."

(E) Section 132.145(b) shall be revised by striking the language and replacing it with the following: "Demonstration of ability to meet the requirement to staff the program with a QMHP or an individual possessing a bachelor's degree in counseling and guidance, rehabilitation counseling, social work, education, vocational counseling, psychology, pastoral counseling, family therapy or related human service field with at least two years of documented clinical experience in Team Based MRO Services under the supervision of a QMHP, who is the full-time team leader and functions as a practitioner on the team."

(c) The Department of Healthcare and Family Services and the Department of Human Services shall file the administrative rule changes required pursuant to this Section by no later than three months following the effective date of this amendatory Act of the 102nd General Assembly.

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