Full Text of SB0558 101st General Assembly
SB0558ham005 101ST GENERAL ASSEMBLY | Rep. Camille Y. Lilly Filed: 1/13/2021
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| 1 | | AMENDMENT TO SENATE BILL 558
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 558, AS AMENDED, | 3 | | with reference to page and line numbers of House Amendment No. | 4 | | 4, as follows:
| 5 | | on page 12, line 25, by inserting ", subject to funding | 6 | | availability," after "program"; and | 7 | | on page 13, lines 8 and 9, by replacing "Certification
shall | 8 | | not be required for reimbursement." with "For reimbursement | 9 | | under the medical assistance program, a community health worker | 10 | | must work under the supervision of an enrolled medical program | 11 | | provider, as specified by the Department, and certification | 12 | | shall be required for reimbursement. The supervision of | 13 | | enrolled medical program providers and certification are not | 14 | | required for community health workers who receive | 15 | | reimbursement through managed care administrative dollars. | 16 | | Non-certified community health workers are reimbursable at the |
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| 1 | | discretion of managed care entities up to 18 months following | 2 | | availability of community health worker certification."; and | 3 | | on page 13, by inserting after line 14 the following: | 4 | | "Section 5-22. Certification. Certification shall not be | 5 | | required for employment of community health workers. | 6 | | Non-certified community health workers may be employed through | 7 | | funding sources outside of the medical assistance program."; | 8 | | and | 9 | | by deleting lines 9 through 24 on page 43 and lines 1 through 6 | 10 | | on page 44; and | 11 | | on page 71, by inserting after line 16 the following: | 12 | | "Article 65. | 13 | | Section 65-1. Short title. This Article may be cited as the | 14 | | Behavioral Health Workforce Education Center of Illinois Act. | 15 | | References in this Article to "this Act" mean this Article. | 16 | | Section 65-5. Findings. The General Assembly finds as | 17 | | follows:
| 18 | | (1) There are insufficient behavioral health | 19 | | professionals in this State's behavioral health workforce |
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| 1 | | and further that there are insufficient behavioral health | 2 | | professionals trained in evidence-based practices.
| 3 | | (2) The Illinois behavioral health workforce situation | 4 | | is at a crisis state and the lack of a behavioral health | 5 | | strategy is exacerbating the problem.
| 6 | | (3) In 2019, the Journal of Community Health found that | 7 | | suicide rates are disproportionately higher among African | 8 | | American adolescents. From 2001 to 2017, the rate for | 9 | | African American teen boys rose 60%, according to the | 10 | | study. Among African American teen girls, rates nearly | 11 | | tripled, rising by an astounding 182%. Illinois was among | 12 | | the 10 states with the greatest number of African American | 13 | | adolescent suicides (2015-2017).
| 14 | | (4) Workforce shortages are evident in all behavioral | 15 | | health professions, including, but not limited to, | 16 | | psychiatry, psychiatric nursing, psychiatric physician | 17 | | assistant, social work (licensed social work, licensed | 18 | | clinical social work), counseling (licensed professional | 19 | | counseling, licensed clinical professional counseling), | 20 | | marriage and family therapy, licensed clinical psychology, | 21 | | occupational therapy, prevention, substance use disorder | 22 | | counseling, and peer support.
| 23 | | (5) The shortage of behavioral health practitioners | 24 | | affects every Illinois county, every group of people with | 25 | | behavioral health needs, including children and | 26 | | adolescents, justice-involved populations, working adults, |
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| 1 | | people experiencing homelessness, veterans, and older | 2 | | adults, and every health care and social service setting, | 3 | | from residential facilities and hospitals to | 4 | | community-based organizations and primary care clinics.
| 5 | | (6) Estimates of unmet needs consistently highlight | 6 | | the dire situation in Illinois. Mental Health America ranks | 7 | | Illinois 29th in the country in mental health workforce | 8 | | availability based on its 480-to-1 ratio of population to | 9 | | mental health professionals, and the Kaiser Family | 10 | | Foundation estimates that only 23.3% of Illinoisans' | 11 | | mental health needs can be met with its current workforce.
| 12 | | (7) Shortages are especially acute in rural areas and | 13 | | among low-income and under-insured individuals and | 14 | | families. 30.3% of Illinois' rural hospitals are in | 15 | | designated primary care shortage areas and 93.7% are in | 16 | | designated mental health shortage areas. Nationally, 40% | 17 | | of psychiatrists work in cash-only practices, limiting | 18 | | access for those who cannot afford high out-of-pocket | 19 | | costs, especially Medicaid eligible individuals and | 20 | | families.
| 21 | | (8) Spanish-speaking therapists in suburban Cook | 22 | | County, as well as in immigrant new growth communities | 23 | | throughout the State, for example, and master's-prepared | 24 | | social workers in rural communities are especially | 25 | | difficult to recruit and retain.
| 26 | | (9) Illinois' shortage of psychiatrists specializing |
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| 1 | | in serving children and adolescents is also severe. | 2 | | Eighty-one out of 102 Illinois counties have no child and | 3 | | adolescent psychiatrists, and the remaining 21 counties | 4 | | have only 310 child and adolescent psychiatrists for a | 5 | | population of 2,450,000 children.
| 6 | | (10) Only 38.9% of the 121,000 Illinois youth aged 12 | 7 | | through 17 who experienced a major depressive episode | 8 | | received care.
| 9 | | (11) An annual average of 799,000 people in Illinois | 10 | | aged 12 and older need but do not receive substance use | 11 | | disorder treatment at specialty facilities.
| 12 | | (12) According to the Statewide Semiannual Opioid | 13 | | Report,
Illinois Department of Public Health,
September | 14 | | 2020, the number of opioid deaths in Illinois has increased | 15 | | 3% from 2,167 deaths in 2018 to 2,233
deaths in 2019.
| 16 | | (13) Behavioral health workforce shortages have led to | 17 | | well-documented problems of long wait times for | 18 | | appointments with psychiatrists (4 to 6 months in some | 19 | | cases), high turnover, and unfilled vacancies for social | 20 | | workers and other behavioral health professionals that | 21 | | have eroded the gains in insurance coverage for mental | 22 | | illness and substance use disorder under the federal | 23 | | Affordable Care Act and parity laws.
| 24 | | (14) As a result, individuals with mental illness or | 25 | | substance use disorders end up in hospital emergency rooms, | 26 | | which are the most expensive level of care, or are |
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| 1 | | incarcerated and do not receive adequate care, if any.
| 2 | | (15) There are many organizations and institutions | 3 | | that are affected by behavioral health workforce | 4 | | shortages, but no one entity is responsible for monitoring | 5 | | the workforce supply and intervening to ensure it can | 6 | | effectively meet behavioral health needs throughout the | 7 | | State.
| 8 | | (16) Workforce shortages are more complex than simple | 9 | | numerical shortfalls. Identifying the optimal number, | 10 | | type, and location of behavioral health professionals to | 11 | | meet the differing needs of Illinois' diverse regions and | 12 | | populations across the lifespan is a difficult logistical | 13 | | problem at the system and practice level that requires | 14 | | coordinated efforts in research, education, service | 15 | | delivery, and policy.
| 16 | | (17) This State has a compelling and substantial | 17 | | interest in building a pipeline for behavioral health | 18 | | professionals and to anchor research and education for | 19 | | behavioral health workforce development. Beginning with | 20 | | the proposed Behavioral Health Workforce Education Center | 21 | | of Illinois, Illinois has the chance to develop a blueprint | 22 | | to be a national leader in behavioral health workforce | 23 | | development.
| 24 | | (18) The State must act now to improve the ability of | 25 | | its residents to achieve their human potential and to live | 26 | | healthy, productive lives by reducing the misery and |
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| 1 | | suffering with unmet behavioral health needs.
| 2 | | Section 65-10. Behavioral Health Workforce Education | 3 | | Center of Illinois.
| 4 | | (a) The Behavioral Health Workforce Education Center of | 5 | | Illinois is created and shall be administered by a teaching, | 6 | | research, or both teaching and research public institution of | 7 | | higher education in this State. Subject to appropriation, the | 8 | | Center shall be operational on or before July 1, 2022.
| 9 | | (b) The Behavioral Health Workforce Education Center of | 10 | | Illinois shall leverage workforce and behavioral health | 11 | | resources, including, but not limited to, State, federal, and | 12 | | foundation grant funding, federal Workforce Investment Act of | 13 | | 1998 programs, the National Health Service Corps and other | 14 | | nongraduate medical education physician workforce training | 15 | | programs, and existing behavioral health partnerships, and | 16 | | align with reforms in Illinois.
| 17 | | Section 65-15. Structure.
| 18 | | (a) The Behavioral Health Workforce Education Center of | 19 | | Illinois shall be structured as a multisite model, and the | 20 | | administering public institution of higher education shall | 21 | | serve as the hub institution, complemented by secondary | 22 | | regional hubs, namely academic institutions, that serve rural | 23 | | and small urban areas and at least one academic institution | 24 | | serving a densely urban municipality with more than 1,000,000 |
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| 1 | | inhabitants.
| 2 | | (b) The Behavioral Health Workforce Education Center of | 3 | | Illinois shall be located within one academic institution and | 4 | | shall be tasked with a convening and coordinating role for | 5 | | workforce research and planning, including monitoring progress | 6 | | toward Center goals.
| 7 | | (c) The Behavioral Health Workforce Education Center of | 8 | | Illinois shall also coordinate with key State agencies involved | 9 | | in behavioral health, workforce development, and higher | 10 | | education in order to leverage disparate resources from health | 11 | | care, workforce, and economic development programs in Illinois | 12 | | government.
| 13 | | Section 65-20. Duties. The Behavioral Health Workforce | 14 | | Education Center of Illinois shall perform the following | 15 | | duties:
| 16 | | (1) Organize a consortium of universities in | 17 | | partnerships with providers, school districts, law | 18 | | enforcement, consumers and their families, State agencies, | 19 | | and other stakeholders to implement workforce development | 20 | | concepts and strategies in every region of this State.
| 21 | | (2) Be responsible for developing and implementing a | 22 | | strategic plan for the recruitment, education, and | 23 | | retention of a qualified, diverse, and evolving behavioral | 24 | | health workforce in this State. Its planning and activities | 25 | | shall include:
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| 1 | | (A) convening and organizing vested stakeholders | 2 | | spanning government agencies, clinics, behavioral | 3 | | health facilities, prevention programs, hospitals, | 4 | | schools, jails, prisons and juvenile justice, police | 5 | | and emergency medical services, consumers and their | 6 | | families, and other stakeholders;
| 7 | | (B) collecting and analyzing data on the | 8 | | behavioral health workforce in Illinois, with detailed | 9 | | information on specialties, credentials, additional | 10 | | qualifications (such as training or experience in | 11 | | particular models of care), location of practice, and | 12 | | demographic characteristics, including age, gender, | 13 | | race and ethnicity, and languages spoken;
| 14 | | (C) building partnerships with school districts, | 15 | | public institutions of higher education, and workforce | 16 | | investment agencies to create pipelines to behavioral | 17 | | health careers from high schools and colleges, | 18 | | pathways to behavioral health specialization among | 19 | | health professional students, and expanded behavioral | 20 | | health residency and internship opportunities for | 21 | | graduates;
| 22 | | (D) evaluating and disseminating information about | 23 | | evidence-based practices emerging from research | 24 | | regarding promising modalities of treatment, care | 25 | | coordination models, and medications;
| 26 | | (E) developing systems for tracking the |
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| 1 | | utilization of evidence-based practices that most | 2 | | effectively meet behavioral health needs; and
| 3 | | (F) providing technical assistance to support | 4 | | professional training and continuing education | 5 | | programs that provide effective training in | 6 | | evidence-based behavioral health practices.
| 7 | | (3) Coordinate data collection and analysis, including | 8 | | systematic tracking of the behavioral health workforce and | 9 | | datasets that support workforce planning for an | 10 | | accessible, high-quality behavioral health system. In the | 11 | | medium to long-term, the Center shall develop Illinois | 12 | | behavioral workforce data capacity by:
| 13 | | (A) filling gaps in workforce data by collecting | 14 | | information on specialty, training, and qualifications | 15 | | for specific models of care, demographic | 16 | | characteristics, including gender, race, ethnicity, | 17 | | and languages spoken, and participation in public and | 18 | | private insurance networks;
| 19 | | (B) identifying the highest priority geographies, | 20 | | populations, and occupations for recruitment and | 21 | | training;
| 22 | | (C) monitoring the incidence of behavioral health | 23 | | conditions to improve estimates of unmet need; and
| 24 | | (D) compiling up-to-date, evidence-based | 25 | | practices, monitoring utilization, and aligning | 26 | | training resources to improve the uptake of the most |
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| 1 | | effective practices.
| 2 | | (4) Work to grow and advance peer and parent-peer | 3 | | workforce development by:
| 4 | | (A) assessing the credentialing and reimbursement | 5 | | processes and recommending reforms;
| 6 | | (B) evaluating available peer-parent training | 7 | | models, choosing a model that meets Illinois' needs, | 8 | | and working with partners to implement it universally | 9 | | in child-serving programs throughout this State; and
| 10 | | (C) including peer recovery specialists and | 11 | | parent-peer support professionals in interdisciplinary | 12 | | training programs.
| 13 | | (5) Focus on the training of behavioral health | 14 | | professionals in telehealth techniques, including taking | 15 | | advantage of a telehealth network that exists, and other | 16 | | innovative means of care delivery in order to increase | 17 | | access to behavioral health services for all persons within | 18 | | this State.
| 19 | | (6) No later than December 1 of every odd-numbered | 20 | | year, prepare a report of its activities under this Act. | 21 | | The report shall be filed electronically with the General | 22 | | Assembly, as provided under Section 3.1 of the General | 23 | | Assembly Organization Act, and shall be provided | 24 | | electronically to any member of the General Assembly upon | 25 | | request.
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| 1 | | Section 65-25. Selection process.
| 2 | | (a) No later than 90 days after the effective date of this | 3 | | Act, the Board of Higher Education shall select a public | 4 | | institution of higher education, with input and assistance from | 5 | | the Division of Mental Health of the Department of Human | 6 | | Services, to administer the Behavioral Health Workforce | 7 | | Education Center of Illinois.
| 8 | | (b) The selection process shall articulate the principles | 9 | | of the Behavioral Health Workforce Education Center of | 10 | | Illinois, not inconsistent with this Act.
| 11 | | (c) The Board of Higher Education, with input and | 12 | | assistance from the Division of Mental Health of the Department | 13 | | of Human Services, shall make its selection of a public | 14 | | institution of higher education based on its ability and | 15 | | willingness to execute the following tasks:
| 16 | | (1) Convening academic institutions providing | 17 | | behavioral health education to:
| 18 | | (A) develop curricula to train future behavioral | 19 | | health professionals in evidence-based practices that | 20 | | meet the most urgent needs of Illinois' residents;
| 21 | | (B) build capacity to provide clinical training | 22 | | and supervision; and
| 23 | | (C) facilitate telehealth services to every region | 24 | | of the State.
| 25 | | (2) Functioning as a clearinghouse for research, | 26 | | education, and training efforts to identify and |
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| 1 | | disseminate evidence-based practices across the State.
| 2 | | (3) Leveraging financial support from grants and | 3 | | social impact loan funds.
| 4 | | (4) Providing infrastructure to organize regional | 5 | | behavioral health education and outreach. As budgets | 6 | | allow, this shall include conference and training space, | 7 | | research and faculty staff time, telehealth, and distance | 8 | | learning equipment.
| 9 | | (5) Working with regional hubs that assess and serve | 10 | | the workforce needs of specific, well-defined regions and | 11 | | specialize in specific research and training areas, such as | 12 | | telehealth or mental health-criminal justice partnerships, | 13 | | for which the regional hub can serve as a statewide leader.
| 14 | | (d) The Board of Higher Education may adopt such rules as | 15 | | may be necessary to implement and administer this Section."; | 16 | | and | 17 | | by replacing lines 20 through 22 of page 141 and lines 1 and 2 | 18 | | of page 142 with the following: | 19 | | "Section 115-5. The Illinois Public Aid Code is amended by | 20 | | adding Section 14-14 as follows: | 21 | | (305 ILCS 5/14-14 new) | 22 | | Sec. 14-14. Increasing access to primary care in "; and
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| 1 | | on page 177, lines 3 and 4, by replacing "4 and 5.4 and by | 2 | | adding Section 5.5" with "4, 5.4, and 8.7"; and | 3 | | on page 177, line 20, by changing " 10 " to " 11 "; and
| 4 | | on page 185, by replacing lines 1 through 9 with the following: | 5 | | "(20 ILCS 3960/8.7) | 6 | | (Section scheduled to be repealed on December 31, 2029) | 7 | | Sec. 8.7. Application for permit for discontinuation of a | 8 | | health care facility or category of service; public notice and | 9 | | public hearing. | 10 | | (a) Upon a finding that an application to close a health | 11 | | care facility or discontinue a category of service is complete, | 12 | | the State Board shall publish a legal notice on 3 consecutive | 13 | | days in a newspaper of general circulation in the area or | 14 | | community to be affected and afford the public an opportunity | 15 | | to request a hearing. If the application is for a facility | 16 | | located in a Metropolitan Statistical Area, an additional legal | 17 | | notice shall be published in a newspaper of limited | 18 | | circulation, if one exists, in the area in which the facility | 19 | | is located. If the newspaper of limited circulation is | 20 | | published on a daily basis, the additional legal notice shall | 21 | | be published on 3 consecutive days. The legal notice shall also | 22 | | be posted on the Health Facilities and Services Review Board's | 23 | | website and sent to the State Representative and State Senator |
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| 1 | | of the district in which the health care facility is located. | 2 | | In addition, the health care facility shall provide notice of | 3 | | closure to the local media that the health care facility would | 4 | | routinely notify about facility events. | 5 | | An application to close a health care facility shall only | 6 | | be deemed complete if it includes evidence that the health care | 7 | | facility provided written notice at least 30 days prior to | 8 | | filing the application of its intent to do so to the | 9 | | municipality in which it is located, the State Representative | 10 | | and State Senator of the district in which the health care | 11 | | facility is located, the State Board, the Director of Public | 12 | | Health, and the Director of Healthcare and Family Services. The | 13 | | changes made to this subsection by this amendatory Act of the | 14 | | 101st General Assembly shall apply to all applications | 15 | | submitted after the effective date of this amendatory Act of | 16 | | the 101st General Assembly. | 17 | | (b) No later than 30 days after issuance of a permit to | 18 | | close a health care facility or discontinue a category of | 19 | | service, the permit holder shall give written notice of the | 20 | | closure or discontinuation to the State Senator and State | 21 | | Representative serving the legislative district in which the | 22 | | health care facility is located. | 23 | | (c) (1) If there is a pending lawsuit that challenges an | 24 | | application to discontinue a health care facility that either | 25 | | names the Board as a party or alleges fraud in the filing of | 26 | | the application, the Board may defer action on the application |
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| 1 | | for up to 6 months after the date of the initial deferral of | 2 | | the application. | 3 | | (2) The Board may defer action on an application to | 4 | | discontinue a hospital that is pending before the Board as of | 5 | | the effective date of this amendatory Act of the 101st General | 6 | | Assembly for up to 60 days from the effective date of this | 7 | | amendatory Act of the 101st General Assembly. | 8 | | (3) The Board may defer taking final action on an | 9 | | application to discontinue a hospital that is filed on or after | 10 | | January 12, 2021 until the earlier to occur of: (i) the | 11 | | expiration of the statewide disaster declaration proclaimed by | 12 | | the Governor of the State of Illinois due to the COVID-19 | 13 | | pandemic that is in effect on January 12, 2021, or any | 14 | | extension thereof, or July 1, 2021, whichever occurs later; or | 15 | | (ii) the expiration of the declaration of a public health | 16 | | emergency due to the COVID-19 pandemic as declared by the | 17 | | Secretary of the U.S. Department of Health and Human Services | 18 | | that is in effect on January 12, 2021, or any extension | 19 | | thereof, or July 1, 2021, whichever occurs later. This | 20 | | paragraph (3) is inoperative as of the date of the expiration | 21 | | of the statewide disaster declaration proclaimed by the | 22 | | Governor of the State of Illinois due to the COVID-19 pandemic | 23 | | that is in effect on January 12, 2021, or any extension | 24 | | thereof, or July 1, 2021, whichever occurs later. | 25 | | (d) The changes made to this Section by this amendatory Act | 26 | | of the 101st General Assembly shall apply to all applications |
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| 1 | | submitted after the effective date of this amendatory Act of | 2 | | the 101st General Assembly.
| 3 | | (Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20.)"; | 4 | | and
| 5 | | on page 200, line 19, by inserting " a majority of " after | 6 | | " representing "; and
| 7 | | on page 202, line 11, by inserting " a majority of " after | 8 | | " representing "; and
| 9 | | on page 202, line 23, by changing " association, and " to | 10 | | " association, a dental association, and ".
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