SB0476 102ND GENERAL ASSEMBLY

  
  

 


 
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.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning mental health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Mental
5Health and Substance Use Disorder Rate Equity Act.
 
6    Section 5. Findings. The General Assembly finds that:
7    (1) The immediate and direct impact of COVID-19 has
8already resulted in thousands of lives lost and significant
9incremental cost to the healthcare system.
10    (2) The impact of COVID-19 on child and family well-being
11is intergenerational and potentially long-lasting without
12appropriate intervention. Research by Child Trends
13demonstrates that parents' health is one of the strongest
14predictors of a child's health, and this effect is even more
15pronounced for low-income families. Addressing health and
16well-being across the life span is essential if Illinois is to
17recover from the pandemic.
18    (3) The rates of anxiety and depression for all
19populations have continued to rise since early June 2020,
20reaching all-time highs from July 1621, with Latinx, Asian,
21Black, and multiracial groups expressing higher levels of
22symptoms than non-Hispanic whites, according to the U.S.
23Census Bureau and the Centers for Disease Control and

 

 

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1Prevention's National Center for Health Statistics.
2    (4) This surge of people experiencing acute behavioral
3health problems, both those with new symptoms and those with
4existing conditions, has the potential to further impact the
5healthcare system for years to come.
6    (5) Analysis shows that people with behavioral health
7diagnoses have around 4 times the average health care spending
8of those without, due to factors such as medical
9complications, reduced access to preventive care, and
10challenges with illness management.
11    (6) The federal Centers for Disease Control and Prevention
12has announced that 2020 will be a record year for drug overdose
13deaths due primarily to the COVID-19 pandemic with deaths due
14to opioids and other substances causing a dramatic and
15long-standing impact upon communities.
16    (7) The Department of Healthcare and Family Services has a
17standard measure that one in 5 Medicaid enrollees have
18behavioral health issues, a measure which yields approximately
1982,100 new clients with mental health or addiction treatment
20needs in 2020.
21    (8) During the COVID-19 pandemic, the social distancing
22and stay-at-home orders have caused isolation, depression, and
23a dramatic increase in reliance upon alcohol and other
24substances. There is a need to address these consequences
25through increased focus upon prevention as well as treatment.
26    (9) With thousands of new behavioral clients seeking care,

 

 

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1there is a need to increase community capacity to meet the
2overwhelming demand for services.
3    (10) The Illinois opioid crisis remains a crisis, with a
4record number of overdoses in 2020.
5    (11) According to data from the Department of Public
6Health, opioid overdose deaths rose 36.5% in the first 5
7months of 2020 from 197 deaths in January to 269 deaths.
8    (12) According to data from the counties, teen suicides
9were up in 2020 compared to 2019, and Cook County's Black
10community experienced 71 suicides in the first 9 months of
112020, compared to 56 in all of 2019.
12    (13) COVID-19 has caused an avalanche of cases to crash
13into a chronically underfunded, understaffed State behavioral
14system further brutalized financially during the budget
15impasse years.
16    (14) Over the next 6 years, the minimum wage in Illinois
17will go from $8.25 to $15 per hour, an hourly rate increase of
18as much as $6.75 (an 82% increase) across the State. The human
19services sector impact is estimated to be $1,300,000,000 for
20the increase in mandated future costs through 2025.
21    (15) A robust framework for addressing behavioral health
22concerns will be necessary to manage demand on the system,
23acknowledging that the full health care impact of COVID-19 may
24not be known for years to come.
25    (16) Community-based behavioral health prevention and
26treatment are less expensive and more impactful than intensive

 

 

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1hospital-based treatment or emergency responders, including
2Illinois' law enforcement officers, who are not as well
3equipped to address crisis interventions.
4    (17) Good mental health and substance use disorder
5prevention and treatment allows people to feel good about
6life, helping people accomplish their goals, and participate
7in their communities. To promote the prosperity of all
8Illinoisans, we need to invest in our State's mental health
9and substance use prevention and treatment services. When we
10improve programs and services that help all Illinoisans
11establish stable behavioral health and well-being, we
12contribute to everyone's prosperity, both now and in the
13future. Increasing our investments in behavioral health
14prevention and early intervention now will help ensure that we
15establish the foundation of a strong future for our State and
16everyone in it.
 
17    Section 10. Funding for community-based prevention
18organizations and providers of mental health and substance use
19disorder treatment. Beginning in 2023, and every State fiscal
20year thereafter, the General Assembly shall appropriate
21sufficient funds to the Department of Human Services to ensure
22grants to community-based prevention organizations and
23providers of mental health and substance use disorder
24treatment under community service grant programs for mental
25health and substance use disorder prevention will be adjusted

 

 

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1upward by an amount equal to the Consumer Price Index-U from
2the previous year, not to exceed 2% in any State fiscal year.
3If there is a decrease in the Consumer Price Index-U, rates
4shall remain unchanged for that State fiscal year.
5    As used in this Section, "consumer price index-u" means
6the index published by the Bureau of Labor Statistics of the
7United States Department of Labor that measures the average
8change in prices of goods and services purchased by all urban
9consumers, United States city average, all items, 1982-84 =
10100.
 
11    Section 15. Funding for certified community mental health
12centers and behavioral health clinics. Beginning in 2024, and
13every State fiscal year thereafter, the General Assembly shall
14appropriate sufficient funds to the Department of Human
15Services to ensure reimbursement rates for certified community
16mental health centers and behavioral health clinics under
17community service grant programs for persons with mental
18illness will be adjusted upward by an amount equal to the
19Consumer Price Index-U from the previous year, not to exceed
202% in any State fiscal year. If there is a decrease in the
21Consumer Price Index-U, rates shall remain unchanged for that
22State fiscal year. The Department shall adopt rules, including
23emergency rules under Section 5-45.1 of the Illinois
24Administrative Procedure Act, to implement the provisions of
25this Section.

 

 

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1    As used in this Section, "consumer price index-u" means
2the index published by the Bureau of Labor Statistics of the
3United States Department of Labor that measures the average
4change in prices of goods and services purchased by all urban
5consumers, United States city average, all items, 1982-84 =
6100.
 
7    Section 20. Funding for licensed or certified
8community-based substance use disorder treatment providers.
9Beginning in 2024, and every State fiscal year thereafter, the
10General Assembly shall appropriate sufficient funds to the
11Department of Human Services to ensure reimbursement rates for
12licensed or certified community-based substance use disorder
13treatment providers under community service grant programs for
14persons with substance use disorders will be adjusted upward
15by an amount equal to the Consumer Price Index-U from the
16previous year, not to exceed 2% in any State fiscal year. If
17there is a decrease in the Consumer Price Index-U, rates shall
18remain unchanged for that State fiscal year. The Department
19shall adopt rules, including emergency rules under Section
205-45.1 of the Illinois Administrative Procedure Act, to
21implement the provisions of this Section.
22    As used in this Section, "consumer price index-u" means
23the index published by the Bureau of Labor Statistics of the
24United States Department of Labor that measures the average
25change in prices of goods and services purchased by all urban

 

 

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1consumers, United States city average, all items, 1982-84 =
2100.
 
3    Section 25. Illinois Administrative Procedure Act is
4amended by adding Section 5-45.8 as follows:
 
5    (5 ILCS 100/5-45.8 new)
6    Sec. 5-45.8. Emergency rulemaking; behavioral health care
7services rate equity. To provide for the expeditious and
8timely implementation of provisions of the Mental Health and
9Substance Use Disorder Rate Equity Act, Section 55-30 of the
10Substance Use Disorder Act, Section 75 of the Mental Health
11and Developmental Disabilities Administrative Act, and Section
125-5.05a of the Illinois Public Aid Code, emergency rules may
13be adopted in accordance with Section 5-45 by the respective
14Department. The adoption of emergency rules authorized by
15Section 5-45 and this Section is deemed to be necessary for the
16public interest, safety, and welfare.
17    This Section is repealed on January 1, 2026.
 
18    Section 30. The Substance Use Disorder Act is amended by
19changing Section 55-30 as follows:
 
20    (20 ILCS 301/55-30)
21    Sec. 55-30. Rate increase.
22    (a) The Department shall by rule develop the increased

 

 

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1rate methodology and annualize the increased rate beginning
2with State fiscal year 2018 contracts to licensed providers of
3community-based substance use disorder intervention or
4treatment, based on the additional amounts appropriated for
5the purpose of providing a rate increase to licensed
6providers. The Department shall adopt rules, including
7emergency rules under subsection (y) of Section 5-45 of the
8Illinois Administrative Procedure Act, to implement the
9provisions of this Section.
10    (b) (Blank) Within 30 days after June 4, 2018 (the
11effective date of Public Act 100-587), the Division of
12Substance Use Prevention and Recovery shall apply an increase
13in rates of 3% above the rate paid on June 30, 2017 to all
14Medicaid and non-Medicaid reimbursable service rates. The
15Department shall adopt rules, including emergency rules under
16subsection (bb) of Section 5-45 of the Illinois Administrative
17Procedure Act, to implement the provisions of this subsection
18(b).
19    (c) Beginning on July 1, 2021, the Division of Substance
20Use Prevention and Recovery shall increase reimbursement rates
21for all community-based substance use disorder treatment and
22intervention services by 9%. On July 1, 2022, such rates shall
23be increased by 7%. On July 1, 2023, such rates shall be
24increased by 5%. Beginning in 2024, and every State fiscal
25year thereafter, reimbursement rates for those community-based
26substance use disorder treatment and intervention services

 

 

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1shall be adjusted upward by an amount equal to the Consumer
2Price Index-U from the previous year, not to exceed 2% in any
3State fiscal year. If there is a decrease in the Consumer Price
4Index-U, rates shall remain unchanged for that State fiscal
5year. The Department shall adopt rules, including emergency
6rules under Section 5-45.1 of the Illinois Administrative
7Procedure Act, to implement the provisions of this Section.
8    For the purposes of this subsection, "consumer price
9index-u" means the index published by the Bureau of Labor
10Statistics of the United States Department of Labor that
11measures the average change in prices of goods and services
12purchased by all urban consumers, United States city average,
13all items, 1982-84 = 100.
14(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
15100-759, eff. 1-1-19; 101-81, eff. 7-12-19.)
 
16    Section 35. The Mental Health and Developmental
17Disabilities Administrative Act is amended by changing Section
1875 as follows:
 
19    (20 ILCS 1705/75)
20    Sec. 75. Rate increase. Beginning on July 1, 2021, the
21Division of Mental Health shall increase reimbursement rates
22for all community-based mental health treatment services by
239%. On July 1, 2022 such rates shall be increased by 7%. On
24July 1, 2023, such rates shall be increased by 5%. Beginning in

 

 

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12024, and every State fiscal year thereafter, reimbursement
2rates for those community-based mental health treatment
3services shall be adjusted upward by an amount equal to the
4Consumer Price Index-U from the previous year, not to exceed
52% in any State fiscal year. If there is a decrease in the
6Consumer Price Index-U, rates shall remain unchanged for that
7State fiscal year. The Department shall adopt rules, including
8emergency rules under Section 5-45.1 of the Illinois
9Administrative Procedure Act, to implement the provisions of
10this Section. Within 30 days after July 6, 2017 (the effective
11date of Public Act 100-23), the Division of Mental Health
12shall by rule develop the increased rate methodology and
13annualize the increased rate beginning with State fiscal year
142018 contracts to certified community mental health centers,
15based on the additional amounts appropriated for the purpose
16of providing a rate increase to certified community mental
17health centers, with the annualization to be maintained in
18State fiscal year 2019. The Department shall adopt rules,
19including emergency rules under subsections (y) and (bb) of
20Section 5-45 of the Illinois Administrative Procedure Act, to
21implement the provisions of this Section.
22    For the purposes of this Section, "consumer price index-u"
23means the index published by the Bureau of Labor Statistics of
24the United States Department of Labor that measures the
25average change in prices of goods and services purchased by
26all urban consumers, United States city average, all items,

 

 

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11982-84 = 100.
2(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18.)
 
3    Section 40. The Illinois Public Aid Code is amended by
4changing Section 5-5.05a and by adding Section 41 as follows:
 
5    (305 ILCS 5/5-5.05a)
6    Sec. 5-5.05a. Reimbursement rates; community mental health
7centers.
8    (a) Notwithstanding the provisions of any other law,
9reimbursement rates, including enhanced payment rates and rate
10add-ons, for psychiatric and behavioral health services
11provided in or by community mental health centers licensed or
12certified by the Department of Human Services shall not be
13lower than the rates for such services in effect on November 1,
142017. The Department of Healthcare and Family Services shall
15apply for any waiver or State Plan amendment, if required, to
16implement the reimbursement rates established in this Section.
17Implementation of the reimbursement rates shall be contingent
18on federal approval.
19    (b) Beginning on July 1, 2021, reimbursement rates,
20including enhanced payment rates and rate add-ons, for
21psychiatric and behavioral health services provided in or by
22community mental health centers or behavioral health clinics
23licensed or certified by the Department of Human Services or
24the Department of Healthcare and Family Services shall be

 

 

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1increased by 9%. On July 1, 2022 such rates shall be increased
2by 7%. On July 1, 2023, such rates shall be increased by 5%.
3Beginning in 2024, and every State fiscal year thereafter,
4reimbursement rates for community mental health centers or
5behavioral health clinics licensed or certified by the
6Department of Human Services or the Department of Healthcare
7and Family Services shall be adjusted upward by an amount
8equal to the Consumer Price Index-U from the previous year,
9not to exceed 2% in any State fiscal year. If there is a
10decrease in the Consumer Price Index-U, rates shall remain
11unchanged for that State fiscal year. The Department of
12Healthcare and Family Services shall adopt rules, including
13emergency rules under Section 5-45.1 of the Illinois
14Administrative Procedure Act, to implement the provisions of
15this Section.
16    For the purposes of this subsection, "consumer price
17index-u" means the index published by the Bureau of Labor
18Statistics of the United States Department of Labor that
19measures the average change in prices of goods and services
20purchased by all urban consumers, United States city average,
21all items, 1982-84 = 100.
22(Source: P.A. 100-587, eff. 6-4-18.)
 
23    (305 ILCS 5/41 new)
24    Sec. 41. Reimbursement rates; substance use disorder
25treatment providers and facilities. Beginning on July 1, 2021,

 

 

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1the Department of Human Services' Division of Substance Use
2Prevention and Recovery shall increase reimbursement rates by
39% for all community-based substance use disorder treatment
4services. On July 1, 2022 such rates shall be increased by 7%.
5On July 1, 2023, such rates shall be increased by 5%. Beginning
6in 2024, and every State fiscal year thereafter, reimbursement
7rates for those community-based substance use disorder
8treatment services shall be adjusted upward by an amount equal
9to the Consumer Price Index-U from the previous year, not to
10exceed 2% in any State fiscal year. If there is a decrease in
11the Consumer Price Index-U, rates shall remain unchanged for
12that State fiscal year. The Department shall adopt rules,
13including emergency rules under Section 5-45.1 of the Illinois
14Administrative Procedure Act, to implement the provisions of
15this Section.
16    For the purposes of this Section, "consumer price index-u"
17means the index published by the Bureau of Labor Statistics of
18the United States Department of Labor that measures the
19average change in prices of goods and services purchased by
20all urban consumers, United States city average, all items,
211982-84 = 100.
 
22    Section 99. Effective date. This Act takes effect upon
23becoming law.

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    New Act
4    5 ILCS 100/5-45.8 new
5    20 ILCS 301/55-30
6    20 ILCS 1705/75
7    305 ILCS 5/5-5.05a
8    305 ILCS 5/41 new