SB3385 101ST GENERAL ASSEMBLY

LRB101 18462 KTG 67910 b

101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB3385

Introduced 2/14/2020, by Sen. Heather A. Steans

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 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, 2020 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, 2020 and every State fiscal year thereafter. Amends the Illinois Public Aid Code. Provides that, beginning on July 1, 2020, 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, 2021 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) A March 2019 report by the USC Schaeffer Center for Health Policy & Economics estimates the following for the State of Illinois: almost 951,066 adults in Illinois experienced serious psychological distress in the past 12 months.

(2) People who experienced serious psychological distress in the past 12 months are more likely to abuse or be dependent on alcohol or illicit drugs during that same time period.

(3) In Illinois, 28.6% of people with serious mental psychological distress have an unmet need of mental health treatment.

(4) In Illinois, 33.3% of people with serious psychological distress and an unmet need of mental health treatment did not receive this treatment due to costs.

(5) In the Medicaid and uninsured population, a higher percentage of adults, 14% and 11.6% respectively, in Illinois reported serious psychological distress during the past year compared to people with Medicare, Veterans, or private health insurance coverage.

(6) Hospital costs in the U.S. and Illinois ranged from $5,000 to $9,000 per stay for patients with serious mental illness.

(7) Total hospital costs in Illinois for hospitalizations for serious mental illness together exceeded $360,000,000 in 2014.

(8) Illinois' mental health agency spends a very low per capita amount, $77 on mental health services, compared to the rest of the U.S., $133.

(9) There are 13.8 behavioral health care professionals for every 10,000 residents in Illinois, which is significantly lower than the average, 21.4, in the U.S.

(10) The number of behavioral health care professionals needed to remove the shortage designation in Health Professional Shortage Areas is high in all states surrounding Illinois, especially in rural areas. However, Illinois has seen the highest increase, +215%, in these shortages between 2017 and 2019.

(11) In Illinois state prisons, approximately 18% of prison inmates, or 7,883 inmates, have been previously diagnosed with a serious mental illness, compared to the overall U.S. prison population, 22%.

(12) The economic burden of schizophrenia, bipolar disorder, and major depressive disorder in adults in Illinois is estimated to be at least $1,400,000,000 for each serious mental illness.

(13) NAMI Illinois reports that youth mental health is worsening. Rates of youth depression increased from 8.5% in 2011 to 11.1% in 2014.

(14) In 2019, the Journal of Community Health found that suicide rates are disproportionately higher among African American adolescents. From 2001 to 2017, the rate for African American teen boys rose 60%, according to the study. Among African American teen girls, rates nearly tripled, rising by an astounding 182%. Illinois was among the 10 states with the greatest number of African American adolescent suicides (2015-2017).

(15) In 2017, according to the National Institute on Drug Abuse, there were 2,202 drug overdose deaths involving opioids in Illinois - a rate of 17.2 deaths per 100,000 persons, which is higher than the national rate of 14.6 deaths per 100,000 persons. The greatest increase in opioid deaths was seen in cases involving synthetic opioids (mainly fentanyl): a rise from 127 deaths in 2014 to 1,187 deaths in 2017. Deaths involving heroin also increased significantly in the same 3-year period: from 844 to 1,251 deaths. There were 623 deaths involving prescription opioids in 2017, nearly double the 343 deaths in 2014.

(16) In the State Fiscal Year 2020 budget, the General Assembly provided a rate increase for behavioral health care services of 2.5%, which is insufficient to meet costs of Illinois' $15 minimum wage increase alone.

(17) Good mental health 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 addiction treatment services. When we improve programs and services that help all Illinoisans establish stable mental 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.

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 15. Funding for certified community mental health centers and behavioral health clinics. Beginning in 2023, 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.

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 20. Funding for licensed or certified community-based substance use disorder treatment providers. Beginning in 2023, 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.

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 25. Illinois Administrative Procedure Act is amended by adding Section 5-45.1 as follows:

(5 ILCS 100/5-45.1 new)

Sec. 5-45.1. Emergency rulemaking; Departments of Healthcare and Family Services and Human Services. 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, 2020, 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, 2021, such rates shall be increased by 7%. On July 1, 2022, such rates shall be increased by 5%. Beginning in 2023, 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, 2020, the Division of Mental Health shall increase reimbursement rates for all community-based mental health treatment services by 9%. On July 1, 2021 such rates shall be increased by 7%. On July 1, 2022, such rates shall be increased by 5%. Beginning in 2023, 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, 2020, 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, 2021 such rates shall be increased by 7%. On July 1, 2022, such rates shall be increased by 5%. Beginning in 2023, 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, 2020, 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, 2021 such rates shall be increased by 7%. On July 1, 2022, such rates shall be increased by 5%. Beginning in 2023, 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.