May 2024 Report

Government Strategy Associates

P.O. Box 242

Oak Lawn, IL 60805

The Legislative session wrapped up in Springfield last week. The Senate adjourned over the weekend and the House of Representatives returned on Tuesday worked literally through the night finishing up their business at 4:44 a.m. on Wednesday morning.

No new stadium deals were hatched, and lawmakers paid no heed to the demand by Chicago Mayor Brandon Johnson that Chicago is owed another billion dollars. Prison Review Board changes did not advance. The state also did not address the transit “fiscal cliff” that will hit the state next year as federal funding expires. Also, Tier 2 and other pension changes still need to be addressed and it is anticipated there will be more hearings throughout the summer and fall.

Several hundred bills have passed both chambers and will be awaiting the signature of the Governor. The legislative proposals that received the most attention were the state budget, the Medicaid omnibus bill, the revenue package.

Bills of Significance that Passed

House Bill 2499 eliminates Short-Term Limited Duration health plans, which did not cover behavioral health or pre-existing conditions and placed significant limitations to coverage. While this bill was not on ACMHAI legislation list, its passage has a significant positive impact on the mental health community.

House Bill 4951 passed by a vote of 60-47. (I stayed up to watch all the fireworks.) The bill was part of the revenue omnibus bill and the Community Mental Health Act amendments are embedded in Senate Amendment #2. Rep. Ness had language added to address the cleanup of the Act, technical fix of the Will County definitions, codify referendum language and address concerns regarding PTELL. The legislative passed both chambers.  This legislation will be sent to the Governor and it is anticipated that he will sign this into law.

House Bill 5094 establishes an Administrative Burden Task Force to develop a plan to reduce the administrative burden on community behavioral health providers. This passed both chambers.

House Bill 5353 streamlines provisions for licensing of mental health professionals.

House Bill 5395 improves network adequacy requirements for health insurance.

House Bill 5457 requires that IDFPR must grant reasonable exam accommodations to people whose first language is not English and to people with disabilities.

House Bill 5530 changes the rules governing the injection of long-acting psychotropic medications by pharmacists. This bill was not monitored by ACMHAI, but is impactful for people living with mental health disorders and clinicians.

Senate Bill 0726 requires schools to create a mental health screening program for public elementary and high schools.

Senate Bill 3137 requires a facility to promptly notify the personal representative of the death of a patient in a mental health facility.

Senate Bill 3268 is the Medicaid Omnibus: Lifts prior authorization requirements for psychiatric drugs that treat serious mental illness in certain circumstances (when a person changes providers or MCOs, or when the dosage of the medication is changed). Increases the Medicaid psychiatry reimbursement rates.  Sets a total compensation per hour benchmark of $264.42. These rate adjustments have an effective date of January 1, 2025. This bill passed both chambers.

Senate Bill 3297 makes the Housing is Recovery Program Available to Youth 18 and Older.  Lowering the eligibility age from 21 to 18 allows youth/young adults experiencing homelessness who are living with a serious mental health and substance use disorder to go from street homelessness to housing with a rental subsidy.

Senate Bill 3405 allows for a county to use funds designated by law or ordinance for transportation purposes to fund rides for persons to attend problem-solving courts. Defines “problem-solving court” as a court program regulated under the Drug Court Treatment Act, the Juvenile Drug Court Treatment Act, the Mental Health Court Treatment Act, or the Veterans and Servicemembers Court Treatment Act.

Senate Bill 3648 amends the Community Emergency Services and Support Act (CESSA). In provisions relating to emergency services dispatched through a 9-1-1 PSAP and coordination of activities with mobile and behavioral health services, provides that the coordination must begin no later than July 1, 2025 (rather than July 1, 2024). Provides that provisions relating to State prohibitions shall take effect once specified conditions are met, but no later than July 1, 2025 (rather than July 1, 2024). Effective immediately.

Senate Bill 3753 amends the Mental Health and Developmental Disabilities Code to provide that the Division of Developmental Disabilities of the Department of Human Services may impose progressive sanctions, excluding a situation in which a recipient of services is placed at immediate risk of harm, on providers that fail to comply with conditions specified by rule, contract, or policy as determined by the Division.

Bills of Significance that Did Not Pass

House Bill 5351 proposed changes to the Mental Health and Developmental Disabilities Code to remove obstacles to outpatient commitment. This was an initiative of Mental Health America of Illinois. The legislation passed the House and stalled in the Senate.

House Bill 4475 strengthens the Mental Health and Substance Use Parity Act. The legislation improves network participation and allows behavioral health providers working toward licensure to practice under the supervision of another fully licensed provider. The bill also sets out to improve reimbursement, and requires certain coverage standards. The bill passed the House and did not move in the Senate.

Governor Pritzker’s reform proposal, House Bill 5395 would make Illinois the first state in the country to ban prior authorization for in-patient adult and children’s mental healthcare. Sponsors said the Healthcare Protection Act could also ban step therapy, the tactic insurers use to force people to receive less effective drug treatments before moving to options initially recommended by doctors. The bill is awaiting Senate committee hearing.

State Budget Highlights

The $53 billion budget, contained in 3,374-page appropriations bill. Lawmakers added more than $1.1 billion in added revenue to balance the budget. These budget and revenue measures passed with only Democratic support in both chambers.

The budget includes new investments in psychiatric services. The funding level is projected at approximately $11 million in the form of rate enhancements for psychiatric services billed under Medicaid.

The budget also increases wages for direct service professions and other frontline staff that serve individuals with intellectual and developmental disabilities in residential and community day services by $1/hr. Out of this increase, $0.75 must be allocated directly to base wages and the remaining $0.25 can be used flexibly for additional wage increases.

Other budget items to note:

·      The plan will pay $10.49 billion towards pensions which meets the full pension payment required by law. The state will also send $198 million to the state’s “rainy day” fund.

·      Illinois’ public school districts will receive $8.6 billion in state funding next year – $350 million more than last year. That’s the minimum annual increase lawmakers agreed to in 2017 when the state created a new evidence-based formula to change how K-12 schools are funded. Over time, districts have received almost $2 billion more in funding from the state.

·      There is a child tax credit for qualifying children under the age of 12, providing parents a credit of 20% of the state’s Earned Income Tax Credit in calendar year 2024 and 40 percent in 2025.

·      Lawmakers will see 5% raises, boosting annual pay for all 177 members of the Illinois General Assembly to $93,712. Leadership and committee chairpersons receive additional compensation. The raises also pertain to affect all constitutional offices and heads of executive agencies.

·      The budget also includes $182 million for migrants and covers $440 million in health care costs for undocumented people.

The budget was not met with unanimous acclaim. A dozen Democrats did not vote for the budget and no Republicans supported it. Republicans were highly critical of this budget.

Despite holding 78 seats in the Illinois House, Democrats needed three tries and some last-minute maneuvering to convince 60 of their members to support the revenue proposal. This measure added $1.1 billion in revenue from several changes to the state’s tax code.

The plan involves a cap on corporate net operating losses that businesses can claim, which is expected to generate $526 million. A tax on companies that re-rent large blocks of rental rooms, like Expedia, will bring in $25 million for the state.

The state continues to eye gaming for more money. The tax rates on state sports betting tax increase and will now be in a tiered structure, with the largest sportsbooks paying a 40% tax and the smallest paying 20%. A 1 percentage point increase to the tax on the state’s video gambling industry would generate an additional $35 million for infrastructure projects next year.

The state will collect $101 million by capping the retailers’ discount for collecting the sales. As a concession to retailers, the General Assembly hastily passed a prohibition on companies charging fees on the sales tax and gratuity portion of electronic transactions. Financial institutions and even airlines are critical and skeptical or the roll out of this. Expect more discussion, possible lawsuits, and follow up legislation.

In the waning days of session other notable measures were also passed. The General Assembly has 30 days to send the measure to the Governor and he has 60 days to take action.

Upcoming Dates

·      Around June 28, 2024 – all bills will have been sent to the Governor

·      Around August 27, 2024 – all bills will have been acted upon by the Governor

·      Tuesday, November 5, 2024 – General Election

·       TBD in the Fall – Veto Session