Electronic Fall 2021 - Issue 48
By: Mark Peysakhovich
IPS Legislative Consultant
It has been a busy summer for state mental health advocates, with some good news to share. Here are several key announcements from the State of Illinois that are worth noting.
Illinois Becomes Third State in the Country to Require Insurance Coverage for Mental Health Disorders And Establishes Innovative Statewide Response to Mental Health Crises
Governor JB Pritzker recently signed two pieces of legislation into law to establish a forward-thinking mental healthcare infrastructure in Illinois.
House Bill 2595: To expand access to quality and reliable insurance for mental healthcare, HB 2595 requires every insurer to provide coverage to all medically necessary mental healthcare across the state. This includes the treatment of mental, emotional, nervous or substance use disorders starting January 1, 2023.
The legislation requires the Illinois Department of Insurance to file a joint report on mental, emotional, nervous, or substance use condition parity to the General Assembly no later than January 1, 2022. requires medically necessary mental healthcare to be covered by insurance beginning January 1, 2023. Illinois follows California and Oregon in requiring coverage for mental, emotional, nervous or substance use disorders.
House Bill 2784 creates a first responder system that will coordinate 911 and 988 emergency responses when the national 988 mental health crisis line is established in the summer of 2022. This initiative – the first statewide approach of its kind in the nation – aims to reduce arrests for those with mental illnesses who are deserving of a specialist’s intervention.
The Community Emergency Services and Support Act – also known as the Stephon Edwards Watts Act – requires all Illinois municipalities to coordinate 911 and 988 services, with the goal of prioritizing community care over incarceration or improper use of force when it comes to mental or behavioral health emergencies.
When an individual is dispatched through a 911 system, HB 2784 ensures that an appropriate mobile response is available, requiring 911 call center operators to coordinate with a mobile mental and behavioral health services, established by the Illinois Department of Human Service’s Division of Mental Health (DMH).
The DMH helps individuals with mental illnesses recover and participate fully in community life. Under this law, DMH will provide guidance on coordinating mobile units, when responding to an individual who is experiencing a crisis. The Division will also establish regional advisory committees in each Emergency Medical Services (EMS) region to advise on mental and behavioral health emergency response systems. To ensure lasting change, the law requires appropriate responder training, which helps train police officers when responding to mental health emergencies.
The legislation continues the administration’s efforts to establish partnerships with law enforcement and mental health resources; therefore, reducing arrests of those who suffer from mental illnesses. The Governor also recently signed into law the First Responder Mental Health Bill, which creates a database and webpage with a comprehensive collection of mental health resources specifically geared toward first responders as well as legislation that made Illinois one of the first states in the nation to permanently expand access to tele-mental health coverage.
Gov. Pritzker Signs Legislation Reforming the Use of Prior Authorization to Protect Patients
Legislation Will Help Ensure Faster Access to Care, Holds Insurance Companies Accountable
Furthering this year’s state efforts to protect the wellbeing of Illinois residents and medical patients, Governor JB Pritzker recently signed legislation that reforms the use of prior authorization. The legislation ensures faster access to medically necessary treatments for patients and holds health insurance companies accountable through timelines for approvals, transparency measures, and discipline for infractions.
HB 711 creates the Prior Authorization Reform Act, effective on January 1, 2022, and makes significant reforms to prior authorization’s use in Illinois. Previous use of prior authorization resulted in patients waiting too long for medically necessary and appropriate treatments. Patients often faced longer wait times, adverse health outcomes, and rising costs for necessary urgent medical treatments.
- Establishing approval timelines. Prior authorization approvals will remain valid for six months, and 12 months for chronic and long-term diseases to ensure continuity of care for patients.
- Establishes a robust system for prior authorization denials which includes the reasons for the denial and instructions on how to appeal.
- Sets guidelines for individuals designated to review prior authorization applications. Determinations must now be done by physicians with same or similar areas of medicine.
- Establishes discipline measures for infractions.
- Increases transparency by requiring insurers to maintain a list of services for which prior authorization is required.
- Reduces the number of medically necessary services that are subjected to prior authorization requirements.
- Requires that a decision must be made no later than 5 calendar days after obtaining the necessary information.
Illinois Department of Agriculture Announces Expansion of Farmer Mental Health Initiatives
Illinois Department of Agriculture received a grant award of $500,000 to increase farmer stress-related mental health initiatives statewide. The Department applied for the grant in coordination with Southern Illinois University Medicine Center for Rural Health and Social Service Development and University of Illinois Extension.
In 2019 the Farm Family Resource Initiative (FFRI) was established in Illinois to specifically address mental health needs of the farming and agricultural communities. The FFRI Committee consists of members from government, commodity groups, academic institutions, healthcare and industry. Led by Southern Illinois University School of Medicine, the FFRI launched a six-county pilot program to provide resources to Christian, Logan, Macon, Macoupin, Morgan and Sangamon counties through a telephone hotline connecting farmers with mental health resources and providers. This grant will allow for the expansion of the pilot program to the entire state.
Additional plans for grant funding include:
- Text and e-mail communication options (in addition to telephone hotline),
- increased marketing of helpline,
- voucher program for professional behavioral health services,
- agricultural literacy training for mental health providers to increase knowledge of agricultural community, and
- further Mental Health First Aid trainings for agricultural community members.
This funding resulted from IDOA’s grant application for the “Farm and Ranch Stress Assistance Network” funded by the United States Department of Agriculture National Food and Agriculture (USDA NIFA). Funds are provided to State Departments of Agriculture to connect individuals who are engaged in farming, ranching, and other agriculture-related occupations to stress assistance programs. The Farmer Assistance Helpline is available 24 hours a day 7 days a week at 1-833-FARM-SOS.