State Legislative Update
Electronic Spring 2021 | Issue 46
State Legislative Update
By: Mark Peysakhovich
IPS Legislative Consultant
The More Things Change, The More They Stay the Same
Even putting aside remote pandemic legislating via Zoom, it has been a time of dramatic change and upheaval in Illinois State Government. But at the same time, our advocacy is focusing on more of the same: protecting the safety of our most vulnerable patients by fending off another attempt to expand psychologist prescription privileges, allowing them to prescribe Schedule II drugs to everyone, including children and seniors.
Let’s start with the new...
New Speaker Elected
Let’s start with perhaps the most exciting change in Springfield, the election of State Rep. Emanuel Chris Welch (D-Hillside) by his peers. Speaker Welch is the first-ever African American Speaker of the Illinois House of Representatives. He took over as the long tenure of his predecessor State Rep. Mike Madigan ended with his recent resignation from the General Assembly. Madigan had served in that position for all but two years since 1983.
The Illinois Psychiatric Society was delighted to welcome Speaker Welch to provide the Keynote Address at the recent Region Four Legislative Institute of the American Psychiatric Association. Speaker Welch spent an hour talking to the group and taking questions, acknowledging that access to quality mental health services remains a priority in Illinois. He also noted the disproportionately high suicide rates among African Americans and predicted that a post-COVID surge of mental health problems is coming. He concluded by asking IPS to work with him to address the state’s many mental health-related needs.
Speaker Welch comes from the west suburbs of Chicago. He was first elected to the Illinois House of Representatives in2013 and has served on several key House Committees. Before his election as Speaker, Rep. Welch served as Chairman of the House Executive Committee, a powerful post that gave him control of some of the most important, high profile, and sensitive issues in Springfield. Before that, he served as Chair of the House Higher Education Committee.
Speaker Welch is a graduate of Proviso West High School, where he later served on the Proviso West Board of Education. He received his undergraduate degree from Northwestern University in 1993 and graduated from The John Marshall Law School in 1997.
New General Assembly Sworn In
The 102nd Illinois General Assembly was sworn in on January 13, 2021 in an unusual, socially distanced ceremony in Springfield. Even new legislators’ families were not allowed to join them for the exciting occasion.
This cohort of legislators is notable for several reasons. First, the sheer amount of turnover is remarkable, with 22 members taking new seats in the legislature this session. The growing level of diversity is also notable. With each election, the Illinois General Assembly is skewing towards younger people, including more females, and is more racially diverse. The contingent of openly-LGBTQ members is also growing, in size and in political power.
Every new General Assembly also sees a slew of changes in committee structure, as well as new procedures and new written (and unwritten) rules governing the way business is done in Springfield. Given the wide range of issues under IPS’ purview, we watch a broad range of committees, including Healthcare, Insurance, Professional Licensing, Adoption and Child Welfare as well as Civil and Criminal Judiciary and others. Notably, this session both the House and the Senate have “mental health” committees, demonstrating the growing importance of the issue.
The House Mental Health & Addiction Committee is Chaired by State Rep. Deb Conroy (D-46th). You can find the full membership of the committee, see pending legislation, and track committee activity here: https://ilga.gov/house/committees/members.asp?CommitteeID=2721&GA=102.
The Senate Behavioral and Mental Health Committee is Chaired by State Sen. Laura Fine (D-9th). You can find the full membership of the committee, see pending legislation and track committee activity here: https://ilga.gov/senate/committees/members.asp?CommitteeID=2736.
IPS members and staff have previously worked with Senator Fine and Representative Conroy, both of whom have demonstrated their expertise and their passion for improving mental health policy. We look forward to collaborating with the Chairpersons and the members of both of these committees. Members on these committees have a lot of influence on issues IPS members care about and we urge each IPS member to check whether YOUR legislators serve on these committees.
Despite All the Changes, an Old Threat to Patient and Public Safety Emerges Again
The Illinois Psychiatric Society is gearing up to protect patient and public safety threatened by recently-introduced Senate Bill 2272. You can find text of the bill here: https://ilga.gov/legislation/billstatus.asp?DocNum=2272&GAID=16&GA=102&DocTypeID=SB&LegID=134926&SessionID=110.
This legislation attempts to expand the scope of psychologist prescribing privileges, allowing them to prescribe Schedule II drugs to everyone, including children and seniors. Currently, the law protects public safety from narcotic diversion and patient safety from medical errors by limiting Schedule II drug prescription privileges to trained, licensed physicians. We have a hard fight ahead of us and we need YOUR help now.
PLEASE ASK YOUR STATE SENATOR NOW AND ASK THEM TO VOTE ‘NO’ ON SENATE BILL 2272
While I realize psychiatrists are doctors and not lobbyists, it is easy for you to make a significant difference in protecting your patients and your community. Here’s how:
- If you don’t already know who your state senator is, here is where you can look it up: https://elections.il.gov/ElectionOperations/DistrictLocator/DistrictOfficialSearchByAddress.aspx.
- Once you have your senator’s name, you can find their contact information here: https://ilga.gov/senate/.
- Call them at their Springfield office, tell the assistant that you are a constituent and ask to leave a message.
- Alternatively, write a brief handwritten note and “snail mail” it. You’d be surprised how much attention your brief note will get while everyone else’s email gets lost in overflowing in-boxes.
- Whether you call or write, the message is simple: Please vote NO on Senate Bill 2272 because it will hurt patient and public safety.
I am including detailed talking points below. If your legislator responds and wants more information, you can download a fact sheet with these points here:
PLEASE VOTE NO ON SENATE BILL 2272
- SB 2272 endangers the lives of Illinois’ most vulnerable citizens by allowing individuals with insufficient medical training to prescribe dangerous and highly addictive Schedule II medications to anyone, including the young and the elderly. The general public will also be less safe because expanding access to opioids and other highly addictive substances will create opportunities for illegal diversion of narcotics, increasing the likelihood of addiction, overdose, and death.
- This bill continues the disparities and inequities in our healthcare system by giving patients an inadequate level of care rather than expanding their access to the best care. Existing evidence-based alternatives like telehealth can be utilized to expand care without watering down training and safety standards. Further, the collaborative care model effectively addresses the shortage of psychiatrists by using primary care physicians as prescribers. This decreases the mental health stigma, encouraging people to seek mental health help while still offering patients the gold-standard of 4 years of medical school and 4 years of residency training required to safely provide care. Children and elderly patients who can least advocate for themselves should have society’s best care, not just the most convenient.
- In 2014, the Illinois General Assembly allowed psychologists to prescribe to adults. At that time, legislators recognized the special medical needs and challenges of children, pregnant people, and seniors by excluding them from the 2014 law. The legislature also addressed the dangers posed by expanding access to dangerous and addictive Schedule II drugs, by reserving prescribing privileges for physicians. Since then, few (5 or less) individuals in Illinois have practiced as prescribing psychologists. Illinois should have clear evidence of increased access, safety and positive clinical outcomes of the 2014 law before making further changes. While compromising patient safety, another handful of lesser trained prescribers won’t increase healthcare access.
- Children and adolescents differ from adults in their continued biological development and sensitivity to medication. A board-eligible child and adolescent psychiatrist is a physician with six years of additional training beyond the four years of medical school education, including two years of additional subspecialty clinical training in psychiatry and neuroscience specific to children and adolescents. The lower level of care created by this bill would put children at greater risk.
- More than half of Americans ages 65 and older have multiple chronic medical conditions. Older adults are often among the sickest patients and take multiple medications. Medical knowledge and medical training are essential to treat complex older adult patients with co-morbid medical and psychiatric conditions.