HB4317 102ND GENERAL ASSEMBLY

LRB102 22494 RLC 31635 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB4317

Introduced 1/5/2022, by Rep. Denyse Wang Stoneback

SYNOPSIS AS INTRODUCED:

New Act

Creates the Commission on Mental Health Reform Act. Creates the Commission on Mental Health Reform. Establishes membership on the Commission and its duties. Provides that the Commission shall be chaired by the Secretary of Human Services or the Secretary's designee. Provides that the Department of Human Services shall provide necessary administrative and other support for the Commission. Provides that the Commission, with administrative support provided by the Department of Human Services, shall produce and submit policy recommendations, both administrative and legislative, to the General Assembly and the Governor in the form of an annual report. Provides that the annual report shall include summary information about mental health services in the State, including challenges, deficiency in services, and recommendations for increasing and improving mental health services and bringing about reform. Provides that the report must address all of the concerns and issues listed. Provides that the Commission shall submit the annual report in the month of March, and during this month its representatives shall testify before the Mental Health and Addiction Committee of the House of Representatives and the Health Committee of the Senate to present its findings, make recommendations, and answer questions. Provides that the first annual report shall be submitted within one year after the first meeting of the Commission. Provides that the Commission shall be dissolved 5 years after the effective date of the Act. Repeal the Act 6 years after its effective date.

A BILL FOR

AN ACT concerning 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 Commission on Mental Health Reform Act.

Section 5. Commission on Mental Health Reform.

(a) It is the intent of the General Assembly to create a Commission on Mental Health Reform to:

(1) assess the current needs and advise on the necessary reform of mental health services in this State;

(2) build upon the existing reform efforts with which State agencies, coalitions, and advocates are currently engaged in the field of mental health;

(3) have a critical role in bringing agencies together to coordinate initiatives, share information, and create a larger systemic impact. This coordination and the input of stakeholders who had mental health issues shall provide a foundation to align systems and identify and bridge systemic gaps around mental health to best serve the needs of the residents of this State;

(4) assess the landscape of mental health care in this State and determine the levels of service and investment of resources in geographical areas across the State; and

(5) make recommendations on the next steps for future investments and actions based upon apparent needs.

(b) There is created the Commission on Mental Health Reform composed of at least 37 members. The Commission shall be appointed by the Secretary of Human Services or the Secretary's designee and shall be composed of at least the following:

(1) the Director of Public Health or the Director's designee;

(2) the Director of the Division of Mental Health of the Department of Human Services, or the Director's designee;

(3) the Secretary of Human Services or the Secretary's designee;

(4) the Director of the Division of Developmental Disabilities, or the Director's designee;

(5) the Director of Children and Family Services or the Director's designee;

(6) the Director of Healthcare and Family Services or the Director's designee;

(7) the Director of Juvenile Justice or the Director's designee;

(8) the Director of Corrections or the Director's designee;

(9) the Director of Insurance or the Director's designee;

(10) a representative of the Governor's Office of Management and Budget;

(11) the Director of the Illinois Housing Development Authority or the Director's designee;

(12) the Director of Aging or the Director's designee;

(13) a mental health clinician with experience managing or directing a program in another state where mental health services are successful;

(14) an expert mental health clinician who has experience evaluating and providing services to people in psychiatric distress in emergency room settings;

(15) representatives from at least 3 geographically diverse mental health provider agencies in Illinois, with experience in community-based services;

(16) at least 2 members of the House of Representatives who serve on the Mental Health and Addiction Committee or the Human Services Committee;

(17) at least 2 members of the Senate who serve on the Health Committee;

(18) a representative from a public health organization that does research on the treatment of mental health conditions and diseases;

(19) representatives from at least 2 non-profit organizations that educate and advocate for people with mental health conditions;

(20) a Medicaid recipient who has received mental health services in this State;

(21) a family member of a Medicaid recipient who has received mental health services in this State;

(22) a member of law enforcement who has been trained in Crisis Intervention Training;

(23) a representative from a non-profit organization that educates and advocates for the prevention of suicide;

(22) the Director of the Office of Firearm Violence Prevention or the Director's designee;

(23) a psychiatrist and a therapist or psychologist specializing in the treatment of adults;

(24) a psychiatrist and a therapist or psychologist specializing in the treatment of children and youth;

(25) a mental health specialist who serves clients who have been recently incarcerated;

(26) a representative of the Community and Residential Services Authority;

(27) a representative of the State Board of Education; and

(28) a representative of the Office of State Guardian.

Additional members may be included on the Commission at the discretion of the Secretary of Human Services to achieve geographic diversity, balance, or representation of necessary perspectives.

Other than ex officio members, members of the Commission shall serve 3-year terms. With the exception of persons impacted by mental health issues serving on the Commission, the members of the Commission shall serve without compensation. The members of the Commission impacted by mental health issues shall receive a stipend from appropriations made to them by the General Assembly.

(c) The Commission shall be chaired by the Secretary of Human Services or the Secretary's designee. The first meeting of the Commission shall be convened no later than 3 months after the effective date of this Act. Meeting of the Commission are subject to the Open Meetings Act. The Commission may meet in person or virtually to carry out its duties. The Department of Human Services shall provide necessary administrative and other support for the Commission. All State agencies represented on the Commission, including the Department of Public Health, Department of Corrections, Department of Juvenile Justice, Department of Children and Family Services, Healthcare and Family Services, Department on Aging, Department of Human Services, Illinois Housing Development Authority, Governor's Office of Management and Budget, Department of Insurance, State Board of Education, and Office of State Guardian, shall facilitate the prompt and timely collection and provision of data as requested by or on behalf of the Commission. The facilitation shall include, without limitation, authorizing the provision of reports and underlying State agency data that the State agency currently or previously has provided or made available to university partners and consultants. Any data provided by State agencies shall redact any personally identifiable information of any clients or families before release to the Commission.

(d) The Commission may organize into sub-committees or subgroups if it deems necessary. The sub-committees or subgroups shall be working groups focused on the following areas:

(1) budgetary needs and insurance;

(2) clinician assessment and recommendations for mental health care for adults;

(3) clinician assessment and recommendations for mental health care for children and youth; and

(4) mental health needs of persons who are or have been incarcerated.

(e) The Commission shall:

(1) assess needs for mental health care in this State;

(2) identify gaps around mental health in geographical areas across this State;

(3) establish rules around data collection and publishing;

(4) meet benchmarks stipulated in this Act and establish a more specific timeframe for recommended reform;

(5) in order to align systems, identify when coordination of initiatives, sharing of information, and transparency is needed between agencies on data of availability of mental health and related services, and funding streams for mental health services;

(6) issue recommendations, goals, and benchmarks for:

(A) improvements to and expansion of community-based mental health and substance abuse treatment services including through Assertive Community Treatment (ACT) and Intensive Case Management (ICM) Teams;

(B) increasing early diagnosis and treatment rather than late-stage treatment of mental health conditions;

(C) increasing availability of psychiatric residential placements based on data analysis and in accordance with least-restrictive standard of care;

(D) in accordance with least-restrictive care principles building service capacity, improving access to services by reforming Medicaid rates to cover the cost, enable capacity growth, and institute value-based payment;

(E) building a system of care for children and young adults;

(F) increasing mental health care for children;

(G) improving insurance practices and coverage of proven treatments, including implementing and enforcing parity laws, and ensuring coverage of proven treatments not covered by insurance;

(H) developing the mental health workforce through incentives to grow this workforce;

(I) enabling affordable housing through rental subsidies, through investment in rental subsidies, combined with treatment, supportive housing, diversion strategies to stop the cycle of hospitalizations, and criminal legal system involvement for those persons with disabilities and left homeless by their disability;

(J) treating currently incarcerated people who suffer from mental health conditions;

(K) improving coordination of mental health related services between government agencies, service providers, and patients; and

(L) easing the administrative burdens that are a barrier to access to mental health services;

(7) take action and implement its findings and recommendations. An explanation must be provided in the annual report for any recommendation an agency does not choose to implement;

(8) review the relevant consent decrees and focus recommendations to comply with the following consent decrees:

(A) Lippert v. Jeffreys (Department of Corrections-healthcare);

(B) Monroe v. Jeffreys (Department of Corrections-gender dysphoria treatment);

(C) Rasho v. Jeffreys (Department of Corrections-mental health care);

(D) RJ v. Mueller (Department of Juvenile Justice-conditions and services available to persons confined at State-operated juvenile justice facilities including issues re: mental health and confinement conditions);

(E) Williams v. Pritzker (Department on Aging, Healthcare and Family Services, Department of Human Services-individuals in nursing homes for persons with mental illnesses-Olmstead);

(F) Ligas v. Eagleson (Healthcare and Family Services-unnecessary segregation and institutionalization of persons with developmental disabilities in large intermediate care facilities when they could be better served in smaller, community settings-Olmstead);

(G) BH v. Smith (Department of Children and Family Services-care and conditions including severe shortages of mental health services and substandard conditions at various residential treatment centers treating youth in care);

(H) NB v. Eagleson (Healthcare and Family Services-Medicaid eligible children under 21 with a mental or behavioral health diagnosis in need of community-based services);

(I) Colbert v. Pritzker (Department of Human Services, Healthcare and Family Services-institutionalizing people with disabilities when they could live in their own homes or other small, community-based settings-Olmstead); and

(J) Memisovski v. Maram (Healthcare and Family Services, Department of Human Services-access and availability of Medicaid services to children).

(e) The Commission, with administrative support provided by the Department of Human Services, shall produce and submit policy recommendations, both administrative and legislative, to the General Assembly and the Governor in the form of an annual report. The first annual report shall be submitted within one year after the first meeting of the Commission.

The annual report shall include summary information about mental health services in this State, including challenges, deficiency in services, and recommendations for increasing and improving mental health services and bringing about reform. The report must address all of the concerns and issues listed. The Commission shall submit the annual report in the month of March, and during this month its representatives shall testify before the Mental Health and Addiction Committee of the House of Representatives and the Health Committee of the Senate to present its findings, make recommendations, and answer questions. The Directors of Public Health, Children and Family Services, Juvenile Justice, Department of Corrections, Healthcare and Family Services, Aging, Insurance, Governor's Office of Management and Budget, Illinois Housing Development Authority, State Board of Education, the Secretary of Human Services, and a representative of the Office of the Governor shall testify before these committees as to their respective actions taken in response to the findings and recommendations of the Commission. Any State agency that has not adopted or implemented a Commission recommendation made for that agency, shall provide written and oral testimony explaining their rationale for this decision. The annual reports shall include the following items:

(1) Year 1: Identification of gaps in mental health care. Assessment of budgetary needs for State agencies to build necessary service capacity to meet the needs of mental health in this State. Assessment of each State agency's compliance with requirements of consent decrees and the State agency's responses to its level of compliance.

(2) Year 2: Report on the progression of implementation of recommended actions from Year 1, including barriers to progress and recommended actions to address these barriers. Roles of State agencies, coalitions, advocates, and other stakeholders currently engaged in the field of mental health in this State. Recommendations of needed coordination between them to bridge the systemic gaps.

(3) Year 3: Report on the progression of implementation of recommended actions from Years 1 and 2, including barriers to progress and recommended actions to address these barriers. Recommendations for expansion of community-based mental health and substance abuse treatment services.

(4) Year 4: Report on the progression of implementation of recommended actions from Years 1, 2, and 3, including barriers to progress and recommended actions to address such barriers. Phasing in of recommendations for gaps in mental health care.

(5) Year 5: Report on the progression of implementation of recommended actions from previous Years. Phasing in of recommendations for gaps in mental health care.

(f) The Commission chair shall convene a final meeting before the repeal date of this Act to discuss an implementation plan based on the produced policy recommendations.

(g) The Commission shall be dissolved 5 years after the effective date of this Act.

Section 10. Repeal. This Act is repealed 6 years after the effective date of this Act.