Healthcare (Mental Health)

Amends the Hospital Services Trust Fund Article of the Illinois Public Aid Code. In provisions requiring the Department of Healthcare and Family Services to pay safety-net hospitals a low volume add-on payment of $200 for each inpatient General Acute and Psychiatric day of care, removes the December 31, 2026 sunset date for such add-on payments. Effective immediately.

Amends the Specialized Mental Health Rehabilitation Act of 2013. Provides that each consumer shall be offered at least 15 hours of treatment programming per week and encouraged to attend the treatment domains that meet the consumer's needs, as reflected in the consumer's treatment plans. Provides that each consumer's program engagement and attendance shall be documented in the consumer's clinical record, and each consumer shall be prompted to attend programming regularly as documented in the consumer's clinical record at least quarterly. Effective July 1, 2026.

Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Human Services to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2027, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2027, the rates shall include adjustments to employment-related expenses as defined by rule by the Department. Requires the Department to adopt rules, including emergency rules, to implement the rate increases. Contains provisions on benchmark rates for therapy and counseling for adults with intellectual and developmental disabilities; tiered rates for community day services; community integration supports for community day services; and benchmark rates for CILA transportation cost and for the supported employment program for adults with intellectual and developmental disabilities. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2027, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the Department of Healthcare and Family Services must incorporate minimum standards governing behavioral health pre-payment and post-payment reviews into MCO contracts effective for all services covered on and after January 1, 2027. Requires the Department to develop or adopt behavioral health-specific pre-payment and post-payment review guidelines and incorporate such guidelines by reference into MCO contracts. Provides that the Department-issued guidelines must: (1) define the documentation and clearly specify the discrete data elements that may be requested prior to and during a pre-payment or post-payment review, and applicable response timeframes, ensuring that all requests are specific, reasonable, and directly tied to the review objectives; (2) identify regulatory, statutory, and contractual standards applicable to behavioral health services; (3) establish uniform evaluation criteria and checklists; and (4) be publicly available and updated as necessary. Contains provisions on MCO contracts and required contract terms; pre-payment and post-payment review processes and notice requirements; timeframes for providers to respond to a documentation request; communication protocols; contract transparency and extrapolation from a statistical sampling of claims; the timeliness and closure of claims reviews; submission methods; reviewer qualifications; and enforcement. Effective immediately.

Amends the Emergency Medical Services (EMS) Systems Act. In provisions concerning when EMS personnel may contact Online Medical Control or an EMS Medical Director or Emergency Communications Registered Nurse to request bypass or diversion of the closest emergency department and request transport to the closest or appropriate EMS System-approved mental health facility, removes the requirement that the patient must not be under the influence of drugs or alcohol.

Creates the Substance Use Disorder and Mental Health Program Transparency Act. Provides that, within 6 months after the effective date of the Act, the Department of Healthcare and Family Services, in coordination with the Department of Human Services, shall compile a report concerning all substance use disorder and mental health programs in the State. Provides that the report shall identify each State-funded substance use disorder and mental health program in the State and provide specified information about each program. Provides that the Department of Healthcare and Family Services, in coordination with the Department of Human Services, shall collaborate with relevant State agencies to ensure the timely and accurate collection of information required for the report. Provides that the Department of Healthcare and Family Services, in coordination with the Department of Human Services, shall submit the report to the General Assembly. Requires both Departments to make the report accessible to the public on their respective websites no later than 6 months after the effective date of the Act. Effective immediately.

Amends the Illinois Controlled Substances Act. Provides that, if any substance, scheduled as a Schedule I controlled substance by the United States Drug Enforcement Administration, is rescheduled for the purpose of treating mental health disorders, including, but not limited to, anxiety, depression, and post traumatic stress disorder, the Department of Human Services shall reschedule the substance accordingly within 30 days from the publication in the Federal Register of the final order rescheduling the substance.

Amends the Nursing Home Care Act and the Specialized Mental Health Rehabilitation Act of 2013. Provides that, to facilitate timely applications for Supplemental Security Income or Social Security Disability Insurance, facilities shall assess residents using the Social Security Administration screener to check eligibility for Social Security benefits within 30 days after admission to a facility. If the resident is likely eligible, requires the facility to assist the resident with completing an application within 60 days after admission to a facility. Provides that, within 6 months after the effective date of the amendatory Act, facilities shall conduct a one-time assessment of all current residents and complete a Social Security Administration screener for all residents without income and without a pending Supplemental Security Income or Social Security Disability Insurance application. Twice per year, requires each facility to publicly post on the facility's website the number of residents screened and the number of applications initiated. Effective immediately.

Amends the Developmental Disability and Mental Disability Services Act. Provides that in one's "own home" means that an adult with a mental disability lives alone; or that an adult with a mental disability is in full-time residence with his or her parents, legal guardian, or other relatives; or that an adult with a mental disability is in full-time residence in a setting not subject to licensure under the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, the MC/DD Act, or the Child Care Act of 1969 with 5 (rather than 3) or fewer other adults unrelated to the adult with a mental disability who do not provide home-based services to the adult with a mental disability.

Amends the Mental Health and Developmental Disabilities Code. Removes a requirement that at least one mental health examiner testify in person at an involuntary admission hearing.