Rep. Lindsey LaPointe

Creates the Psychiatric Residential Treatment Facilities (PRTF) Act. Requires the Department of Healthcare and Family Services to establish an Illinois Psychiatric Residential Treatment Facilities (PRTF) program that is family-driven, youth-guided, and trauma-informed, and includes youth and family involvement in all aspects of care planning. Requires the Department to submit a State Plan Amendment, by January 1, 2026, to the Centers for Medicare and Medicaid Services to establish coverage of federally authorized, medically necessary inpatient psychiatric services delivered by a certified PRTF to medical assistance beneficiaries under 21 years of age. Provides that the Department shall adopt rules to implement the PRTF program that at a minimum shall include: (i) certification and participation requirements for PRTF providers in compliance with all applicable federal laws, regulations, requirements, and policies; (ii) monitoring and oversight of PRTF services; (iii) a limit on allowable beds at any one PRTF, not to exceed 40 total beds; and other matters. Requires the Department to establish, and update as needed, a methodology for completing a statewide PRTF capacity analysis for the purposes of identifying capacity needs for PRTF services under the Illinois Medical Assistance Program. Requires the Department to establish a PRTF Advisory Committee responsible for reviewing and providing guidance on the Department's policies and implementations of the PRTF program. Requires the Department to publish on its website counts of reported emergency safety interventions and serious occurrences by State fiscal year and quarter. Makes conforming changes to the Specialized Mental Health Rehabilitation Act of 2013, the Child Care Act of 1969, and other various Acts. Effective immediately.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Expands the classes of persons eligible for medical assistance to include, beginning January 1, 2027 and subject to any federal waivers or approvals necessary for implementation, persons licensed under the Clinical Psychologist Licensing Act, the Clinical Social Work and Social Work Practice Act, the Illinois Dental Practice Act, the Medical Practice Act of 1987, the Licensed Certified Professional Midwife Practice Act, the Nurse Practice Act, the Physician Assistant Practice Act of 1987, or the Registered Surgical Assistant and Registered Surgical Technologist Title Protection Act. Permits such licensed persons to apply for medical assistance by submitting an application to the Department of Healthcare and Family Services between January 1 and March 31. Requires the Director of Healthcare and Family Services to determine the form and manner of submitting an application. Requires the Department to post application instructions on its website. Requires an eligible person who satisfies all application requirements to pay a premium for medical assistance coverage that shall be no higher than 5% of the person's annual income. Provides that any premiums paid shall be automatically allocated to the Department's medical assistance budget for the next fiscal year. Requires the Department to adopt rules.

Amends the Illinois Insurance Code. Makes a technical change in a Section concerning the purpose of the Article regarding nonprofit risk organizations.

Amends the Rebuild Illinois Mental Health Workforce Act. Provides that beginning January 1, 2026, for each State fiscal year, a monthly directed payment shall be paid to each community mental health provider of community support individual services based on the number of Medicaid users of community support individual services documented by Medicaid fee-for-service and managed care encounter claims delivered by the provider in the base year. Sets forth how the monthly directed payment shall be calculated. Requires the Department of Healthcare and Family Services to adjust and pay community mental health providers for any payments authorized for all services from a community mental health provider which have been paid by a Medicaid managed care organization but no encounter claim has been recorded in the Departments' Enterprise Data Warehouse. Provides that the Department must develop a process for community mental health providers to reconcile these payments and submit claims for which the Department has not used for making payments. Permits the Department to sanction Medicaid managed care organizations for services not received by the Department.

Amends the Illinois Insurance Code to require an insurance policy to provide coverage for medically necessary treatments for genetic, rare, unknown or unnamed, and unique conditions, including Ehlers-Danlos syndrome and altered drug metabolism. Provides that an insurance policy that provides coverage for prescription drugs shall include coverage for opioid alternatives, coverage for medicines included in the Model List of Essential Medicines published by the World Health Organization, and coverage for custom-made medications and medical food. Provides that an insurance policy that limits the quantity of a medication in accordance with applicable State and federal law shall not require pre-approval for the treatment of patients with rare metabolism conditions that may need a higher dose of medication than what is otherwise allowed within a time frame or prescription schedule. Provides that the burden of proving that treatment is medically necessary shall not lie with the insured in cases of rejections for filing claims, preauthorization requests, and appeals related to coverage required under the Section.

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026, shall not impose any prior authorization or utilization management controls on covered behavioral health services. Makes conforming changes to the State Employees Group Insurance Act of 1971, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, and the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Insurance and the Department of Healthcare and Family Services to establish a process for receiving complaints from providers and covered individuals for violations of the mandate. Grants the Department of Insurance and the Department of Healthcare and Family Services the authority to issue cease and desist orders and administrative fines. Amends the Prior Authorization Reform Act. Provides that the Department of Healthcare and Family Services shall adopt rules consistent with the Act. Provisions amending the Prior Authorization Reform Act are effective immediately.

Amends the County Department of Corrections Division of the Counties Code, the Unified Code of Corrections, and the County Jail Act. Provides that, upon the release of a prisoner or committed person from a county correctional institution, county jail, or Department of Corrections correctional institution or facility, the sheriff, warden, or Department shall provide the prisoner or committed person with an opioid antagonist if the prisoner was incarcerated for drug-related charges or was identified as having a substance abuse disorder.

Amends the Property Tax Code. Provides that, for taxable years 2025 and thereafter, the maximum income limitation for the Low-Income Senior Citizens Assessment Freeze Homestead Exemption is $75,000 for all qualified property. Effective immediately.

Maddy summaryThis is a ceremonial resolution (not a policy bill) recognizing Illinois House Speaker Emanuel "Chris" Welch for becoming the first Black lawmaker elected as Illinois House Speaker in the state's 200+ year history. The resolution formally celebrates his leadership during Black History Month and acknowledges his re-election as Speaker in 2023 and 2025. It serves as a symbolic gesture from the Illinois House of Representatives to honor his historic role, with no new laws or policy changes enacted.

Maddy summaryHB 3575, titled the "Specialized Mental Health Rehabilitation Facility Task Force Act," creates a new state task force to study specialized mental health rehabilitation facilities in Illinois. The bill does not include substantive policy changes but establishes this task force to examine facility operations and needs. It directly affects state agencies responsible for mental health services, requiring them to participate in the task force's work. As a procedural bill with no other provisions, it focuses solely on creating this oversight body without specifying further actions or funding.