IL Lawmakers Push 4-Year Plan to Rescue Beleaguered Mental Health Care System

After the historic, two-year Illinois budget impasse financially knee-capped the state’s community mental health providers, derailing care for more than 80,000 individuals, a new legislative plan is being advanced in Springfield by lawmakers and mental health advocates that seeks to provide a long-term financial rescue.

(Springfield, IL) –After the historic, two-year Illinois budget impasse financially knee-capped the state’s community mental health providers, derailing care for more than 80,000 individuals, a new legislative plan is being advanced in Springfield by lawmakers and mental health advocates that seeks to provide a long-term financial rescue.

The legislation, House Bill 2486 and Senate Bill 1673, sponsored by State Rep. Deb Conroy (D-Villa Park) and State Senator Heather Steans (D-Chicago), would steadily increase state investment in mental health treatment over the next four years, by $50 million. The measure would also change how the state regulates and funds mental health

CBHA CEO Marvin Lindsey

providers, ensuring they have the means to innovate to meet patients’ needs, and rewarding those providers who produce good health outcomes.

Most of the new funding would come through the state’s Medicaid program, drawing at least a 50% match in federal dollars. That would limit the state’s out-of-pocket cost to no more than $13 million a year over the four years, above what is spent now on mental health treatment.

Advocates and lawmakers pushing for the new focus on mental health treatment funding say the legislation is long overdue, a funding problem compounded by the two-budget impasse that plunged the state’s mental health system into crisis.

“The two-year budget impasse completely destabilized Illinois’ behavioral health system with nearly80,000 residents losing access to mental health,” said Community Behavioral Health Association (CBHA) CEO Marvin Lindsey. “Illinois’ behavioral health system will need 7 to 10 years to recover from the financial body blow inflicted by that self-made crisis, and the legislation proposed by Senator Steans and Rep. Conroy provides a roadmap for financial recovery and long-term investment.”

Tim Sheehan, CBHA’s Chairman of the association’s Public Policy committee and Vice President of Lutheran Social Service of Illinois, highlighted the budget impasse impact.

“During the stalemate, mental health providers across the state received only court-ordered Medicaid dollars, but state grant money was halted, causing layoffs, service cuts, and program shutdowns of those providers across the state,” Sheehan said. “The first casualty of the budget impasse was the Delta Center in Cairo, the poorest city in Illinois, which was forced to closed completely.”

Moreover, Lindsey said that a survey of Illinois community mental health providers during that time showed that 73% had either shut down a program or cut services.

“For far too long, state policymakers have ignored addressing the foundation of the mental health system – Medicaid rates and antiquated state regulations,” said Heather O’Donnell, Senior Vice President of Public Policy and Advocacy at Thresholds, a major provider of mental health services in the Chicagoland area. “We have focused too much on small pilot projects, but never get at the root of the problem. With these bills, we will finally provide a real solution: improving access to foundational mental health treatment.”

“As chair of the Senate Appropriations Committee overseeing human services agencies, I have seen firsthand devastation caused by the Rauner Administration to the state’s already fragile mental health infrastructure,” said Sen. Steans, D-Chicago. “With these proposals, we can change course, work with the Pritzker Administration to create a stronger, more effective and more efficient mental health service delivery system and give families throughout Illinois the treatment resources and support they need and deserve.”

Conroy echoed Steans’ comments.

“Thousands of Illinois families across the state of Illinois are victims of our mental health crisis. For too long, they have had nowhere to turn as the mental health services infrastructure was decimated, particularly over the last four years,” said Rep. Conroy, D-Villa Park, who is chair of the House Mental Health Committee. “By creating a multi-year solution to reinvest and restructure our mental health programs with targeted, federally matched dollars, we can provide renewed hope to the millions affected by our mental health crisis.”

Marvin Lindsey, CEO, CBHA: 

$35,000 Student Loan Repayment for Illinois Psychiatrists OK’d by IL House

(Springfield, IL) – The Illinois House has given its unanimous backing to a legislative plan that would create a student loan repayment program for behavioral health professionals who commit to working in the state’s rural and underserved areas.

The House approved 101-0 legislation, House Bill 5109 sponsored State Rep. Lou Lang (D-Skokie), to provide student loan assistance to eligible mental health and substance abuse professionals practicing in community mental health centers in underserved or in rural communities designated by the federal government as professional shortage areas.

According to the federal Health Resources and Services Administration, Illinois has the 6th largest number of mental health professional shortage areas in the U.S. with 85 of 102 counties in Illinois having areas designated shortages.

“Illinoisans who need mental health counseling can wait up to three months or longer before they see a specialist due to a severe behavioral health workforce shortage,” said Community Behavioral Health Association of Illinois C.E.O. Marvin Lindsey. “As Illinois faces an ongoing opioid crisis and a reemergence of meth usage in Southern Illinois, the state’s behavioral workforce shortage cripples our response to the crisis.”

Continue reading “$35,000 Student Loan Repayment for Illinois Psychiatrists OK’d by IL House”

$10 Million Owed to Illinois Mental Health Providers Stretching to 2014

CBHA_Lindsey_Hearing_MCO(Chicago) – A top behavioral health advocate group told Illinois lawmakers at public hearing in Chicago on Thursday that multiple insurance companies managing the state’s Medicaid program owe community care providers an estimated $10 million on overdue bills stretching back to 2014.

Community Behavioral Healthcare (CBHA) CEO Marvin Lindsey revealed to members of the House Human Services Appropriations Committee that some MCOs have made progress on paying providers since the panel’s last legislative hearing in March 2017.

“While some Managed Care Organizations have made progress in paying outstanding claims, before the start of the new contract date, our members are still owed $10 million that date back as far as three years,” said Lindsey.

The House panel, chaired by State Rep. Greg Harris (D-Chicago), is reviewing the Illinois Department of Health and Family Services’ new, $60 billion Medicaid managed care contract with seven different insurance companies that took effect January 1, 2018.

Among those behavioral health providers with outstanding bills payable by managed care insurance companies is Lutheran Social Services of Illinois, which is currently owed $2.3 million. Of that amount, $1,026,000 is 90 days or more overdue and $436,615 is more than 365 days overdue.

“According to their contract with the Illinois Department of Health and Family Services, managed care companies are required to pay 90% of claims within 30 days and 99% of claims within 90 days,” Lutheran Social Services of Illinois Home and Community Services Vice President Tim Sheehan. “Fortunately, some Medicaid managed care organizations have made a concerted effort to pay down outstanding claims while others have not.”

Lindsey also noted that the state has contracted a private auditor to examine MCOs’ estimated liabilities to providers and that a report is scheduled to be released next month, but that the auditor has yet to contact community behavioral health providers.

“I am not aware of the auditing firm contacting one of our members,” said Lindsey. “And an interim report is due February 2018 and the clock is ticking on both the report and our members getting paid.”

The Department of Family Services hired Meyers and Stauffer, LLC, effective November 1, 2017, to audit the current MCOs to estimate liabilities for services provided by community behavioral health providers from July 1, 2014 to December 31, 2017.

“Last March, we testified before this committee on the MCO contract on what we believed would lead to a smoother process and transitions for community behavioral health providers, and providers getting paid for services delivered was near the top of that list,” said Lindsey. “Over the last 9 months, some managed care companies have made progress in paying back claims, but the fact remains other insurance companies are seriously lagging behind and community behavioral health providers are still owed $10 million.”

Local, State Advocates Sound Alarm on Illinois Mental Health Care Crisis

(Springfield, IL) – Local and state behavioral health advocates are sounding the alarm on Illinois’ swelling mental health crisis.

“Wait times to see a psychiatrist in Illinois’ community mental health system can now range from 4 to 6 months,” said Tim Sheehan, Chairperson of the Public Policy Committee of the Community Behavioral Healthcare Association of Illinois and Vice President of Home and Community Services at the Des Plaines-based Lutheran Social Services of Illinois. “The lack of an adequate behavioral health care workforce is causing longer and longer wait times for people struggling with mental illness to receive care, a situation which has reached crisis proportions in the state.”

Sheehan noted that according to the Illinois Department of Healthcare and Family Services, the inadequate behavioral health workforce is responsible for the state’s “insufficient community behavioral health services capacity.”

In fact, Illinois ranks 30th in mental health workforce availability with 844 people per mental health worker compared to the national median of 752, Sheehan points out.

A top Illinois behavioral health advocacy group leader says that the limited access to front-line mental health care in Illinois is “staggering and shameful” while local community agencies’ budgets are spending more on administrative costs due to the state’s new managed care system.

“There is a staggering and shameful lack of access to behavioral health care represented by a shortage of specialists, such as child and adolescent psychiatrists, advanced practice nurses, and physician assistants,” said Community Behavioral Health Association of Illinois CEO Marvin Lindsey. “Meanwhile, the administrative staff costs of providing community behavioral health services have increased dramatically, by as much as two to five times, since Illinois implemented Medicaid Managed Care.”

Sheehan agreed.

“More money is being devoured by administrative costs associated with paperwork demands of Illinois’ expanded Medicaid Managed Care program and less on investing in an adequate, front-line behavioral health workforce to care for patients,” Sheehan said.

Lindsey, Sheehan and other behavioral health advocates are planning a two-prong state legislative offensive to address Illinois’ deepening mental health care crisis.

“We’re planning on pushing a Resolution in the Illinois General Assembly to declare a ‘mental health care emergency in Illinois’ to raise awareness of the critical problem of access to care,” Lindsey said. “And we are going to advance legislation that would comprehensively address the behavioral health workforce crisis, which is undermining mental health care in Illinois.”

Fixing behavioral health workforce is a “priority,” says Sheehan.

“For community mental health agencies across the state, including Lutheran Social Services of Illinois, providing more support, more training, and a deeper bench to the behavioral health workforce is a top advocacy priority,” said Sheehan. “It’s critical.”

Survey: $142 Million Owed to Mental Health Providers as Psychiatrist Wait Times Mushroom, Services Shudder

(Springfield, IL) – A new survey by a top behavioral health advocate group reveals that the state of Illinois owes community mental health centers statewide a staggering $142 million in unpaid bills, a debt that is squeezing care for people struggling with mental illness and addiction.

The Community Behavioral Healthcare Association of Illinois released on Wednesday a survey of state community mental health providers that shows that these agencies are owed for fiscal year 2017 a total of $142,558,150 or nearly 90% of what has been budgeted for the current fiscal year that expires on June 30.

Moreover, the survey shows that, in Fiscal Year 2016, 73.5% of community agencies had reduced or eliminated behavioral health programs and that in Fiscal Year 2017 an additional 33.7% of agencies further cut or ended services.

“To say that community mental health providers are operating on fumes would be incorrect. They consumed the fumes long ago,” said Community Behavioral Healthcare Association of Illinois C.E.O. Marvin Lindsey. “The financial starvation of providers has shriveled our ability to serve an exploding need to the extent that Illinois is fast becoming a behavioral health system Potemkin Village.”

Continue reading “Survey: $142 Million Owed to Mental Health Providers as Psychiatrist Wait Times Mushroom, Services Shudder”

OP-ED: Rauner Administration 2018 Behavioral Healthcare Budget Fails to Meets its Ambitions

OP-ED: The Rauner Administration’s proposed FY 2018 budget for the Illinois Department of Human Services (DHS) falls dramatically short of the governor’s stated ambition to place behavioral health care at the center of a human services transformation. The money requested and the ambition articulated fail to align.

According to the Governor’s Office of Management and Budget FY 2018 budget book, less than half of the 750,000 people needing mental health treatment in Illinois actually received treatment, but the governor’s proposed budget fails to address this need. In fact, 80,000 people in Illinois have lost access to needed mental health services. This proposed budget also fails to restore the community behavioral health community infrastructure – counselors, case managers, community programs, and facilities that have been pulverized into dust – by the budget impasse that has ravaged community care providers over the last 22 months.

Yet, the governor’s appropriation request for the Division of Mental Health is $36 million less than the FY 2015 GRF actual expenditures. $36 million less. The governor’s stated aim of reducing institutional care and increasing community-based services cannot be achieved with this proposed budget. In fact, it goes backwards.

The governor’s proposed FY 18 DHS budget for the Division of Alcoholism and Substance Abuse (DASA) is no better.

In the DASA budget, there is no recognition of the heroin and opioid wildfire blazing across the state, especially in southern Illinois, suburban counties and on the Westside and Southside of Chicago. According to the Illinois Department of Public Health, a broad swath of southern Illinois counties has been walloped by a 200% plus increase of opioid related overdose deaths between 2010- 2015, with 57% to 74% being between the ages of 25-44. Those numbers are projected to increase. In fact, 24,000 fewer Illinoisans have received addiction treatment services.

Yet, the governor’s appropriation request for DASA is $26 million less than the FY 2015 GRF actual expenditures.

Community providers struggle to operate under a climate of uncertainty of payments. Compounding that problem of payment uncertainty is the problem of potential deeper cuts. ‘Doing more with less’ is fine for a bumper sticker or a campaign speech, but doing with less, in a reality based world in which the books need to be balanced, gets you less. Period.

In the case of behavioral healthcare, getting less means that an untreated mental health crisis can cost a mother her job or, worse, 10 days in county jail. Untreated heroin addiction can cost a life. You can’t put a crisis on a waiting list.

Finally, the two-year budget ordeal has forced longer, bulging client waiting lists, program cuts, agency closures, and employee layoffs in community mental health and addiction agencies across the state. In a March 2017 United Way of Illinois “Stop Gap” survey, 33% of community mental health providers have reduced the number of individuals they can now serve.

The impasse has struck at many constituents of Illinois lawmakers. We encourage legislators, no, we plead with them, to, please, find the will to compromise, to find a way forward. Your constituents are depending on you.

Now is the time for the executive and legislative branches to set partisan politics aside and pass a responsible budget. We insist on an immediate resolution to this crisis.

Is this too much to ask?

Marvin Lindsey, CEO, Community Behavioral Healthcare Association of Illinois

Advocates to Lawmakers: Illinois Should Slash Medicaid Managed Care Organizations from 12 to 5

(Springfield, IL) – At a public hearing before state lawmakers last week in Springfield, Illinois’ top behavioral healthcare advocates recommended that the state reduce the number of its Medicaid Managed Care Organizations under contract from 12 to five.

At a joint Illinois House public hearing on Thursday of the chamber’s human service committees about the Rauner Administration’s plan to reform the state’s $9 billion Medicaid program by, in part, reducing the number of Medicaid Managed Care Organizations under state contract, Community Behavioral Healthcare Association of Illinois CEO Marvin Lindsey told House lawmakers during the four-hour hearing that because of “enormous amount of administrative burden” placed on community behavioral health providers that any new state contract should limit Managed Care providers to “five.”

“Currently, many of our members contract with as many as 7 to 10 Medicaid MCOs, which creates an enormous amount of administrative burden on providers of all sizes, especially small- to moderate- size providers,” Lindsey told legislators. “We support reducing the number from the current number of 12 to 5 to allow providers to focus more time and energy on providing care and treatment instead of being on the phone trying to track down staff from 7-10 MCOs to get authorizations, answers to billing questions or explanations for denied services.”

Under the Rauner Administration’s slated contract “Request for Proposal,” the new Medicaid program calls for more than 80 percent of Medicaid beneficiaries to receive services through managed care, up from 65 percent today. It also extends managed care to every county in Illinois and to children under the care of the Department of Children and Family Services. The new program is scheduled to become effective January 1, 2018.

Today, approximately two million of the state’s 3.1 million Medicaid members are served by managed care plans. But providers and plans have withdrawn from the program in recent months; leading to several counties in central Illinois without any managed care options.

“We support Governor Bruce Rauner’s intent to reduce the number of Medicaid Managed Care Organizations because community behavioral health providers are consumed by navigating a mish-mash of vast, uncoordinated corporate bureaucracies,” said Lindsey. “Those corporate bureaucracies are distracting us from for our core mission: delivering care to individuals working to recovering from mental illness and drug addiction.”