Bill Targeting “Patient Brokers” Exploiting Opioids Crisis Faces Illinois House Vote


Illinois Association for Behavioral Health C.E.O. Sara Howe (R) testifies at Illinois House Mental Health Committee hearing on “patient brokering” bill. State Rep. Sara Feigenholtz (D-Chicago) (L).

(Springfield, IL) – Bipartisan legislation that targets out-of-state “patient brokers” taking advantage of Illinois residents struggling with opioid addiction and other behavioral health crisis by marketing expensive, questionable ‘treatment’ services faces a looming vote by the full Illinois House.

The measure, House Bill 4949, in which the Illinois House Mental Health Committee voted 21-0 in favor on March 8, seeks to prohibit marketers from falsely encouraging patients and families to seek treatment outside of Illinois, which would result in out-of-network expenses and travel costs.

“Scam artists marketing unscrupulous drug treatment providers have mushroomed since the opioid crisis exploded in the United States and in Illinois, and they’re preying on desperate families seeking to help a loved one overcome their addiction,” said Illinois Association for Behavioral Health C.E.O. Sara Howe. “This legislation bans the tactics that are driving patient brokering, such as barring marketers and patient brokers from seeking kickbacks and referral fees in exchange for directing patients for mental health and substance use disorder treatment.”

State Rep. Sara Feigenholtz (D-Chicago) is sponsoring the bill.

Howe, who testified before lawmakers in behalf of the bill, said the patient brokers specifically target families with private insurance and aim to run up out-of-network expenses. She cited a case to lawmakers of an Illinois woman, 26, who had travelled to Florida for drug treatment but ended dying from a drug overdose but not before her insurance company had paid more than $1.3 million to the treatment provider.

“In the case of the Illinois woman who died in Florida, the so-called treatment provider had, for example, been performing three drug tests per day, way over the industry standard, for the sole purpose of running up the bill,” said Howe. “These type of facilities, which are marketed as ‘beach front locations; are also advertising that an individual can continue using drugs while in treatment.”

In addition to prohibiting referral fees, Feigenholtz’s plan would require marketers located outside of Illinois to inform patients and families that free or low-cost treatment services may be available in Illinois and directs them to the Department of Human Services, Division of Mental Health and Division of Alcoholism and Substance Abuse for more information. Importantly, the legislation would also require that marketers inform consumers whether the facility offers services that could be covered by an Illinois insurance or managed care plan and if they are in-network of those plans as well as note that free or low-cost treatment services may be available in Illinois.

“Patient brokers operate like predators, pushing unscrupulous drug treatment programs on families who are desperate to find treatment for opioid addiction and mental illness for their loved ones,” said Feigenholtz. “HB4949 will shut down these deceptive marketing practices and dry up ‘finder fees’ for brokers referring patients. Illinois must end this practice now.”

The full Illinois House is set to vote on the bill.

For more information, contact: Sara Howe,

IL Graded “C” on Mental Health Parity Law; Advocates Join National Compliance Push

(Springfield, IL) – Next year will mark the 10th anniversary of landmark federal legislation providing insurance parity for mental health and addiction treatment, but lagging enforcement in Illinois and elsewhere around the country has pushed state behavioral health advocates to join a national compliance campaign to “jumpstart” the law and nudged state lawmakers to launch a probe of parity gaps.

“On the U.S. Mental Health Parity and Addiction Equity Act, Illinois gets a “C” on enforcement,” said Illinois Association for Behavioral Health CEO Sara Moscato Howe, who will lead Illinois’ compliance effort. “Too often, insurance companies get away with denying care to individuals struggling with mental illness or addiction. That’s why we are joining a national effort to pursue full enforcement of the law.”

Illinois and four other states – Maryland, New Jersey, New York, and Ohio – form the vanguard of the Parity@10 Compliance Campaign, a three-year, 10-state push to ensure that the federal law lives up to its promise nationwide.

Spearheading the campaign nationally are the Legal Action Center, The Kennedy Forum, The National Center on Addiction and Substance Abuse, Partnership for Drug-Free Kids, and the Research & Evaluation Group at Public Health Management Corporation.

“The campaign is ready to jumpstart parity enforcement,” said Ellen Weber, vice president for health initiatives at the Legal Action Center and the director of the campaign. “Achieving more robust parity compliance in 10 states over the next three years will not only benefit millions of people living in those states, but will also establish models that can be adopted by other states.”

Howe says that the campaign’s goal in Illinois is to ensure that insurance carriers and State Medicaid programs offer fully parity compliant substance use and mental health benefits and that regulators end complaint-driven enforcement models that put the onus on consumers.

“Generally, insurance plan documents fail to provide sufficient information for consumers to determine whether coverage complies with the law or not, which stifles complaints, and without consumers filing complaints regulators are unable to act,” said Howe. “The system is rigged in favor of insurance companies, not consumers. That’s why we need proactive enforcement that empowers regulators to police insurance companies before their plans are sold.”

Howe says that in Illinois, the campaign will work with lawmakers, regulators, and the Attorney General to develop more effective compliance and enforcement frameworks.

Howe noted that a September 2017 report by the Kennedy Forum, with whom Howe’s group collaborated, revealed that 75 percent of Illinois behavioral health providers surveyed reported that Medicaid Managed Care Organizations “sometimes/often/always” denied coverage for mental health and addiction inpatient and outpatient treatment, among other services, prompting State Rep. Steve Andersson (R-Geneva), member of the House Mental Health Committee, to file a resolution urging action to address the report findings.

Meanwhile, the House mental health panel will hold a hearing in Chicago on December 4 to launch its own investigation of mental health and addiction treatment service “barriers” experienced by community behavioral health providers.

IABH’s work with The Kennedy Forum on the report and on other parity initiatives lead the national Parity@10 Compliance Campaign organizers to select Illinois in the effort’s roll out.

“Illinois is one of five states selected to launch the campaign based on the work the Illinois Association of Behavioral Health (IABH) and The Kennedy Forum Illinois have been doing to advocate for comprehensive health insurance coverage of mental health and substance use disorders,” said the Legal Action Center’s Weber.

Top Behavior Health Advocate Group Praises Rauner Approval of Youth DUI Law


Illinois Association for Behavioral Health Vice President for Substance Use Policy Eric Foster

(Springfield, IL) – A top Illinois behavioral health advocated lauded Governor Bruce Rauner’s approval on Tuesday of legislation requiring law enforcement to develop policies to care for intoxicated young people after a D.U.I. arrest, including attempts to contact a responsible adult.

“Providing new, standardized training for local law enforcement across the state on the appropriate police responses to youth arrested for being under the influence of alcohol or drugs can potentially help avert individual and community tragedies,” said Illinois Association for Behavioral Health Vice President for Substance Use Policy Eric Foster. “We commend Governor Rauner for signing this measure to help to decrease harm to youth and others.”

The legislation is named after Conor Vesper, a 20-year old college student from Macoupin County who committed suicide hours after a drunk driving arrest. Vesper was the valedictorian of Staunton High School and an active campus leader at Blackburn College where he had earned a full ride scholarship.

“Following an arrest, it is critical that we protect impaired young people while they are still at risk for dangerous decision-making,” said Rauner. “Ensuring law enforcement has thoughtful policies related to the care of individuals under the influence that focus on reaching out to responsible adults will help prevent tragic situations and protect all Illinoisans.”

Conor’s Law requires the Illinois Law Enforcement Training Standards Board to develop policies regarding the response and care for intoxicated young people after an arrest.

The bill’s chief sponsor, State Senator Andy Manar (D-Bunker Hill), expressed his appreciation to Rauner and cited the bi-partisan effort to advance the legislation.

“I appreciate that Gov. Rauner saw the merit of this bipartisan legislation and chose to make it the law in Illinois,” said Manar. “Well over a year of work went into Conor’s Law and my only hope is that it prevents other families from experiencing the same heartbreak and anguish the Vespers experienced when they tragically lost their son, Conor. The Vesper family should be commended for their determination.”

Foster noted that IABH worked on the bill with Manar and praised the senator for his “thoughtful collaboration.”

“IABH worked with Senator Manar and his staff on the bill,” said Foster. “The senator’s thoughtful collaboration made it a good bill that we could support.”

Illinois Budget Crisis: SchuyIer County Mental Health Center in Danger of Closing by June 1

(Rushville, IL) – As the Illinois legislature struggles to craft a budget by its May 31 adjournment deadline, the Schuyler County Mental Health Center is adding itself to the list of behavioral health centers across the state that is in danger of closing within the next 10 days.

“We have been waiting for multiple payments from the State of Illinois for multiple months and have been unable to consistently meet payroll,” said Executive Director Trent Chockley. “And we’re not only waiting for payment for mental health and substance abuse treatment services, but we also have unpaid bills from the Illinois Department on Aging.”

The agency provides services to nearly 60 people, over the age of 60, every month and the state owes Schuyler a total of $64,000 for just the services provided under the Illinois Department on Aging’s Community Care Program.

“The State of Illinois continues to add deserving clients to their list that we need to serve, but has no willingness to pay the bills,” said Chockley. “We are dangerously close to shutting our doors for good without payment by June 1.”

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Report: 60% of IL Behavioral Health Providers Say Budget Impasse Pushes Out Physicians, Clinical Staff over “Job Insecurities”

IABH CEO Sara Howe

(Springfield, IL) – Illinois’ behavioral health first responders are abandoning community providers across the state as the state budget impasse has unleashed a “tsunami” of “job insecurities,” according to new a survey.

The Illinois Association for Behavioral Health and the Illinois Association of Rehabilitation Facilities on Wednesday rolled out a statewide membership survey that reveals that 60.3% of Illinois behavioral health providers have “lost physicians or clinical staff due to job insecurities.”

“A tsunami of job insecurities is washing over behavioral health providers from Chicago to Cairo and is igniting a brain drain of vital behavioral health first responders for mental health crisis and drug overdoses,” said Illinois Association for Behavioral Health C.E.O. Sara Howe. “When we talk about ‘infrastructure’ collapse because of the Illinois budget impasse, this is what we mean. That is the loss of clinical staff, doctors, and psychiatrists who are no longer willing to endure the chaotic lack of funding.”

The state currently owes behavioral health providers $143 million for Fiscal Year 2017 for services already delivered, stretching back to July 1, 2016, or 90% of the amount budgeted for the current year.

“Worry over whether someone’s job will be around next month or next week is pushing talented clinical staff to find more secure employment,” said Howe. “Who can blame them?”

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OP-ED: Illinois Budget Impasse Impact: A Behavioral Healthcare Autopsy Report

OP-ED: Unlike the warnings two years ago directed at Illinois lawmakers about human services program closures and employee layoffs at the beginning of the Illinois budget impasse, now the warnings have ended.

They have been replaced by autopsy reports.

Since the budget stalemate began, more than 1 million Illinois residents have lost access to critical human services. 1 million.

More specifically, regarding behavioral healthcare, 80,000 people in Illinois have lost access to needed mental health services and more than 24,000 fewer residents have been admitted to addiction treatment services.

In the past, governors from the executive branch and lawmakers from previous General Assemblies had determined critical human services were best delivered at the local level by the private sector as Illinois moved away from expensive state-operated institutional models to community level care.  As those decisions were made, policy makers turned to our community providers and other human service provider organizations to carry out the policy of providing government services more effectively and efficiently. And the private sector delivered.

Yet, the executive branch and the legislative branch have walked away from community care providers who delivered their goals, evidenced by year-after-year of budget cuts and financial starvation of crucial behavioral health programs.

Currently, lawmakers and the governor are making impossible, no, absurd, demands: accept months or sometimes years-long wait for payments of services delivered. The wait has financially brutalized our agencies. We’ve exhausted our reserves. We’ve sapped our lines of credit.  We’ve drained our staff. Our employees, who are on the front line of providing care to those with substance abuse and mental health disorders, arrive at work each week wondering: is this the last day?

Have you the merest notion of how such uncertainty disables a workforce?

To heave insult on top of injury, providers and their staff often hear some lawmakers and policy makers in the executive branch refer to human services as a “drain” on the General Revenue Fund. A drain?

Well, let’s be clear: when your local human service agency lays of staff – staff who pay taxes, buy homes, cars, furniture, groceries, sodas, sandwiches, etc. from your districts’ local businesses – those businesses, local chambers of commerce, and lawmakers’ districts suffer.

As of last March 2016, more than 1,000 mental health and substance abuse clinicians alone had lost their jobs. That doesn’t include case workers or administrative staff. The number of job losses has only grown in the last 12 months as the impasse has grinded forward.

The budget crisis is both a human service crisis that strikes at vulnerable citizens of Illinois and it’s an economic crisis that undermines local business owners and lawmakers’ constituents and communities and local economies.

The budget standoff and its impact are ravaging communities across the state from those who receive care, their families, the agencies that provide the care, to the local businesses that earn their income from serving them.

Without the adoption of a FY 2018 budget, the autopsy report that community behavioral healthcare providers deliver next year will only be more gruesome.

Jessica Hayes, Vice President, Board of Directors, Illinois Association for Behavioral Healthcare

OP-ED: Trumpcare Plan Would Sink Illinois Mental Health Care, Addiction Treatment for 27,000

OP-ED: Obamacare, coupled with Medicaid expansion, has transformed access to behavioral health care for Illinois residents with mental illness and addiction disorders. Since the inception of the Affordable Care Act, almost 66,000 Illinois residents have accessed care that they otherwise would not have obtained.

Today, however, tens of thousands risk losing behavioral health care in Illinois. A survey by the Illinois Association for Behavioral Health of its members estimated that 26,490 Illinois citizens would lose behavioral health services if the Medicaid expansion component is rescinded under proposed Trumpcare. Financially, in fiscal year 2019, the president’s health plan would cut Illinois’ share of Medicaid funding by $1.4 billion.

Overall, according to the non-partisan Congressional Budget Office, the Trumpcare plan would cut coverage for 975,700 Medicaid beneficiaries; cause 301,600 Illinoisans to lose employer-sponsored health insurance; cut 62,000 from the Illinois insurance exchange; and cut coverage for 55,000 elderly residents, totaling more than 1.3 million Illinoisans who would lose health insurance under the federal legislation currently under consideration.

Moreover, roughly 2,038,000 individuals in Illinois, who have pre-existing health conditions, are at risk of having their coverage rescinded, being denied coverage, or being charged significantly more for coverage if the Congress approves the proposed American Health Care Act.

The loss of addiction treatment and mental health care services would cut not only care to 26,490, but also it would inflame the heroin and opioid epidemic that is convulsing the state.

In Illinois, heroin-related overdose deaths increased 22 percent from 2013 to 2014 and the opioid-related death rate rose 120 percent from 2014 from 2015. In 2016, Illinois Criminal Justice Information Authority researchers surveyed police chiefs and sheriffs for its Illinois Drug Threat Assessment and more than half of respondents identified heroin as the greatest drug threat in the state.

For example, in 2015, Will County registered 53 overdose deaths linked to heroin and fentanyl, which is more than the 51 deaths caused by traffic accidents. In Cook County, there were 526 heroin and fentanyl deaths in 2015 compared to 240 traffic deaths.

Critically, in the current opioid epidemic fight, Medicaid pays for 15.4% of addiction treatment medication in Illinois.

Additionally, Governor Bruce Rauner’s signature criminal justice reform goal to reduce the Illinois prison system by 25% would be jeopardized with the loss of federal money from the rollback of Medicaid expansion.

Without Medicaid expansion, Illinois will need to spend tens of millions of its general revenue fund dollars—an estimated $84.5 million—to pay for critical community-based behavioral healthcare services in support of the Commission on Criminal Justice and Sentencing Reform’s goal to reduce the state’s prison population 25% by 2025. That’s money that Illinois does not have.

The health legislation being considered currently by Congress would unleash a health care crisis, in general, and a behavioral health care crisis, in particular, in Illinois on a staggering financial and human scale if approved by federal lawmakers.

Illinois’ congressional delegation – which has a healthy interest in its constituents’ behavioral health well-being and their own – has a clear choice.

Drug Treatment Center Collapses; Exasperated Advocates Point Finger of “Moral Culpability” at Illinois Elected Officials

IABH CEO Sara Moscato Howe

(Springfield, IL) – The slated closure of a Central Illinois addiction treatment center because of Illinois’ budget crisis has pushed exasperated behavioral health advocates to demand that Illinois’ top elected leaders “do their job” or face “moral culpability” for “abetting heroin crisis.”

The Jacksonville-based Wells Center, which provides a 32-inpatient and outpatient addiction treatment program, announced on Friday that it will close in April and layoff all 33 employees.

Wells Center, which serves 500 clients annually, is owed approximately $1.4 million from the state, which provides 70 percent of its funding.

“The Wells Center closure is an another self-inflected wound in a long list of self-inflicted wounds committed by the state’s elected leaders,” said Illinois Association for Behavioral Health CEO Sara Moscato Howe. “We ask our elected leaders to stop marching in parades; stop schmoozing at political fundraisers; stop working the rubber-chicken circuit and, instead, focus like a laser on a budget deal. Period. Nothing else matters.”

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Affordable Care Act Repeal Would Cost Illinois 114,000 Jobs

(Springfield, IL) – Pledges by President Donald Trump and U.S. congressional leaders to repeal the Affordable Care Act would deal an economic blow to Illinois, costing the state 114,000 jobs, says a new report.

A new report by Health Care for America Now shows the impact that repealing the Affordable Care Act would have on Illinois. It says more than a million people in the state would lose health coverage.

The fallout also includes $1.2 billion in new uncompensated care, 114,000 lost jobs, and $2.7 billion in lost income for hospitals and physicians. In Illinois, 260,000 people receive subsidies to help pay for their coverage, and the report says repeal would cost each of them over $4,300 in 2019.

Lynda DeLaforgue, the co-director of Citizen Action Illinois thinks without a good replacement plan, a repeal is irresponsible and dangerous.

“When people can get medical care at the front end, then we prevent a lot of catastrophic illness at the back end,” she said. “And so, the whole system is benefited through this, not to mention all of the lives that are saved when people have access to health care at the front end.”

66,000 Illinois Citizens Got Mental Health, Drug Treatment Thanks to Obamacare Advocates Tell Durbin

spr_capitol_v2(Springfield, IL) ­– In a letter to U.S. Senator Dick Durbin (D-IL), a top Illinois behavioral health advocacy group claims that Obamacare has provided 66,000 Illinois citizens treatment for mental illness and substance abuse that “they otherwise would not have obtained.”

The letter to Durbin, dated January 2, 2017 from the Illinois Association for Behavioral Health CEO Sara Howe, heralded the Affordable Care Act impact in Illinois.

“The ACA, coupled with Medicaid expansion, has made a tremendous positive difference in access to services for those with mental illness and substance use disorders,” Howe wrote. “Since the inception of the ACA, IABH members have provided almost 66,000 Illinois citizens services they otherwise would not have obtained.”

Howe warned Illinois’ senior senator that “thousands” risk losing behavioral health care in Illinois if the U.S. Congress repeals the federal health insurance plan.

“The loss of services under the auspices of the ACA would not only lead to thousands of clients losing services, it would exacerbate the all too common occurrence of those with mental illness and substance use disorders being incarcerated due to actions taken as a result of their lack of access to care,” Howe stated.

A survey of its members by the group estimated that 26,490 Illinois citizens would lose behavioral health services if the Medicaid expansion component of the ACA is rescinded.

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