OP-ED: IABH Charts Behavioral Health Course for COVID-19 and Post-COVID-19 Illinois

OP-ED: In 2020, the Illinois Association for Behavioral Health and its members face some of the most trying circumstances in its fifty-plus years of existence. A global pandemic, civil rights abuses, financial hardship, and uncertainty in our government makes this point one of our most critical. The Association will face this turbulent future by focusing on our immediate needs but also looking ahead and keeping in mind future opportunities.

First, IABH will continue to champion funding for its members to ensure uninterrupted operations during this crisis. Our staff and our lobbying team will work to ensure that the Pritzker Administration’s promise to make providers whole under grant funding and under Medicaid relying upon rate increases, directed payments, and other options. Additionally, IABH intends to leverage federal and state regulations permitting directed, pass-through, and/or hardship payments to fully fund providers, while working in collaboration with our partners to obtain increases in rates for critical mental health and addiction treatment.

From the outset of the COVID-19 pandemic, IABH led the effort to expand treatment flexibility to permit providers to engage in alternative treatment models and locations. IABH prepared an Executive Order on telehealth, signed by Governor JB Pritzker, that not only mandated commercial insurance coverage for telehealth services but also removed prior authorization requirements and unnecessary utilization review protocols.

These changes eliminated cost-sharing for clients and guaranteed parity. And it ensured that services provided remotely would be reimbursed the same as those provided face-to-face. IABH advocated for additional funding and for the full benefits of the Medicaid waivers so members could continue to provide services during the pandemic.

Second, building upon the COVID-19 efforts, IABH turns toward the future. The Association will be pushing for the permanent adoption of telehealth flexibility so that clients can receive mental health and substance use disorder (SUD) treatment without the need for travel or close proximity in the post-COVID-19 environment.

Looking to the future, IABH introduced first-of-its-kind legislation, House Bill 4970, for the creation of Certified Community Behavioral Health Clinics (CCBHCs), legislation that is being held up by the National Council for Behavioral Health as a national model. The CCBHC bill, sponsored by State Rep. Deb Conroy (D-Villa Park), proposes to create a tailored CCBHC model that takes into consideration the requirements and unique aspects of the Illinois mental health and SUD field.

The cornerstone of this advocacy effort is a transition to value-based payment and the adoption of a prospective payment system (PPS) that focuses upon quality rather than traditional fee-for-service reimbursement. The goal of PPS is to obtain the full reimbursement of all provider costs while at the same time removing unnecessary and costly interference in provider operations by focusing on the outcome rather than the process. Management should be left to the sound professional judgment of our expert healthcare professionals and clinicians.

The shift to PPS also aims to remove the interference of managed care organizations (MCOs), which have been imposing barriers to quality treatment. No longer will the emphasis be upon processes that produce unneeded and unnecessary paperwork and red tape. The future model will focus on how our clients respond to treatment and return to productive, healthy lives.

The short-term goal to ensure adequate funding and the long-term goal of system transformation both further the same vision.

IABH will be crafting a strategic plan to provide capacity for a current population in need of treatment as well as a long-term plan providing for full treatment capacity. The improved capacity will seek to help those have suffered through the pandemic, through financial crisis, survived civil unrest and police brutality. And we need to be ready as we transition out of the pandemic and crisis to provide the necessary behavioral health services our clients will desperately need over the long-term.

We are up to the challenge.

Jud DeLoss, CEO, Illinois Association for Behavioral Health

$1.3 Million from Feds Will Help IL Bolster Mental Health, Drug Treatment Parity

IABH CEO Sara Moscato Howe

IABH CEO Sara Moscato Howe

(Springfield, IL) – The Illinois Department of Insurance has received a $1.3 million federal grant to improve consumer and healthcare provider outreach, focusing on parity in mental health & substance use disorder benefits, and preventative health services.

“This is a tremendous opportunity to further our Administration’s coordinated efforts on mental health,” Acting Director of DOI Anne Melissa Dowling said. “These funds will help extend our outreach.”

Illinois Association Behavioral Healthcare CEO Sara Moscato Howe echoed Dowling comments.

“The grant does present an important outreach opportunity to help individuals struggling mental health or substance use disorders to get the care that they need, but otherwise may forgo by being unaware of insurance benefits to which they are entitled,” Howe said.

A portion of the grant will be directed to the Office of Consumer Health Insurance to improve data tracking and consumer complaint analysis. It will also help in increasing awareness of the internal and external appeals processes for health insurance consumers.  The grant will allow the state insurance department to develop community-focused health insurance consumer education for Illinois residents.

The state agency will also work with health plans, consumers and providers to ensure that mental health parity compliance is understood.

“I am committed to furthering this collaboration to achieve mental health parity in the commercial health care system by collaborating with my colleagues as well as with the provider community in Illinois,” said Dowling.


Quinn Aide Jumps to Top Substance Abuse Treatment, Mental Health Advocacy Group

(Springfield, IL) – A key aide to Governor Pat Quinn at the Illinois Department of Human Services has accepted a new post at a top substance abuse treatment, mental health advocacy group.

The current Director of Legislative Affairs for the Department of Human Services, Randy Wells, has been appointed to a newly created position of Vice President for Mental Health Policy at the Illinois Alcoholism and Drug Dependence Association the group announced on Wednesday.

“As the behavior health field has evolved in the wake of the Affordable Care Act, IADDA’s investment in its mental health policy agenda has evolved,” said IADDA CEO Sara Moscato Howe. “That evolution includes expanding the reach of our mental health policy agenda, and Randy will be vital to that expansion.”

In addition to his role under DHS Secretary Michelle Saddler, Wells previously led the National Alliance on Mental Illness (NAMI) for Illinois for eight-years, Howe noted.

“Randy brings to the Association membership a long history and leadership experience in mental health policy, particularly at NAMI-Illinois,” said Howe. “Randy will be charged with tracking mental health legislation, working with the legislature and the new Administration, and devising recommendations and policy positions.”