OP-ED: On August 31^st, people in Illinois will observe the 20^th International Overdose Awareness Day.

International Overdose Awareness Day (IOAD) is about remembering the loved ones we have lost and acknowledging the grief of family and friends left behind.

It also about taking real action to save lives.

This year, the cause is more important than ever.

Because the evidence is clear: there were 2,772 Illinois statewide drug overdose deaths in 2018. Of those, 2,167 (79%) were opioid overdose-related fatalities, according to the Illinois Department of Public Health. Moreover, in 2020 Illinois will exceed the 2018 overdose numbers.

In Cook County, for example, the state’s largest county is on track to double the number of opioid-related deaths from 2019. And while African Americans make up under 24 percent of the County’s population, they account for half of all opioid deaths in the County this year.

Last year, the Cook County Medical Examiner’s Office confirmed 605 opioid overdose deaths between January 1 and July 13. This year, that number stands at 773. But that only tells part of the story. The Office is still awaiting results of 580 pending cases. According to Chief Medical Examiner Dr. Ponni Arunkumar, 70 – 80 percent of those cases will be confirmed as opioid overdoses. This means that there are already approximately 1,200 opioid toxicity deaths in Cook County this year.

Additionally, it is also clear that COVID-19 is creating enormous challenges for Illinois and our health system.

But we simply cannot ignore the health crisis of opioid overdoses staring us in the face.

Governor JB Pritzker and the Illinois General Assembly must redouble their efforts and their investments in the state’s behavioral health system to respond to the escalating opioid overdose healthcare crisis.

First, continuing to make it easier for people to access lifesaving Narcan (naloxone) or opioid substitution therapies that help them stay safe is a priority. Second, avoid undermining the addiction treatment financing system by imposing untested rate reimbursement schemes that harm the ability of residential and detox providers to care for individuals in their facilities.

Together – treatment providers, the governor, and lawmakers – we can honor International Overdose Awareness Day 2020 by embracing, funding, and remaining faithful to proven policy solutions to fight opioid overdoses.

Gerald (Jud) DeLoss, CEO, Illinois Association for Behavioral Health

(Red Bud, IL) – Human Service Center, a local non-profit provider of behavioral health, substance use, and developmental disability services, announced on this week a major rebrand and name change to reflect the company’s community-driven focus.

“At its core, our agency advocates for community wellness,” Executive Director Shea Haury said in a statement issued on June 23. “It was important to our Board of Directors and to our team that we develop a brand that reflects that commitment.”

ComWell, formerly Human Service Center, leadership worked closely with staff to develop a new brand identity that represents the agency’s inclusivity and its many efforts and services provided in supporting community needs.

“The name ComWell came easily after we discussed our vision of being an agency where community meets wellness,” Haury said. “Although we are moving forward with a new agency name, it’s important that the community knows we are the same quality service provider that they have come to know and depend on.”

The rebrand is the first for the agency since its establishment in 1975.

ComWell is committed to empowering individuals to pursue growth and wellness by promoting positive, healthy changes for individuals and communities through engagement, education, treatment and recovery.

“Our core beliefs have not changed at all,” Haury said. “Our unwavering commitment to our community, our clients and our programs remain the same. Our mission and vision have only evolved to better serve those commitments.”

The agencies steady growth and commitment to the community has brought new clients, new teammates, new goals and a refined mission. The new, modernized brand represents ComWell’s ongoing dedication to serve as a resource for healing, growth and hope for individuals and families.

The rebrand includes the tagline, “where community meets wellness,” which speaks to the heart of ComWell’s mission to provide high quality behavioral health and developmental disability services that promote a recovery oriented lifestyle.

The rebrand includes a top-to-bottom redesign of the company’s website, logo, graphics communications and correspondence.

(Springfield, IL) –US voters are overwhelmingly prepared to back candidates in the 2020 election who “promise to do more” to support mental health and addiction treatment care, according to a new poll.

A Morning Consulting national survey of 1,994 registered voters found that 62% would be “more likely” to vote for a candidate in the 2020 election if “they promised to do more to address mental health and addiction in the U.S.”

The survey, conducted August 16-18, 2019, also says 75% of Democrats are “more likely” to back candidates pledging support for mental health and addiction treatment while 57% of Independents and 52% of Republicans are “more likely” to do so, too.

“Clearly, voters heading into the 2020 elections are prepared to reward – or punish – candidates who fail to back mental health and addiction treatment services,” said Illinois Association for Behavioral Health CEO Sara Howe said. “Not so long ago behavioral health was not on voters’ political radars, but those days are over.”

Additionally, the poll finds that voters think state governments are falling short on their efforts to support mental health and addiction treatment services with 64% saying their state is “not doing enough to address addiction” and 70% saying states are falling shorting also on mental health.

“Illinois under Governor JB Pritzker has reversed the years of budget cuts under his predecessor by securing modest funding increases in the fiscal year 2020 budget,” said Howe. “But the tepid budget boost is too little to make an impression on the broader voting public.”

An Illinois “Marshall Plan” for behavioral health.

“If Illinois officials want voters take notice of their efforts and jolt public opinion, they would need to pledge to fund an Illinois ‘Marshall Plan’ for mental health and addiction prevention and treatment,” said Howe, referring to the post-World War II American aid initiative for West European countries. “Otherwise, incremental funding hikes will likely draw a collective shrug from Illinois voters or even go unnoticed.”

Methodology This poll was conducted between August 16-August 18, 2019 among a national sample of 1,994 registered voters. The interviews were conducted online and the data were weighted to approximate a target sample of registered voters based on age, educational attainment, gender, race, and region. Results from the full survey have a margin of error of plus or minus 2 percentage points.

Sara Howe, sara@ilabh.org 

(Springfield, IL) – Today, the Illinois State House approved, 115-0, a mental health first aid plan to help Illinois school children who may be contemplating suicide.

The legislation, SB1731, a trailer bill to HB4658, which passed last year, requires all licensed school personnel and administrators who work with pupils in kindergarten through grade 12 to be trained, at least once every 2 years, on the current best practices for mental health issues. The new measureprovides further instruction on the type of program that can satisfy the teachers in-service training requirements. The bill passed the Senate last month, 53-0.

“We applaud both State Senator David Koehler (D-46, Edwards) and State Representative Maurice West (D-67, Rockford) for championing this legislation,” said Sara Howe, Chief Executive Officer, Illinois Association for Behavioral Health. “Mental Health First Aid gives teachers, law enforcement, and average citizens the tools they need to help students who may be facing a behavioral health crisis, such as suicidal thoughts.”

The bill recommends the use of the Mental Health First Aid training program, which is administered by certified instructors who are trained by a national association recognized as an authority in behavioral health. Illinois already has a Mental Health First Aid training infrastructure with over 63,000 trained First Aiders and close to 600 certified instructors in-state.

“Too often mental health and substance use issues end in tragedy, such as suicide,” said West. “But by training educators, law enforcement, first responders, and other members of the public who deal with vulnerable populations, including youth, we can provide those in need the opportunity to receive timely professional help.”

The bill now moves to Governor JB Pritzker’s desk for his consideration.

sara@ilabh.org

(Springfield, IL) – A top mental health advocate group has delivered a strong warning to Illinois lawmakers on the legalization of marijuana: prepare to boost mental health, drug prevention and treatment funding to address demand surge for behavioral health services with any legalization law.

At the Illinois Senate’s April 10^thbudget hearing for the Illinois Department of Human Services, Illinois Association for Behavioral Health CEO Sara Howe made clear to Senators that marijuana legalization will come with a behavioral healthcare impact, particularly on teens, and lawmakers must be ready to pony up the money to pay for care.

“According to data from the National Survey on Drug Use and Health, the average rate of regular teen marijuana use in the legalized states of Alaska, Colorado, Oregon, and Washington is 30% higher than the U.S. rate as a whole,” according to Howe’s written testimony. “The same data found that almost one-third of all 18-25-year old individuals in legalized marijuana states used marijuana in the past month, up from around one-fifth 10 years ago.”

Howe told Senators that local behavioral health providers are ready to help shape a responsible marijuana legalization bill, but lawmakers and Governor JB Pritzker need to fund care and warned against being naïve.

“IABH members stand ready to assist you in crafting a well thought out and carefully implemented policy,” Howe stated in testimony. “However, we cannot and under no circumstances should be expected to, prevent or treat the increase in substance use or mental health disorder diagnoseswithout a significant and permanent increase in monetary resources – to not do so is simply naïve and ignores the reality of what will occur in communities.”

Lawmakers are expected to formally introduce marijuana legalization legislation after the legislature returns to Springfield on April 30.

Sara Howe, sara@ilabh.org

(Springfield, IL) – A veteran Illinois lawmaker and long-time legislative champion of mental health care and substance abuse treatment, State Rep. Sara Feigenholtz (D-Chicago), has won a prestigious national award for her advocacy in the state legislature, according to a top Illinois behavioral health leader.

Feigenholtz has been selected by the National Council for Behavioral Health – from among 230 other candidates from across the country – as the group’s recipient of the “2019 Excellence in Advocacy” by an elected official, says Illinois Association for Behavioral Health CEO Sara Howe who nominated Feigenholtz for the award.

“State Rep. Sara Feigenholtz has been a passionate champion of addiction and mental health services throughout her 24-year legislative career,” said Howe. “In 2018 alone, she carried that commitment forward by successfully sponsoring multiple bills that significantly advanced behavioral health in Illinois, including measures that targeted patient brokering, strengthened Illinois’ mental health parity law, and removed prior authorization requirements previously required by health plans and managed care organizations for most treatment services.”

Feigenholtz is the second Illinois lawmaker in the last three years to snag the 3,000-member National Council’s advocacy award. In 2016, former Illinois House Deputy Majority Leader Lou Lang (D-Skokie) won.

“The National Council for Behavioral Health’s advocacy award represents a significant honor,” said Feigenholtz, who sits on the executive board of the Kennedy Forum of Illinois, a non-profit with the goal of ending the stigma and discrimination against people with mental health and addiction challenges.”Bringing our personal stories of addiction and mental illness into the legislative arena is the fuel that drives legislative reform, and rest assured that I am just getting started.”

The National Council’s president & CEO Linda Rosenberg also hailed Feigenholtz.

“The National Council’s Awards of Excellence honor the best and the brightest in behavioral health. A passionate champion of addiction and mental health services throughout her legislative career makes Rep. Sara Feigenholtz the natural choice for the 2019 Excellence in Advocacy by an Elected Official Award,” said Linda Rosenberg, president & CEO at the National Council. “She is not afraid to stand up for her constituents and last year’s successes on opioid treatment and parity prove she is a leader for our field.”

Feigenholtz will officially receive the award in Nashville at the Gaylord Opryland & Convention Center on March 26 during the National Council’s annual awards ceremony.

Sara Howe, sara@ilabh.org 

(Springfield, IL) – Nearly 12,000 Sangamon County residents who are enrolled in the Affordable Care Act are at risk of losing their health insurance if a recent ruling from a federal judge in Texas is upheld, and Illinois’ new governor and legislature should begin to make a contingency plan, a top advocate group says.

There were 11,791 Sangamon residents enrolled in the ACA in 2017, according to Illinois Department of Healthcare and Family Services data, and the estimated 1,886 of those who suffer from mental illness could see their care jeopardized if the federal health care law falls, according to Sara Howe, CEO of the Illinois Association for Behavioral Health, which is based in Springfield.

“Here in Sangamon County, nearly 12,000 people could lose their health insurance and an estimated 2,000 with mental illness would lose access to behavioral health care,” said Howe. “Rolling back the Affordable Care Act would steam roll the health care and mental health care on which our neighbors depend.”

A federal judge in Texas ruled on December 14 that the entire Affordable Care Act is unconstitutional citing its mandate requiring people to buy health insurance.

Overall, the National Alliance on Mental Illness-Chicago estimates approximately 2.1 million Illinois adults live with mental illness and 434,000 with a serious mental illness, Howe noted.

“Because hope is not a plan, Governor-elect J.B. Pritzker and the Illinois legislature will need to make a contingency plan to address the health care for the 12,000 Sangamon county residents and the 630,000 Illinois residents overall enrolled in the ACA if the worst happens and the law collapses,” said Howe.

Sara Howe, sara@ilabh.org

(Springfield, IL) – A key component in addressing the Illinois opioid crisis advanced this week as Governor Bruce Rauner approved a plan to help people struggling with addiction get immediate access to outpatient treatment.

Rauner signed legislation on August 22, Senate Bill 682, which was championed by the Illinois Association for Behavioral Health, that removes an administrative barrier  to treat substance abuse addiction.

“Obtaining treatment is often a matter of life and death for people fighting addiction,” Rauner said. “SB 682 helps give them the tools to win that fight.”

Currently, individuals experiencing an opioid overdose or reaction must wait for their treatment to be approved by their insurance plan before entering a facility. The legislation removes prior authorization barriers so people do not have to wait for treatment.

“This year Illinois tackled the issue of substance use, working closely with providers to remove barriers to admission,” said State Rep. Sara Feigenholtz (D-Chicago), chief sponsor of the legislation in the House. “The moment a person decides they are ready to enter a recovery program is a crucial one — and that person should never be turned away. SB 682 removes the prior authorization requirement to eliminate barriers to recovery treatment.”

The new law “will save lives” says top state behavioral health advocate.

“Both rural and urban Illinois families have lost loved ones to drug overdoses that, in many cases, could have been prevented with immediate access to addiction treatment,” said Illinois Association for Behavioral Health CEO Sara Moscato Howe. “By eliminating insurance pre-authorization red tape for critical care, Gov. Rauner deserves praise for now ensuring swift access to vital addiction services that will save lives.”

In the event the insurance company denies treatment, SB 682 requires the insurance plan to cover outpatient treatment for 72 hours while the patient challenges the denial.

“It gives those in need the option for immediate coverage while they determine future coverage,” said the Department of Insurance’s Hammer. “It provides the support these people need at the right place at the right time.”

The law takes effect on January 1, 2019.

sara@ilabh.org

(Springfield, IL) – Illinois’ existing behavioral health parity law last week won added enforcement power and enhanced access to addiction treatment under a bill approved by Governor Bruce Rauner.

The legislation, Senate Bill 1707, spearheaded by the Kennedy Forum Illinois, the Illinois Association for Behavioral Health and members of the Illinois Parity Implementation Coalition, and which passed with overwhelming bipartisan support, was signed by Rauner on August 22.

The new law improves the scope and coverage of Illinois’ parity laws and provides clear enforcement power to the Department of Insurance. The legislation also prohibits prior authorization and step-therapy requirements for FDA-approved medications to treat substance use disorders and requires generic medications be on the lowest-tier of prescription formularies.

“This law is putting the ability to treat people and get them well back in the hands of providers,” Rauner said. “It lets providers do their jobs saving lives.”

The legislation also prohibits exclusions of the prescription coverage and related support services for substance use disorders.

“To combat the opioid crisis, people need immediate access to medications for medically assisted treatment,” said Illinois Association for Behavioral Health C.E.O Sara Moscato Howe. “By prohibiting prior authorization and other administrative barriers, individuals will get the right care and get the care when they need it.”

This legislation also aims to improve transparency by requiring insurance companies to make parity compliance information available via a public website, according to the bill’s chief sponsor.

“Complying with state and federal mental health parity laws only happens when insurers are held accountable,” said State Rep. Lou Lang (D-Skokie). “Transparency holds insurers to account and helps prevent coverage discrimination while enhanced enforcement power for the Department of Insurance can be invoked against insurance companies that violate parity law.”

Additionally, the legislation clarifies that medication-assisted treatment medical necessity determinations must comply with the American Society of Addiction medicine guidelines.

“This state, like many others, has a serious problem with the overuse of prescription painkillers and runaway opioid addictions,” said Rep. Margo McDermed, R-Mokena, who co-sponsored the bill. “Simplifying this process will most certainly improve patients’ quality of life and it will hopefully lead to less opioid overdoses.”

The law takes effect on January 1 2019.

sara@ilabh.org

(Springfield, IL) – A top Illinois behavioral health advocate group is sounding the alarm on inadequate state and federal funding for crisis call centers as pleas for help to the national suicide help line surge.

“Both suicide hot line calls and suicide itself in Illinois and U.S. are approaching crisis levels,” said Illinois Association for Behavioral Health C.E.O. Sara Howe. “But inadequate funding is eroding the network of crisis centers across the country as suicide has increased in 49 out 50 states in the last two decades.

Howe noted that during the next four years, the National Suicide Prevention Lifeline (800-273-8255) expects 12 million calls, equal to the calls it previously received over 12-years between 2005 and 2017.

There are currently 150 local crisis centers across the country that answer calls from the Lifeline, but from 2008-2012, nine centers dropped out of the network and from 2013-2017, 23 centers dropped out. In 2018, three centers closed.

In Illinois, there are currently seven crisis call centers. In the last six months of 2017, those seven centers could answer only 27% of the 32,675 calls from Illinois residents that poured in. The rest of the Illinois calls had to had bounce elsewhere around the country in search of an available crisis counselor.

Meanwhile, the Illinois Department of Human Services, which funds crisis services through grants to community-based providers, has seen their crisis care prevention budget cut by $400,000. In Fiscal Year 2015 there were 85 awards to community-based providers totaling $13.2 million. And in Fiscal Year 2019 there are 76 awards totaling $12.8 million.

“The crisis call center network funding needs to be growing, not shrinking, as the call volume escalates,” said Howe. “Desperate pleas for help can’t bounce around from one overwhelmed crisis center to another throughout the country if we’re serious about preventing suicide.”

In June, a report from the Centers for Disease Control and Prevention revealed that in every state except Nevada, rates of suicide increased between 1999 and 2016. Illinois saw an increase of 22.8 percent.

Between 2006 and 2015 in Illinois, 12,121 succumbed to suicide, according to the Illinois Department of Public Health. The department also reports that for young adults, 15 to 34, suicide is the 3^rd leading cause of death in Illinois.

The highest rate of suicide in Illinois per 10,000 residents between 2006-2015 was in Central Illinois’ Mason County with a 24.6 rate. Cook, Kane, and De Witt Counties tied with the lowest rate at 7.8. The City of Chicago had a 6.8 rate.

Howe says state funding for Illinois’ seven centers must increase by 10% or $1.2 million over the current budget of $12.8 million.

“We are losing youth and young adults to suicide at an alarming rate, while the state has eroded funding for suicide prevention, putting even more young people at risk,” said Howe. “State governments need to step up their crisis care funding by at least 10% or $1.2 million, and suicide prevention should a top priority of Illinois’ next governor.”

Sara Howe, sara@ilabh.org