(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

(Springfield, IL) – With the November 6 election less than four months away, a new poll reveals that majorities of Illinois voters back increased state funding for both mental health and addiction treatment services.

A July 12 survey of 423 likely voters conducted by Illinois Public Opinion, Inc. found that a whopping 68.5% want the State of Illinois “investment more money in mental health care” while only 8.7% “invest less.” And 22.6% were undecided.

“Clearly, Illinois voters overwhelmingly support increasing funding for mental health services,” said Sara Howe, C.E.O. of the Illinois Association for Behavioral Health. “Mental health care has increasingly won vocal, bi-partisan support among state and federal lawmakers as they scramble to respond to tragic and more frequent mass shootings across the country, with mental health care being one of multiple prevention strategies, and public opinion is responding.”

Howe, notes that state funding for mental health funding has been, however, on a long, steady decline with an exception of a minor bump in the current state budget.

In Fiscal Year 2008, the legislature appropriated $368 million from the state’s general revenue fund to community mental health agencies. By Fiscal Year 2018, that amount had fallen by more than half to $170 million. In the Fiscal Year 2019 spending plan, community mental health providers, however, saw a 3% rate increase.

“The bottom line is that Illinois’ mental health budget has wilted despite public opinion,” said Howe. “The message from voters is loud and clear: more money for mental health care is a priority.”

The poll also showed that most voters, 52.4%, also support “investing more money” for treatment to help people struggling with drug addiction while 19.9% said “invest less” and 27.6% were undecided.

“The stigma of drug addiction has long weighed on public support for treatment services even though addiction is a neurological brain disease,” said Howe, explaining the gap in support in comparison to mental health. “That said, now having more than 50% of voters supporting greater financial in addiction treatment services is a sea-change in public opinion, and I’m convinced that the heroin epidemic and broader opioid crisis has driven that change because virtually no community has been untouched.”

The state general revenue funding pattern for addiction treatment services has also followed that of mental health care, dropping from $165 million in 2008 to $78 million in 2018.

“What is clear from the polling data is that voters by wide margins want the state to invest more money in behavioral health care,” said Howe. “Conditions in communities across the state, like the opioid crisis and mass shootings, are propelling public opinion forward.”

The automated survey contacted voters by both landline and cell phones and the margin of error was +/- 5.0%.

(Springfield, IL) – Bipartisan legislation that targets out-of-state “patient brokers,” which takes advantage of Illinois residents struggling with opioid addiction and other behavioral health crisis by marketing expensive, questionable ‘treatment’ services, is heading to Governor Bruce Rauner’s desk

The measure, House Bill 4949, has zipped through unanimously both the House and Senate.

The legislation 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 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.”

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(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  has been approved by the full Illinois House.

The measure, House Bill 4949, zipped through the House 110-0 last week.

The legislation 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 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.

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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, sara@ilabh.org.

(Springfield, IL) – Next year will mark the 10^th 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.

sara@ilabh.org

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