Behavioral Health Updates and Resources

December 21, 2021

Memorandum

Below are several updates and resources concerning hospital and health system behavioral healthcare focused on:

  • Medicaid updates from the Illinois Dept. of Healthcare and Family Services (HFS);
  • Expedited youth evaluations for the Illinois Dept. of Children and Family Services (DCFS); and
  • A reminder of new state laws effective before or on Jan. 1.

Medicaid Updates

SBIRT Reimbursement for Substance Use Intervention and Treatment
On Dec. 15, HFS issued a Public Notice seeking federal approval for a separate Screening, Brief Intervention, and Referral to Treatment (SBIRT) service reimbursement under Medicaid for implementation of Public Act 102-0598. HFS’s proposal describes SBIRT as a model for early intervention and treatment for persons who are under-identified with and at risk of developing substance use disorders including, but not limited to, an addiction to alcohol, opioids, nicotine, or cannabis. The notice did not detail how SBIRT would be reimbursed, but did estimate this change will increase expenditures by $9.8 million annually. The notice was silent on the provision in Public Act 102-0598 requiring coverage of hospital fees for direct opioid antagonist distribution, intended to eliminate a barrier to distribution without a prescription. Questions or comments may be submitted by Jan. 14 to:

  • Bureau of Program and Policy Coordination, Division of Medical Programs, Healthcare and Family Services, 201 South Grand Avenue East, Springfield, IL 62763-0001; or HFS.bpra@illinois.gov.

Coverage of LCPC and LMFT Services
On Nov. 30, HFS issued a Provider Notice informing providers of new coverage for certain diagnostic and therapeutic services rendered by Licensed Clinical Professional Counselors (LCPCs) and Licensed Marriage and Family Therapists (LMFTs) in an office, home, or community setting beginning with dates of service on or after Dec. 1.

Reminder: Youth Counseling Eligibility Expansion and Adaptive Behavior Support Services
The following notice summaries are reminders regarding youth coverage changes, based on an increase in inquiries related to Medicaid youth service access.

On Oct. 27, HFS issued a Provider Notice updating the Community-Based Behavioral Health Services Handbook with information for providers that deliver Medicaid Rehabilitation Option – Mental Health (MRO-MH) and Targeted Case Management (TCM) services. For services that can be delivered to youth under age 21 before completion of the Integrated Assessment and Treatment Planning (IATP; using the IM+CANS tool), see p. 19, Section 207.1.2. Therapy/Counseling services may be provided for youth with mental health needs prior to receiving a mental health diagnosis for up to eight clinical sessions, not exceeding 90 minutes per session.

On Sept. 30, HFS posted a Provider Notice broadening its coverage of services for youth up to age 20 with Autism Spectrum Disorder to be inclusive of Adaptive Behavior Support (ABS) services, effective Oct. 1. Covered ABS services include Behavioral Assessment and Treatment Planning and Behavioral Analytic Intervention. ABS services must be delivered by individuals meeting the qualifications of a Board-Certified Behavior Analyst (BCBA) or a Registered Behavior Technician (RBT).

Expedited DCFS Youth Evaluations

IHA has partnered with DCFS to provide an opportunity that may expedite DCFS-required evaluations for Youth In Care while in hospital settings. In order to provide a psychological evaluation (PE) or neuropsychological evaluation (NP) for DCFS Youth In Care while they are hospitalized, licensed clinical psychologists need to be credentialed to perform clinical services at the hospital and be approved by DCFS. PEs and NPs are requested to provide information that will clarify diagnosis, identify treatment needs, and guide treatment for Youth In Care as well as parents whose children are in care. Psychologists who are credentialed by private Illinois hospitals are encouraged to complete a short, two-page application to become DCFS-approved clinicians. Click here for the program flyer, PE application, and NP application. Application materials, questions and comments can be sent directly to Erin Alexander, Psychology and Psychiatry Program Director, DCFS Division of Clinical and Child Services, at Erin.Alexander@illinois.gov or 312-523-3584.

New State Laws Effective Before or on Jan. 1, 2022

As a reminder, the behavioral health-related legislation listed below is effective before or on Jan. 1, 2022. For a complete summary of these new laws, please see IHA’s Overview of General Assembly’s Spring 2021 Session.

  • SB106/Public Act 102-0076 (Sen. Sara Feigenholtz/Rep. Delia C. Ramirez) – DCFS Annual Reports for Youth in Care, effective July 9, 2021
  • SB693/Public Act 102-0623 (Sen. Melinda Bush/Rep. Deb Conroy) EMS Systems Transport, effective Aug. 27, 2021
  • SB1966/Public Act 102-0371 (Sen. Adriane Johnson/Rep. Rita Mayfield) – Mental Health Out-of-State Care, effective Jan. 1, 2022
  • SB1970/Public Act 102-0372 (Sen. Laura Fine /Rep. Jennifer Gong-Gershowitz) – Access to Mental Health Information, effective Jan. 1, 2022
  • SB2294/Public Act 102-0043 (Sen. Ann Gillespie/Rep. Greg Harris) – Medicaid Omnibus
    • Hospital Opioid Inpatient Status, effective July 6, 2021
    • Long-Acting Injectables Hospital Reimbursement, effective Jan. 1, 2022
  • SB2323/Public Act 102-0649 (Sen. Sara Feigenholtz/Rep. Stephanie Kifowit) – DCFS Prohibited Restraints for Youth Transport, effective Aug. 27, 2021
  • HB2589/Public Act 102-0598 (Rep. Deb Conroy/Sen. Laura Fine) – Substance Use Disorder/Opioids, effective Jan. 1, 2022
    • To order and distribute naloxone directly in your facility, click here for expedited hospital enrollment in the Illinois Dept. of Human Services Drug Overdose Prevention Program.
  • HB2595/Public Act 102-0579 (Rep. Deb Conroy/Sen. Laura Fine) - Generally Accepted Standards of Behavioral Health Care Act, effective Jan. 1, 2022
  • HB2784/Public Act 102-0580 (Rep. Kelly Cassidy/Sen. Robert Peters) – Community Emergency Services and Support Act (CESSA), effective Jan. 1, 2022
  • HB3308/Public Act 102-0104 (Rep. Thaddeus Jones/Sen. Napoleon Harris III) – Insurance Telehealth Services, effective July 22, 2021

Contact us with any questions or comments.