The Illinois General Assembly is scheduled to conclude its 103rd legislative session on May 24. Rep. Lindsey LaPointe (D-Chicago), chair of the Mental Health and Addiction Committee, spoke with State of Reform about the successes and challenges of this legislative session, and her ongoing legislative priorities.
LaPointe will be speaking on the “Legislators Discuss Health Policy” panel at the 2024 Illinois State of Reform Health Policy Conference, which will be held on May 29 at the Fairmont Chicago Millennium Park. Those interested can register here.
State of Reform: Can you tell me about the healthcare-related legislative work you focused on this year?
Rep. Lindsey LaPointe: “The lens that we’re trying to see things through is that behavioral healthcare is healthcare, and healthcare is a human right … Just to level set, when I say behavioral health, I mean mental healthcare, substance use disorder treatment, recovery and trauma support. To many of us, it’s more of an all encompassing term than just mental health. Obviously, this is all long-term work, because for decades and decades, behavioral health was seen as an “other” thing, very distinct from physical healthcare and highly stigmatized. So we’re trying to make progress and it takes long-term persistence.
This session, in particular, it is more of a maintenance budget year in Illinois because our revenues are projected to go down. We’re all living in that reality, so we can’t have grandiose new investments in behavioral health this year.
One bill that I’m really excited about is a bill that we call the Strengthening Mental Health and Substance Use Disorder Parity Act [House Bill 4475]. It’s a bill that applies to state-regulated commercial insurance, which encompasses about 40 percent of everybody on commercial insurance in Illinois, including state and local government employees. What it aims to do is to really grow the behavioral health insurance networks … People who have commercial insurance use it for behavioral health needs—like therapy, a psychiatrist, (and) substance use treatment—and there are not enough providers.
Part of that is we are in a workforce crisis, but another very distinctive part of it is [around] 20 percent of all behavioral health providers don’t deal with insurance. They’ve taken themselves out of networks because the reimbursement rate is so low and the administrative burden is so high.
So [HB 4475] remedies that by creating a rate reimbursement floor … [The bill] gets to something I really believe in, and that is: the amount that our behavioral health providers are getting paid—which is directly tied to reimbursement rates—is so important.”
SOR: What are your goals as we head into the final week of the session?
LL: “I have three really big goals related to behavioral health. One is making progress or passing [HB 4475]. We’re doing lots of things related to behavioral health, but if we don’t stay focused on the most fundamental things of growing insurance networks so people can actually use their insurance—whether that be commercial or Medicaid—then we’re missing the most fundamental part.
Another really big goal of mine that we’re trying to get across the finish line is getting rid of prior authorization for psychotropic drugs for people with serious mental illness who are on Medicaid … We are working on [HB 2456] in collaboration with the state’s Healthcare and Family Services Department. There are [also] some other big healthcare access bills that have some element of getting rid of prior authorization in them, including having to do with mental health.
The other thing I want to mention is making sure we maintain our funding for a relatively new thing called the Mental Health Early Action on Campus Act. That is a state funding stream that we just started in calendar year 2023. [It is for] all the state universities and community colleges across Illinois to set up some mental health and wellness infrastructure on their campuses to help students and young people.
The governor has proposed to cut that funding stream in his introduced budget by about 70 percent, and we want to get it back at least to that level of $13 million. We understand it’s a maintenance budget year … But we cannot be cutting anything related to behavioral health.”
SOR: What have been some of your greatest challenges and successes in this session?
LL: “Continuing to make progress on behavioral healthcare access—even in a maintenance budget year—has been a challenge. What we all know, both intuitively and because the data shows it, is when we make investments in behavioral health that increase people’s access to the support they need, it saves money in the long-term.
[But] we have to put together a balanced state budget in May, so we can’t really bank on those long-term savings when we’re trying to basically solve a math problem and create a balanced budget in terms of all the revenue we have to deal with and all the budget line items we are putting together.
This year we’re taking the approach [that] we have to at least maintain all the great work we’ve done already. And I will say Gov. J.B. Pritzker has made behavioral health access a key issue, and I’m so grateful for that.
I would say the bipartisan nature of behavioral health issues [has been a success]. It’s what I call an all-partisan issue. Everybody across Illinois cares about behavioral health access … When you break it down into human language, all of the residents of Illinois that we all represent, whether we’re Democrats or Republicans, this issue speaks to them because they’re seeing that in their day-to-day lives.”
SOR: What are some gaps in the state’s health policy that you want to continue working on in the future?
LL: “We’ve made a lot of progress but we still have gaping holes in our behavioral health system across the lifespan. One that I think is very urgent is growing our workforce and really making sure our workforce is diverse in terms of race, ethnicity, and genders to truly reflect the population of Illinois [which is] super diverse.
The mental health profession, social work in particular … Is historically a white profession. And white women, in particular, are overrepresented and there is so much impact, efficacy, power, and support in people being able to access behavioral healthcare from people that share race and ethnicity with them. And we’re just so incredibly overdue to break down barriers for people of color to get into this field at every stage.
Last year, we passed a bill to create an alternative to the licensed clinical social work (LCSW) exam and that bill became law in January. We needed to do that because data indicated that the LCSW exam was extremely racially disparate and a racially biased exam … So we changed the law to create an alternative to the exam that relies much more on somebody’s field experience and education, rather than a standardized test. We’re so pleased to report that already 168 people have become an LCSW through that alternative exam.”
SOR: Is there anything else I should know, or anything else you’d like to say?
LL: “We’re making great progress at destigmatizing mental health and addiction, and the more that people share their own experiences and need for behavioral health support, in particular to their elected officials if they’re comfortable doing so, helps us make progress and break down barriers. So I just want to encourage people to reach out to their elected officials and share about how much they care about access to behavioral health.
We’re [also] building out our 988 crisis response system … The ultimate goal is to have a fully-functioning, well-resourced crisis response system. Where no matter where you are in Illinois, if you are in a mental health crisis and you need support, everyone knows you can call 988 [and] everyone would be able to access somebody to come in person if needed, that is not the police, and that everyone would have access to a place to go de-escalate and stabilize the crisis if needed. And that shouldn’t be jail, and in most cases that should not be an inpatient hospital.
We’re not there yet in Illinois; we’re working on it. But building up a robust crisis response system and ending our criminalization of mental health systems is key, and a huge priority for Illinois and other states.”
This Q&A has been edited for clarity and length.