Illinois Code § 185-3

§ 185-3.

Findings. The General Assembly finds as follows: (1) This Act seeks to remedy a fraction of a much larger broken system by addressing access to health care, managed care organization reform, mental and substance abuse treatment services, and services to address the social determinants of health. (2) Illinois transitioned Medicaid services to managed care with the goals of achieving better health outcomes for the Medicaid population and reducing the per capita costs of health care. (3) Illinois benefits when people have support constructing the sturdy foundation of health and well-being that we all need to reach our potential. Medicaid managed care can be a vital tool in ensuring that people have the full range of supports that form this foundation, including services from community providers that address behavioral health needs, as well as related services that help people access food, housing, and employment. (4) However, there are barriers that prevent Illinois from fully realizing the benefits of Medicaid managed care. The 2 devastating years of the State budget impasse resulted in 2 years of lost opportunity for community providers to invest in the people, systems, and technology that are necessary for them to participate in Medicaid managed care. A recent survey by the Illinois Collaboration on Youth of more than 130 community providers revealed that the majority do not have contracts with managed care organizations, and most do not have adequate billing and technology infrastructure sufficient for Medicaid billing now or in the future. The survey also revealed that community-based providers primarily serving people of color are the least prepared to participate in Medicaid managed care. (5) The disparity in readiness between providers primarily serving people of color and those who serve a more mixed or white clientele is especially urgent because 62% of Illinois' Medicaid recipients are people of color. Racial disparities in behavioral health care result in significant human and financial costs to both the individual and to the State. (6) The COVID-19 pandemic has further exacerbated the health disparities experienced by communities of color. COVID-19 has increased both the Medicaid-eligible population in Illinois, and increased the demand for behavioral health services, as Illinois residents grapple with trauma, death, job loss, depression, suicide, addiction, and exposure to violence. In addition, COVID-19 threatens the stability and viability of community-based providers, further straining the health care safety net for people who depend on Medicaid for these essential services. (7) Lack of support for a diversity of providers reduces choice for Medicaid recipients and may incentivize managed care organizations to focus on a narrow selection of community partners. Having some choice in which providers people see for these essential services and having access to providers who understand their community, culture, and language has been demonstrated to reduce disparities in health outcomes and improve health and well-being across the life span. (8) The Medicaid managed care system lacks consistent, statewide support for community providers, creating inefficiency and duplication. Providers need targeted trainings focused on their levels of readiness, learning collaboratives to provide group-level support for those experiencing similar challenges, and a mechanism to identify problems that need systemic solutions. Illinois could receive up to 70% in Medicaid matching funds from the federal government to supplement the costs of operating a Medicaid Technical Assistance Center. (9) When community-based health care providers are able to contract with managed care organizations to deliver Medicaid services, people can access the care they need, in their communities, from providers they trust. (Source: P.A. 102-4, eff. 4-27-21.)