Bill Text: IL HB1364 | 2023-2024 | 103rd General Assembly | Enrolled

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Bill Title: Reinserts the provisions of the introduced bill with the following changes. Changes the short title of the Act to the 9-8-8 Suicide and Crisis Lifeline Workgroup Act. Provides that the Department of Human Services, Division of Mental Health, shall convene a working group that includes members of the General Assembly, representatives of State agencies, the State's Chief Behavioral Health Officer, the Director of the Children's Behavioral Health Transformation Initiative, service providers from the regional and statewide 9-8-8 call centers, representatives of organizations that represent people with mental health conditions or substance use disorders and that operate an Illinois social services helpline or crisis line other than 9-8-8, including veterans' crisis services, more than one individual with personal or family lived experience of a mental health condition or substance use disorder, experts in research and operational evaluation, and any other person or persons as determined by the Department of Human Services, Division of Mental Health. Requires the Department of Human Services, Division of Mental Health, to submit a report to the General Assembly regarding the Workgroup's findings related to the 9-8-8 call system. Modifies the Workgroup's responsibilities, including removing requirements to review the recommendations and decisions of previous State-led workgroups on transforming the mental health crisis response system and that the action plan must include a plan to sustainably fund a statewide 9-8-8 call center network in fiscal year 2025 and beyond. Effective immediately.

Spectrum: Strong Partisan Bill (Democrat 28-2)

Status: (Enrolled) 2023-05-24 - Added as Alternate Co-Sponsor Sen. Mike Simmons [HB1364 Detail]

Download: Illinois-2023-HB1364-Enrolled.html

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AN ACT concerning government.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the 9-8-8
Suicide and Crisis Lifeline Workgroup Act.
Section 5. Findings. The General Assembly finds that:
(1) In the summer of 2022, 31% of Illinois adults
experienced symptoms of anxiety or depression more than half
of the days of each week, which is an increase of 20% since
2019.
(2) Suicide is the third leading cause of death in
Illinois for young adults who are 15 to 34 years of age, and it
is the 11th leading cause of death for all Illinoisans. In
2021, 1,488 Illinois lives were lost to suicide, and an
estimated 376,000 adults had thoughts of suicide.
(3) Historically, people in Illinois and nationwide have
had few and fragmented options to call upon during a mental
health crisis and have relied upon 9-1-1 and various privately
funded crisis lines for help.
(4) In July 2022, Illinois joined the nation in launching
the 9-8-8 Suicide and Crisis Lifeline, a universal 3-digit
dialing code for a national suicide prevention and mental
health hotline, meant to offer 24-hour-a-day, 7-day-a-week

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access to trained counselors who can help people experiencing
mental health-related distress.
(5) Congress delegated to the states significant
decision-making responsibility for structuring and funding the
states' 9-8-8 call center networks.
(6) States had limited data on which to base their initial
decisions because the Substance Abuse and Mental Health
Services Administration's projections of future increases in
call volumes varied widely, and there was no national
best-practice model for the number and organization of 9-8-8
call centers.
(7) The Substance Abuse and Mental Health Services
Administration described the 2022 launch of 9-8-8 as being
just the first step toward reimagining our country's mental
health crisis system and stipulated that long-term
transformation will rely on the willingness of states and
territories to build and invest strategically in every level
of the continuum of mental health crisis care over the next
several years.
(8) In 2023, the General Assembly and other State leaders
can assess the first year of operations of the 9-8-8 call
center system, identify legislative solutions to any funding
and programmatic gaps that are emerging, and set the course
for Illinois to eventually lead the country in providing
quality and accessible 9-8-8 care and in connecting
individuals with the mental health resources necessary to

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sustain long-term recovery.
(9) The launch of the 9-8-8 Suicide and Crisis Lifeline
has created a once-in-a-generation opportunity to improve
mental health crisis care in Illinois.
(10) Illinois' success or failure in building a
high-quality call center network in the initial years will be
an important factor in determining whether 9-8-8 is perceived
as a trusted resource in the State.
(11) Illinois' success or failure in building a
high-quality 9-8-8 call center network will disproportionately
affect Black, Brown, and other marginalized residents who are
most likely to rely on crisis services to access mental health
care and are most likely to be criminalized or harmed by the
existing crisis response system.
Section 10. Suicide and Crisis Lifeline Workgroup.
(a) The Department of Human Services, Division of Mental
Health, shall convene a workgroup that includes:
(1) bicameral, bipartisan members of the General
Assembly;
(2) at least one representative from the Department of
Human Services, Division of Substance Use Prevention and
Recovery; the Department of Public Health; the Department
of Healthcare and Family Services; and the Department of
Insurance;
(3) the State's Chief Behavioral Health Officer;

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(4) the Director of the Children's Behavioral Health
Transformation Initiative;
(5) service providers from the regional and statewide
9-8-8 call centers;
(6) representatives of organizations that represent
people with mental health conditions or substance use
disorders;
(7) representatives of organizations that operate an
Illinois social services helpline or crisis line other
than 9-8-8, including veterans' crisis services;
(8) more than one individual with personal or family
lived experience of a mental health condition or substance
use disorder;
(9) experts in research and operational evaluation;
and
(10) and any other person or persons as determined by
the Department of Human Services, Division of Mental
Health.
(b) On or before December 31, 2023, the Department of
Human Services, Division of Mental Health, shall submit a
report to the General Assembly regarding the Workgroup's
findings under Section 15 related to the 9-8-8 call system.
Section 15. Responsibilities; action plan.
(a) The Workgroup has the following responsibilities:
(1) to review existing information about the first

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year of 9-8-8 call center operations in Illinois,
including, but not limited to, state-level and
county-level use data, progress around the federal
measures of success determined by the Substance Abuse and
Mental Health Services Administration, and research
conducted by any State-contracted partners around cost
projections, best-practice standards, and geographic
needs;
(2) to review other states' models and emerging best
practices around structuring 9-8-8 call center networks,
with an emphasis on promoting high-quality phone
interventions, coordination with other crisis lines and
crisis services, and connection to community-based support
for those in need;
(3) to review governmental infrastructures created in
other states to promote sustainability and quality in
9-8-8 call centers and crisis system operations;
(4) to review changes and new initiatives that have
been advanced by the Substance Abuse and Mental Health
Services Administration and Vibrant Emotional Health since
Vibrant transitioned to 9-8-8 in July 2022, such as new
training curricula for call takers and new technology
platforms;
(5) to consider input from call center personnel,
providers, and advocates about strengths, weaknesses, and
service gaps in Illinois; and

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(6) to develop an action plan with recommendations to
the General Assembly that include the following:
(A) a future structure for a network of 9-8-8 call
centers in Illinois that will best promote equity,
quality, and connection to care;
(B) metrics that Illinois should use to measure
the success of our statewide system in promoting
equity, quality, and connection to care and a system
to measure those metrics, considering the metrics
imposed by the Substance Abuse and Mental Health
Services Administration as only a starting point for
measurement of success in Illinois;
(C) recommendations to further fund and strengthen
the rest of Illinois' behavioral health services and
crisis assistance programs based on lessons learned
from 9-8-8 use; and
(D) recommendations on a long-term governmental
infrastructure to provide advice and recommendations
necessary to sustainably implement and monitor the
progress of the 9-8-8 Suicide and Crisis Lifeline in
Illinois and to make recommendations for the statewide
improvement of behavioral health crisis response and
suicide prevention services in the State.
The action plan shall be approved by a majority of
Workgroup members.
(b) Nothing in the action plan filed under this Section

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shall be construed to supersede the recommendations of the
Statewide Advisory Committee or Regional Advisory Committees
created by the Community Emergency Services and Support Act.
Section 20. Repeal. This Act is repealed on January 1,
2025.
Section 85. The Community Emergency Services and Support
Act is amended by changing Sections 5, 15, 20, 25, 30, 35, 40,
45, 50, and 65 and by adding Section 70 as follows:
(50 ILCS 754/5)
Sec. 5. Findings. The General Assembly recognizes that the
Illinois Department of Human Services Division of Mental
Health is preparing to provide mobile mental and behavioral
health services to all Illinoisans as part of the federally
mandated adoption of the 9-8-8 phone number. The General
Assembly also recognizes that many cities and some states have
successfully established mobile emergency mental and
behavioral health services as part of their emergency response
system to support people who need such support and do not
present a threat of physical violence to the mobile mental
health relief providers responders. In light of that
experience, the General Assembly finds that in order to
promote and protect the health, safety, and welfare of the
public, it is necessary and in the public interest to provide

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emergency response, with or without medical transportation, to
individuals requiring mental health or behavioral health
services in a manner that is substantially equivalent to the
response already provided to individuals who require emergency
physical health care.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/15)
Sec. 15. Definitions. As used in this Act:
"Division of Mental Health" means the Division of Mental
Health of the Department of Human Services.
"Emergency" means an emergent circumstance caused by a
health condition, regardless of whether it is perceived as
physical, mental, or behavioral in nature, for which an
individual may require prompt care, support, or assessment at
the individual's location.
"Mental or behavioral health" means any health condition
involving changes in thinking, emotion, or behavior, and that
the medical community treats as distinct from physical health
care.
"Mobile mental health relief provider" means a person
engaging with a member of the public to provide the mobile
mental and behavioral service established in conjunction with
the Division of Mental Health establishing the 9-8-8 emergency
number. "Mobile mental health relief provider" does not
include a Paramedic (EMT-P) or EMT, as those terms are defined

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in the Emergency Medical Services (EMS) Systems Act, unless
that responding agency has agreed to provide a specialized
response in accordance with the Division of Mental Health's
services offered through its 9-8-8 number and has met all the
requirements to offer that service through that system.
"Physical health" means a health condition that the
medical community treats as distinct from mental or behavioral
health care.
"PSAP" means a Public Safety Answering Point
tele-communicator.
"Community services" and "community-based mental or
behavioral health services" may include both public and
private settings.
"Treatment relationship" means an active association with
a mental or behavioral care provider able to respond in an
appropriate amount of time to requests for care.
"Responder" is any person engaging with a member of the
public to provide the mobile mental and behavioral service
established in conjunction with the Division of Mental Health
establishing the 9-8-8 emergency number. A responder is not an
EMS Paramedic or EMT as defined in the Emergency Medical
Services (EMS) Systems Act unless that responding agency has
agreed to provide a specialized response in accordance with
the Division of Mental Health's services offered through its
9-8-8 number and has met all the requirements to offer that
service through that system.

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(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/20)
Sec. 20. Coordination with Division of Mental Health.
Each 9-1-1 PSAP and provider of emergency services dispatched
through a 9-1-1 system must coordinate with the mobile mental
and behavioral health services established by the Division of
Mental Health so that the following State goals and State
prohibitions are met whenever a person interacts with one of
these entities for the purpose of seeking emergency mental and
behavioral health care or when one of these entities
recognizes the appropriateness of providing mobile mental or
behavioral health care to an individual with whom they have
engaged. The Division of Mental Health is also directed to
provide guidance regarding whether and how these entities
should coordinate with mobile mental and behavioral health
services when responding to individuals who appear to be in a
mental or behavioral health emergency while engaged in conduct
alleged to constitute a non-violent misdemeanor.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/25)
Sec. 25. State goals.
(a) 9-1-1 PSAPs, emergency services dispatched through
9-1-1 PSAPs, and the mobile mental and behavioral health
service established by the Division of Mental Health must

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coordinate their services so that the State goals listed in
this Section are achieved. Appropriate mobile response service
for mental and behavioral health emergencies shall be
available regardless of whether the initial contact was with
9-8-8, 9-1-1 or directly with an emergency service dispatched
through 9-1-1. Appropriate mobile response services must:
(1) whenever possible, ensure that individuals
experiencing mental or behavioral health crises are
diverted from hospitalization or incarceration whenever
possible, and are instead linked with available
appropriate community services;
(2) include the option of on-site care if that type of
care is appropriate and does not override the care
decisions of the individual receiving care. Providing care
in the community, through methods like mobile crisis
units, is encouraged. If effective care is provided on
site, and if it is consistent with the care decisions of
the individual receiving the care, further transportation
to other medical providers is not required by this Act;
(3) recommend appropriate referrals for available
community services if the individual receiving on-site
care is not already in a treatment relationship with a
service provider or is unsatisfied with their current
service providers. The referrals shall take into
consideration waiting lists and copayments, which may
present barriers to access; and

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(4) subject to the care decisions of the individual
receiving care, provide transportation for any individual
experiencing a mental or behavioral health emergency.
Transportation shall be to the most integrated and least
restrictive setting appropriate in the community, such as
to the individual's home or chosen location, community
crisis respite centers, clinic settings, behavioral health
centers, or the offices of particular medical care
providers with existing treatment relationships to the
individual seeking care.
(b) Prioritize requests for emergency assistance. 9-1-1
PSAPs, emergency services dispatched through 9-1-1 PSAPs, and
the mobile mental and behavioral health service established by
the Division of Mental Health must provide guidance for
prioritizing calls for assistance and maximum response time in
relation to the type of emergency reported.
(c) Provide appropriate response times. From the time of
first notification, 9-1-1 PSAPs, emergency services dispatched
through 9-1-1 PSAPs, and the mobile mental and behavioral
health service established by the Division of Mental Health
must provide the response within response time appropriate to
the care requirements of the individual with an emergency.
(d) Require appropriate mobile mental health relief
provider responder training. Mobile mental health relief
providers Responders must have adequate training to address
the needs of individuals experiencing a mental or behavioral

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health emergency. Adequate training at least includes:
(1) training in de-escalation techniques;
(2) knowledge of local community services and
supports; and
(3) training in respectful interaction with people
experiencing mental or behavioral health crises, including
the concepts of stigma and respectful language.
(e) Require minimum team staffing. The Division of Mental
Health, in consultation with the Regional Advisory Committees
created in Section 40, shall determine the appropriate
credentials for the mental health providers responding to
calls, including to what extent the mobile mental health
relief providers responders must have certain credentials and
licensing, and to what extent the mobile mental health relief
providers responders can be peer support professionals.
(f) Require training from individuals with lived
experience. Training shall be provided by individuals with
lived experience to the extent available.
(g) Adopt guidelines directing referral to restrictive
care settings. Mobile mental health relief providers
Responders must have guidelines to follow when considering
whether to refer an individual to more restrictive forms of
care, like emergency room or hospital settings.
(h) Specify regional best practices. Mobile mental health
relief providers Responders providing these services must do
so consistently with best practices, which include respecting

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the care choices of the individuals receiving assistance.
Regional best practices may be broken down into sub-regions,
as appropriate to reflect local resources and conditions. With
the agreement of the impacted EMS Regions, providers of
emergency response to physical emergencies may participate in
another EMS Region for mental and behavioral response, if that
participation shall provide a better service to individuals
experiencing a mental or behavioral health emergency.
(i) Adopt system for directing care in advance of an
emergency. The Division of Mental Health shall select and
publicly identify a system that allows individuals who
voluntarily chose to do so to provide confidential advanced
care directions to individuals providing services under this
Act. No system for providing advanced care direction may be
implemented unless the Division of Mental Health approves it
as confidential, available to individuals at all economic
levels, and non-stigmatizing. The Division of Mental Health
may defer this requirement for providing a system for advanced
care direction if it determines that no existing systems can
currently meet these requirements.
(j) Train dispatching staff. The personnel staffing 9-1-1,
3-1-1, or other emergency response intake systems must be
provided with adequate training to assess whether coordinating
with 9-8-8 is appropriate.
(k) Establish protocol for emergency responder
coordination. The Division of Mental Health shall establish a

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protocol for mobile mental health relief providers responders,
law enforcement, and fire and ambulance services to request
assistance from each other, and train these groups on the
protocol.
(l) Integrate law enforcement. The Division of Mental
Health shall provide for law enforcement to request mobile
mental health relief provider responder assistance whenever
law enforcement engages an individual appropriate for services
under this Act. If law enforcement would typically request EMS
assistance when it encounters an individual with a physical
health emergency, law enforcement shall similarly dispatch
mental or behavioral health personnel or medical
transportation when it encounters an individual in a mental or
behavioral health emergency.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/30)
Sec. 30. State prohibitions. 9-1-1 PSAPs, emergency
services dispatched through 9-1-1 PSAPs, and the mobile mental
and behavioral health service established by the Division of
Mental Health must coordinate their services so that, based on
the information provided to them, the following State
prohibitions are avoided:
(a) Law enforcement responsibility for providing mental
and behavioral health care. In any area where mobile mental
health relief providers responders are available for dispatch,

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law enforcement shall not be dispatched to respond to an
individual requiring mental or behavioral health care unless
that individual is (i) involved in a suspected violation of
the criminal laws of this State, or (ii) presents a threat of
physical injury to self or others. Mobile mental health relief
providers Responders are not considered available for dispatch
under this Section if 9-8-8 reports that it cannot dispatch
appropriate service within the maximum response times
established by each Regional Advisory Committee under Section
45.
(1) Standing on its own or in combination with each
other, the fact that an individual is experiencing a
mental or behavioral health emergency, or has a mental
health, behavioral health, or other diagnosis, is not
sufficient to justify an assessment that the individual is
a threat of physical injury to self or others, or requires
a law enforcement response to a request for emergency
response or medical transportation.
(2) If, based on its assessment of the threat to
public safety, law enforcement would not accompany medical
transportation responding to a physical health emergency,
unless requested by mobile mental health relief providers
responders, law enforcement may not accompany emergency
response or medical transportation personnel responding to
a mental or behavioral health emergency that presents an
equivalent level of threat to self or public safety.

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(3) Without regard to an assessment of threat to self
or threat to public safety, law enforcement may station
personnel so that they can rapidly respond to requests for
assistance from mobile mental health relief providers
responders if law enforcement does not interfere with the
provision of emergency response or transportation
services. To the extent practical, not interfering with
services includes remaining sufficiently distant from or
out of sight of the individual receiving care so that law
enforcement presence is unlikely to escalate the
emergency.
(b) Mobile mental health relief provider Responder
involvement in involuntary commitment. In order to maintain
the appropriate care relationship, mobile mental health relief
providers responders shall not in any way assist in the
involuntary commitment of an individual beyond (i) reporting
to their dispatching entity or to law enforcement that they
believe the situation requires assistance the mobile mental
health relief providers responders are not permitted to
provide under this Section; (ii) providing witness statements;
and (iii) fulfilling reporting requirements the mobile mental
health relief providers responders may have under their
professional ethical obligations or laws of this state. This
prohibition shall not interfere with any mobile mental health
relief provider's responder's ability to provide physical or
mental health care.

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(c) Use of law enforcement for transportation. In any area
where mobile mental health relief providers responders are
available for dispatch, unless requested by mobile mental
health relief providers responders, law enforcement shall not
be used to provide transportation to access mental or
behavioral health care, or travel between mental or behavioral
health care providers, except where no alternative is
available.
(d) Reduction of educational institution obligations. The
services coordinated under this Act may not be used to replace
any service an educational institution is required to provide
to a student. It shall not substitute for appropriate special
education and related services that schools are required to
provide by any law.
(e) Subsections (a), (c), and (d) are operative beginning
on the date the 3 conditions in Section 65 are met or July 1,
2024, whichever is earlier. Subsection (b) is operative
beginning on July 1, 2024.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/35)
Sec. 35. Non-violent misdemeanors. The Division of Mental
Health's Guidance for 9-1-1 PSAPs and emergency services
dispatched through 9-1-1 PSAPs for coordinating the response
to individuals who appear to be in a mental or behavioral
health emergency while engaging in conduct alleged to

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constitute a non-violent misdemeanor shall promote the
following:
(a) Prioritization of Health Care. To the greatest
extent practicable, community-based mental or behavioral
health services should be provided before addressing law
enforcement objectives.
(b) Diversion from Further Criminal Justice
Involvement. To the greatest extent practicable,
individuals should be referred to health care services
with the potential to reduce the likelihood of further law
enforcement engagement and referral to a pre-arrest or
pre-booking case management unit should be prioritized in
any areas served by pre-arrest or pre-booking case
management.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/40)
Sec. 40. Statewide Advisory Committee.
(a) The Division of Mental Health shall establish a
Statewide Advisory Committee to review and make
recommendations for aspects of coordinating 9-1-1 and the
9-8-8 mobile mental health response system most appropriately
addressed on a State level.
(b) Issues to be addressed by the Statewide Advisory
Committee include, but are not limited to, addressing changes
necessary in 9-1-1 call taking protocols and scripts used in

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9-1-1 PSAPs where those protocols and scripts are based on or
otherwise dependent on national providers for their operation.
(c) The Statewide Advisory Committee shall recommend a
system for gathering data related to the coordination of the
9-1-1 and 9-8-8 systems for purposes of allowing the parties
to make ongoing improvements in that system. As practical, the
system shall attempt to determine issues including, but not
limited to:
(1) the volume of calls coordinated between 9-1-1 and
9-8-8;
(2) the volume of referrals from other first
responders to 9-8-8;
(3) the volume and type of calls deemed appropriate
for referral to 9-8-8 but could not be served by 9-8-8
because of capacity restrictions or other reasons;
(4) the appropriate information to improve
coordination between 9-1-1 and 9-8-8; and
(5) the appropriate information to improve the 9-8-8
system, if the information is most appropriately gathered
at the 9-1-1 PSAPs.
(d) The Statewide Advisory Committee shall consist of:
(1) the Statewide 9-1-1 Administrator, ex officio;
(2) one representative designated by the Illinois
Chapter of National Emergency Number Association (NENA);
(3) one representative designated by the Illinois
Chapter of Association of Public Safety Communications

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Officials (APCO);
(4) one representative of the Division of Mental
Health;
(5) one representative of the Illinois Department of
Public Health;
(6) one representative of a statewide organization of
EMS responders;
(7) one representative of a statewide organization of
fire chiefs;
(8) two representatives of statewide organizations of
law enforcement;
(9) two representatives of mental health, behavioral
health, or substance abuse providers; and
(10) four representatives of advocacy organizations
either led by or consisting primarily of individuals with
intellectual or developmental disabilities, individuals
with behavioral disabilities, or individuals with lived
experience.
(e) The members of the Statewide Advisory Committee, other
than the Statewide 9-1-1 Administrator, shall be appointed by
the Secretary of Human Services.
(f) The Statewide Advisory Committee shall continue to
meet until this Act has been fully implemented, as determined
by the Division of Mental Health, and mobile mental health
relief providers are available in all parts of Illinois. The
Division of Mental Health may reconvene the Statewide Advisory

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Committee at its discretion after full implementation of this
Act.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/45)
Sec. 45. Regional Advisory Committees.
(a) The Division of Mental Health shall establish Regional
Advisory Committees in each EMS Region to advise on regional
issues related to emergency response systems for mental and
behavioral health. The Secretary of Human Services shall
appoint the members of the Regional Advisory Committees. Each
Regional Advisory Committee shall consist of:
(1) representatives of the 9-1-1 PSAPs in the region;
(2) representatives of the EMS Medical Directors
Committee, as constituted under the Emergency Medical
Services (EMS) Systems Act, or other similar committee
serving the medical needs of the jurisdiction;
(3) representatives of law enforcement officials with
jurisdiction in the Emergency Medical Services (EMS)
Regions;
(4) representatives of both the EMS providers and the
unions representing EMS or emergency mental and behavioral
health responders, or both; and
(5) advocates from the mental health, behavioral
health, intellectual disability, and developmental
disability communities.

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If no person is willing or available to fill a member's
seat for one of the required areas of representation on a
Regional Advisory Committee under paragraphs (1) through (5),
the Secretary of Human Services shall adopt procedures to
ensure that a missing area of representation is filled once a
person becomes willing and available to fill that seat.
(b) The majority of advocates on the Regional Advisory
Emergency Response Equity Committee must either be individuals
with a lived experience of a condition commonly regarded as a
mental health or behavioral health disability, developmental
disability, or intellectual disability, or be from
organizations primarily composed of such individuals. The
members of the Committee shall also reflect the racial
demographics of the jurisdiction served. To achieve the
requirements of this subsection, the Division of Mental Health
must establish a clear plan and regular course of action to
engage, recruit, and sustain areas of established
participation. The plan and actions taken must be shared with
the general public.
(c) Subject to the oversight of the Department of Human
Services Division of Mental Health, the EMS Medical Directors
Committee is responsible for convening the meetings of the
committee. Impacted units of local government may also have
representatives on the committee subject to approval by the
Division of Mental Health, if this participation is structured
in such a way that it does not give undue weight to any of the

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groups represented.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/50)
Sec. 50. Regional Advisory Committee responsibilities.
Each Regional Advisory Committee is responsible for designing
the local protocol to allow its region's 9-1-1 call center and
emergency responders to coordinate their activities with 9-8-8
as required by this Act and monitoring current operation to
advise on ongoing adjustments to the local protocol. Included
in this responsibility, each Regional Advisory Committee must:
(1) negotiate the appropriate amendment of each 9-1-1
PSAP emergency dispatch protocols, in consultation with
each 9-1-1 PSAP in the EMS Region and consistent with
national certification requirements;
(2) set maximum response times for 9-8-8 to provide
service when an in-person response is required, based on
type of mental or behavioral health emergency, which, if
exceeded, constitute grounds for sending other emergency
responders through the 9-1-1 system;
(3) report, geographically by police district if
practical, the data collected through the direction
provided by the Statewide Advisory Committee in
aggregated, non-individualized monthly reports. These
reports shall be available to the Regional Advisory
Committee members, the Department of Human Service

HB1364 Enrolled - 25 - LRB103 24835 AWJ 51167 b
Division of Mental Health, the Administrator of the 9-1-1
Authority, and to the public upon request; and
(4) convene, after the initial regional policies are
established, at least every 2 years to consider amendment
of the regional policies, if any, and also convene
whenever a member of the Committee requests that the
Committee consider an amendment; and .
(5) identify regional resources and supports for use
by the mobile mental health relief providers as they
respond to the requests for services.
(Source: P.A. 102-580, eff. 1-1-22.)
(50 ILCS 754/65)
Sec. 65. PSAP and emergency service dispatched through a
9-1-1 PSAP; coordination of activities with mobile and
behavioral health services. Each 9-1-1 PSAP and emergency
service dispatched through a 9-1-1 PSAP must begin
coordinating its activities with the mobile mental and
behavioral health services established by the Division of
Mental Health once all 3 of the following conditions are met,
but not later than July 1, 2024 2023:
(1) the Statewide Committee has negotiated useful
protocol and 9-1-1 operator script adjustments with the
contracted services providing these tools to 9-1-1 PSAPs
operating in Illinois;
(2) the appropriate Regional Advisory Committee has

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completed design of the specific 9-1-1 PSAP's process for
coordinating activities with the mobile mental and
behavioral health service; and
(3) the mobile mental and behavioral health service is
available in their jurisdiction.
(Source: P.A. 102-580, eff. 1-1-22; 102-1109, eff. 12-21-22.)
(50 ILCS 754/70 new)
Sec. 70. Report. On or before July 1, 2023 and on a
quarterly basis thereafter, the Division of Mental Health
shall submit a report to the General Assembly on its progress
in implementing this Act, which shall include, but not be
limited to, a strategic assessment that evaluates the success
toward current strategy, identification of future targets for
implementation that help estimate the potential for success
and provides a basis for assessing future performance, and key
benchmarks to provide a comparison to set in context and help
stakeholders understand their positions.
Section 90. The Illinois Insurance Code is amended by
changing Section 370c.1 as follows:
(215 ILCS 5/370c.1)
Sec. 370c.1. Mental, emotional, nervous, or substance use
disorder or condition parity.
(a) On and after July 23, 2021 (the effective date of

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Public Act 102-135), every insurer that amends, delivers,
issues, or renews a group or individual policy of accident and
health insurance or a qualified health plan offered through
the Health Insurance Marketplace in this State providing
coverage for hospital or medical treatment and for the
treatment of mental, emotional, nervous, or substance use
disorders or conditions shall ensure prior to policy issuance
that:
(1) the financial requirements applicable to such
mental, emotional, nervous, or substance use disorder or
condition benefits are no more restrictive than the
predominant financial requirements applied to
substantially all hospital and medical benefits covered by
the policy and that there are no separate cost-sharing
requirements that are applicable only with respect to
mental, emotional, nervous, or substance use disorder or
condition benefits; and
(2) the treatment limitations applicable to such
mental, emotional, nervous, or substance use disorder or
condition benefits are no more restrictive than the
predominant treatment limitations applied to substantially
all hospital and medical benefits covered by the policy
and that there are no separate treatment limitations that
are applicable only with respect to mental, emotional,
nervous, or substance use disorder or condition benefits.
(b) The following provisions shall apply concerning

HB1364 Enrolled - 28 - LRB103 24835 AWJ 51167 b
aggregate lifetime limits:
(1) In the case of a group or individual policy of
accident and health insurance or a qualified health plan
offered through the Health Insurance Marketplace amended,
delivered, issued, or renewed in this State on or after
September 9, 2015 (the effective date of Public Act
99-480) that provides coverage for hospital or medical
treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions the
following provisions shall apply:
(A) if the policy does not include an aggregate
lifetime limit on substantially all hospital and
medical benefits, then the policy may not impose any
aggregate lifetime limit on mental, emotional,
nervous, or substance use disorder or condition
benefits; or
(B) if the policy includes an aggregate lifetime
limit on substantially all hospital and medical
benefits (in this subsection referred to as the
"applicable lifetime limit"), then the policy shall
either:
(i) apply the applicable lifetime limit both
to the hospital and medical benefits to which it
otherwise would apply and to mental, emotional,
nervous, or substance use disorder or condition
benefits and not distinguish in the application of

HB1364 Enrolled - 29 - LRB103 24835 AWJ 51167 b
the limit between the hospital and medical
benefits and mental, emotional, nervous, or
substance use disorder or condition benefits; or
(ii) not include any aggregate lifetime limit
on mental, emotional, nervous, or substance use
disorder or condition benefits that is less than
the applicable lifetime limit.
(2) In the case of a policy that is not described in
paragraph (1) of subsection (b) of this Section and that
includes no or different aggregate lifetime limits on
different categories of hospital and medical benefits, the
Director shall establish rules under which subparagraph
(B) of paragraph (1) of subsection (b) of this Section is
applied to such policy with respect to mental, emotional,
nervous, or substance use disorder or condition benefits
by substituting for the applicable lifetime limit an
average aggregate lifetime limit that is computed taking
into account the weighted average of the aggregate
lifetime limits applicable to such categories.
(c) The following provisions shall apply concerning annual
limits:
(1) In the case of a group or individual policy of
accident and health insurance or a qualified health plan
offered through the Health Insurance Marketplace amended,
delivered, issued, or renewed in this State on or after
September 9, 2015 (the effective date of Public Act

HB1364 Enrolled - 30 - LRB103 24835 AWJ 51167 b
99-480) that provides coverage for hospital or medical
treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions the
following provisions shall apply:
(A) if the policy does not include an annual limit
on substantially all hospital and medical benefits,
then the policy may not impose any annual limits on
mental, emotional, nervous, or substance use disorder
or condition benefits; or
(B) if the policy includes an annual limit on
substantially all hospital and medical benefits (in
this subsection referred to as the "applicable annual
limit"), then the policy shall either:
(i) apply the applicable annual limit both to
the hospital and medical benefits to which it
otherwise would apply and to mental, emotional,
nervous, or substance use disorder or condition
benefits and not distinguish in the application of
the limit between the hospital and medical
benefits and mental, emotional, nervous, or
substance use disorder or condition benefits; or
(ii) not include any annual limit on mental,
emotional, nervous, or substance use disorder or
condition benefits that is less than the
applicable annual limit.
(2) In the case of a policy that is not described in

HB1364 Enrolled - 31 - LRB103 24835 AWJ 51167 b
paragraph (1) of subsection (c) of this Section and that
includes no or different annual limits on different
categories of hospital and medical benefits, the Director
shall establish rules under which subparagraph (B) of
paragraph (1) of subsection (c) of this Section is applied
to such policy with respect to mental, emotional, nervous,
or substance use disorder or condition benefits by
substituting for the applicable annual limit an average
annual limit that is computed taking into account the
weighted average of the annual limits applicable to such
categories.
(d) With respect to mental, emotional, nervous, or
substance use disorders or conditions, an insurer shall use
policies and procedures for the election and placement of
mental, emotional, nervous, or substance use disorder or
condition treatment drugs on their formulary that are no less
favorable to the insured as those policies and procedures the
insurer uses for the selection and placement of drugs for
medical or surgical conditions and shall follow the expedited
coverage determination requirements for substance abuse
treatment drugs set forth in Section 45.2 of the Managed Care
Reform and Patient Rights Act.
(e) This Section shall be interpreted in a manner
consistent with all applicable federal parity regulations
including, but not limited to, the Paul Wellstone and Pete
Domenici Mental Health Parity and Addiction Equity Act of

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2008, final regulations issued under the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act of
2008 and final regulations applying the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity Act of
2008 to Medicaid managed care organizations, the Children's
Health Insurance Program, and alternative benefit plans.
(f) The provisions of subsections (b) and (c) of this
Section shall not be interpreted to allow the use of lifetime
or annual limits otherwise prohibited by State or federal law.
(g) As used in this Section:
"Financial requirement" includes deductibles, copayments,
coinsurance, and out-of-pocket maximums, but does not include
an aggregate lifetime limit or an annual limit subject to
subsections (b) and (c).
"Mental, emotional, nervous, or substance use disorder or
condition" means a condition or disorder that involves a
mental health condition or substance use disorder that falls
under any of the diagnostic categories listed in the mental
and behavioral disorders chapter of the current edition of the
International Classification of Disease or that is listed in
the most recent version of the Diagnostic and Statistical
Manual of Mental Disorders.
"Treatment limitation" includes limits on benefits based
on the frequency of treatment, number of visits, days of
coverage, days in a waiting period, or other similar limits on
the scope or duration of treatment. "Treatment limitation"

HB1364 Enrolled - 33 - LRB103 24835 AWJ 51167 b
includes both quantitative treatment limitations, which are
expressed numerically (such as 50 outpatient visits per year),
and nonquantitative treatment limitations, which otherwise
limit the scope or duration of treatment. A permanent
exclusion of all benefits for a particular condition or
disorder shall not be considered a treatment limitation.
"Nonquantitative treatment" means those limitations as
described under federal regulations (26 CFR 54.9812-1).
"Nonquantitative treatment limitations" include, but are not
limited to, those limitations described under federal
regulations 26 CFR 54.9812-1, 29 CFR 2590.712, and 45 CFR
146.136.
(h) The Department of Insurance shall implement the
following education initiatives:
(1) By January 1, 2016, the Department shall develop a
plan for a Consumer Education Campaign on parity. The
Consumer Education Campaign shall focus its efforts
throughout the State and include trainings in the
northern, southern, and central regions of the State, as
defined by the Department, as well as each of the 5 managed
care regions of the State as identified by the Department
of Healthcare and Family Services. Under this Consumer
Education Campaign, the Department shall: (1) by January
1, 2017, provide at least one live training in each region
on parity for consumers and providers and one webinar
training to be posted on the Department website and (2)

HB1364 Enrolled - 34 - LRB103 24835 AWJ 51167 b
establish a consumer hotline to assist consumers in
navigating the parity process by March 1, 2017. By January
1, 2018 the Department shall issue a report to the General
Assembly on the success of the Consumer Education
Campaign, which shall indicate whether additional training
is necessary or would be recommended.
(2) The Department, in coordination with the
Department of Human Services and the Department of
Healthcare and Family Services, shall convene a working
group of health care insurance carriers, mental health
advocacy groups, substance abuse patient advocacy groups,
and mental health physician groups for the purpose of
discussing issues related to the treatment and coverage of
mental, emotional, nervous, or substance use disorders or
conditions and compliance with parity obligations under
State and federal law. Compliance shall be measured,
tracked, and shared during the meetings of the working
group. The working group shall meet once before January 1,
2016 and shall meet semiannually thereafter. The
Department shall issue an annual report to the General
Assembly that includes a list of the health care insurance
carriers, mental health advocacy groups, substance abuse
patient advocacy groups, and mental health physician
groups that participated in the working group meetings,
details on the issues and topics covered, and any
legislative recommendations developed by the working

HB1364 Enrolled - 35 - LRB103 24835 AWJ 51167 b
group.
(3) Not later than January 1 of each year, the
Department, in conjunction with the Department of
Healthcare and Family Services, shall issue a joint report
to the General Assembly and provide an educational
presentation to the General Assembly. The report and
presentation shall:
(A) Cover the methodology the Departments use to
check for compliance with the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008, 42 U.S.C. 18031(j), and any
federal regulations or guidance relating to the
compliance and oversight of the federal Paul Wellstone
and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008 and 42 U.S.C. 18031(j).
(B) Cover the methodology the Departments use to
check for compliance with this Section and Sections
356z.23 and 370c of this Code.
(C) Identify market conduct examinations or, in
the case of the Department of Healthcare and Family
Services, audits conducted or completed during the
preceding 12-month period regarding compliance with
parity in mental, emotional, nervous, and substance
use disorder or condition benefits under State and
federal laws and summarize the results of such market
conduct examinations and audits. This shall include:

HB1364 Enrolled - 36 - LRB103 24835 AWJ 51167 b
(i) the number of market conduct examinations
and audits initiated and completed;
(ii) the benefit classifications examined by
each market conduct examination and audit;
(iii) the subject matter of each market
conduct examination and audit, including
quantitative and nonquantitative treatment
limitations; and
(iv) a summary of the basis for the final
decision rendered in each market conduct
examination and audit.
Individually identifiable information shall be
excluded from the reports consistent with federal
privacy protections.
(D) Detail any educational or corrective actions
the Departments have taken to ensure compliance with
the federal Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008, 42
U.S.C. 18031(j), this Section, and Sections 356z.23
and 370c of this Code.
(E) The report must be written in non-technical,
readily understandable language and shall be made
available to the public by, among such other means as
the Departments find appropriate, posting the report
on the Departments' websites.
(i) The Parity Advancement Fund is created as a special

HB1364 Enrolled - 37 - LRB103 24835 AWJ 51167 b
fund in the State treasury. Moneys from fines and penalties
collected from insurers for violations of this Section shall
be deposited into the Fund. Moneys deposited into the Fund for
appropriation by the General Assembly to the Department shall
be used for the purpose of providing financial support of the
Consumer Education Campaign, parity compliance advocacy, and
other initiatives that support parity implementation and
enforcement on behalf of consumers.
(j) (Blank). The Department of Insurance and the
Department of Healthcare and Family Services shall convene and
provide technical support to a workgroup of 11 members that
shall be comprised of 3 mental health parity experts
recommended by an organization advocating on behalf of mental
health parity appointed by the President of the Senate; 3
behavioral health providers recommended by an organization
that represents behavioral health providers appointed by the
Speaker of the House of Representatives; 2 representing
Medicaid managed care organizations recommended by an
organization that represents Medicaid managed care plans
appointed by the Minority Leader of the House of
Representatives; 2 representing commercial insurers
recommended by an organization that represents insurers
appointed by the Minority Leader of the Senate; and a
representative of an organization that represents Medicaid
managed care plans appointed by the Governor.
The workgroup shall provide recommendations to the General

HB1364 Enrolled - 38 - LRB103 24835 AWJ 51167 b
Assembly on health plan data reporting requirements that
separately break out data on mental, emotional, nervous, or
substance use disorder or condition benefits and data on other
medical benefits, including physical health and related health
services no later than December 31, 2019. The recommendations
to the General Assembly shall be filed with the Clerk of the
House of Representatives and the Secretary of the Senate in
electronic form only, in the manner that the Clerk and the
Secretary shall direct. This workgroup shall take into account
federal requirements and recommendations on mental health
parity reporting for the Medicaid program. This workgroup
shall also develop the format and provide any needed
definitions for reporting requirements in subsection (k). The
research and evaluation of the working group shall include,
but not be limited to:
(1) claims denials due to benefit limits, if
applicable;
(2) administrative denials for no prior authorization;
(3) denials due to not meeting medical necessity;
(4) denials that went to external review and whether
they were upheld or overturned for medical necessity;
(5) out-of-network claims;
(6) emergency care claims;
(7) network directory providers in the outpatient
benefits classification who filed no claims in the last 6
months, if applicable;

HB1364 Enrolled - 39 - LRB103 24835 AWJ 51167 b
(8) the impact of existing and pertinent limitations
and restrictions related to approved services, licensed
providers, reimbursement levels, and reimbursement
methodologies within the Division of Mental Health, the
Division of Substance Use Prevention and Recovery
programs, the Department of Healthcare and Family
Services, and, to the extent possible, federal regulations
and law; and
(9) when reporting and publishing should begin.
Representatives from the Department of Healthcare and
Family Services, representatives from the Division of Mental
Health, and representatives from the Division of Substance Use
Prevention and Recovery shall provide technical advice to the
workgroup.
(k) An insurer that amends, delivers, issues, or renews a
group or individual policy of accident and health insurance or
a qualified health plan offered through the health insurance
marketplace in this State providing coverage for hospital or
medical treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions shall submit
an annual report, the format and definitions for which will be
determined developed by the workgroup in subsection (j), to
the Department and , or, with respect to medical assistance,
the Department of Healthcare and Family Services and posted on
their respective websites, starting on September 1, 2023 and
annually thereafter, or before July 1, 2020 that contains the

HB1364 Enrolled - 40 - LRB103 24835 AWJ 51167 b
following information separately for inpatient in-network
benefits, inpatient out-of-network benefits, outpatient
in-network benefits, outpatient out-of-network benefits,
emergency care benefits, and prescription drug benefits in the
case of accident and health insurance or qualified health
plans, or inpatient, outpatient, emergency care, and
prescription drug benefits in the case of medical assistance:
(1) A summary of the plan's pharmacy management
processes for mental, emotional, nervous, or substance use
disorder or condition benefits compared to those for other
medical benefits.
(2) A summary of the internal processes of review for
experimental benefits and unproven technology for mental,
emotional, nervous, or substance use disorder or condition
benefits and those for other medical benefits.
(3) A summary of how the plan's policies and
procedures for utilization management for mental,
emotional, nervous, or substance use disorder or condition
benefits compare to those for other medical benefits.
(4) A description of the process used to develop or
select the medical necessity criteria for mental,
emotional, nervous, or substance use disorder or condition
benefits and the process used to develop or select the
medical necessity criteria for medical and surgical
benefits.
(5) Identification of all nonquantitative treatment

HB1364 Enrolled - 41 - LRB103 24835 AWJ 51167 b
limitations that are applied to both mental, emotional,
nervous, or substance use disorder or condition benefits
and medical and surgical benefits within each
classification of benefits.
(6) The results of an analysis that demonstrates that
for the medical necessity criteria described in
subparagraph (A) and for each nonquantitative treatment
limitation identified in subparagraph (B), as written and
in operation, the processes, strategies, evidentiary
standards, or other factors used in applying the medical
necessity criteria and each nonquantitative treatment
limitation to mental, emotional, nervous, or substance use
disorder or condition benefits within each classification
of benefits are comparable to, and are applied no more
stringently than, the processes, strategies, evidentiary
standards, or other factors used in applying the medical
necessity criteria and each nonquantitative treatment
limitation to medical and surgical benefits within the
corresponding classification of benefits; at a minimum,
the results of the analysis shall:
(A) identify the factors used to determine that a
nonquantitative treatment limitation applies to a
benefit, including factors that were considered but
rejected;
(B) identify and define the specific evidentiary
standards used to define the factors and any other

HB1364 Enrolled - 42 - LRB103 24835 AWJ 51167 b
evidence relied upon in designing each nonquantitative
treatment limitation;
(C) provide the comparative analyses, including
the results of the analyses, performed to determine
that the processes and strategies used to design each
nonquantitative treatment limitation, as written, for
mental, emotional, nervous, or substance use disorder
or condition benefits are comparable to, and are
applied no more stringently than, the processes and
strategies used to design each nonquantitative
treatment limitation, as written, for medical and
surgical benefits;
(D) provide the comparative analyses, including
the results of the analyses, performed to determine
that the processes and strategies used to apply each
nonquantitative treatment limitation, in operation,
for mental, emotional, nervous, or substance use
disorder or condition benefits are comparable to, and
applied no more stringently than, the processes or
strategies used to apply each nonquantitative
treatment limitation, in operation, for medical and
surgical benefits; and
(E) disclose the specific findings and conclusions
reached by the insurer that the results of the
analyses described in subparagraphs (C) and (D)
indicate that the insurer is in compliance with this

HB1364 Enrolled - 43 - LRB103 24835 AWJ 51167 b
Section and the Mental Health Parity and Addiction
Equity Act of 2008 and its implementing regulations,
which includes 42 CFR Parts 438, 440, and 457 and 45
CFR 146.136 and any other related federal regulations
found in the Code of Federal Regulations.
(7) Any other information necessary to clarify data
provided in accordance with this Section requested by the
Director, including information that may be proprietary or
have commercial value, under the requirements of Section
30 of the Viatical Settlements Act of 2009.
(l) An insurer that amends, delivers, issues, or renews a
group or individual policy of accident and health insurance or
a qualified health plan offered through the health insurance
marketplace in this State providing coverage for hospital or
medical treatment and for the treatment of mental, emotional,
nervous, or substance use disorders or conditions on or after
January 1, 2019 (the effective date of Public Act 100-1024)
shall, in advance of the plan year, make available to the
Department or, with respect to medical assistance, the
Department of Healthcare and Family Services and to all plan
participants and beneficiaries the information required in
subparagraphs (C) through (E) of paragraph (6) of subsection
(k). For plan participants and medical assistance
beneficiaries, the information required in subparagraphs (C)
through (E) of paragraph (6) of subsection (k) shall be made
available on a publicly-available website whose web address is

HB1364 Enrolled - 44 - LRB103 24835 AWJ 51167 b
prominently displayed in plan and managed care organization
informational and marketing materials.
(m) In conjunction with its compliance examination program
conducted in accordance with the Illinois State Auditing Act,
the Auditor General shall undertake a review of compliance by
the Department and the Department of Healthcare and Family
Services with Section 370c and this Section. Any findings
resulting from the review conducted under this Section shall
be included in the applicable State agency's compliance
examination report. Each compliance examination report shall
be issued in accordance with Section 3-14 of the Illinois
State Auditing Act. A copy of each report shall also be
delivered to the head of the applicable State agency and
posted on the Auditor General's website.
(Source: P.A. 102-135, eff. 7-23-21; 102-579, eff. 8-25-21;
102-813, eff. 5-13-22.)