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Overview of Illinois State Budget and Legislative Session
While this past legislative session was more subdued than in previous years due to economic strains and legislative apprehension with the upcoming fall election, notable advancements were made. Representing our collective, 5,000+ membership, the NASW-Illinois Chapter engaged with over 200 bills affecting Illinois social workers and their clients across a wide range of issues. Additionally, we relaunched the NASW-Illinois Chapter Legislative Committee to support the chapter on important professional matters and provide insights into how prospective legislation would impact their practice or agency.
You can see some of the bills the NASW-Illinois Chapter weighed in on through our Bill Tracker webpage: https://www.naswil.org/billtracker
Key Developments and Achievements
Structural and Administrative Progress:
Establishment of a Chief Behavioral Health Officer and a Chief Children’s Behavioral Health Officer within the governor's office.
Creation of the Illinois Behavioral Healthcare Workforce Center aimed at addressing workforce shortages and enhancing training opportunities. NASW-Illinois Chapter Executive Director Joel L. Rubin, MSW, LSW, ACSW, CAE, serves as a member of the advisory committee for this crucial workforce center.
The Illinois Department of Financial and Professional Regulation (IDFPR) has implemented several technical and substantive changes to the administrative code that directly affect social workers. These changes include new continuing education requirements and modifications to licensure processes. It is essential for social workers to review these updates to understand their implications fully. A detailed breakdown of the rule changes can be found on our website.
Legislative Highlights
Below are some of the bills in which the chapter provided input during the past legislative session. All bill status are accurate at time of printing. For the latest status on bills, please check our Bill Tracker webpage: https://www.naswil.org/billtracker.
Medicaid Omnibus Bill (SB 3268): Prior Authorization for Adults with Serious Mental Illness. This legislation removes the need for prior authorization for many psychotropic drugs for adults with serious mental illness on Medicaid under specific circumstances. Signed into law.
Direct Care Expansion Act (HB 5094): Establishes the Behavioral Health Administrative Task Force to reduce administrative burdens on Medicaid-serving behavioral healthcare providers. Signed into law.
First Responder Mental Health Support (HB 4460, SB 3538):
HB 4460: Requires health plans to cover couples therapy for law enforcement officers and firefighters. Passed both Houses, awaiting the Governor's signature.
SB 3538: Eliminates out-of-pocket expenses for first responders seeking mental health treatment. Includes a $10M appropriation for First Responder Wellness programming in Chicago. Passed both Houses, awaiting the Governor's signature.
Healthcare Protection Act (HB 5395): Expands access to inpatient behavioral health services by reforming prior authorization processes and eliminating barriers such as "ghost networks." Signed into law.
ESL Accommodations & Immigrant Clinician Protections (HB 5457): Enshrines the accommodations shall be provided by exam providers (ASWB) for individuals where English is not their primary language and those with disabilities protected by the ADA. Signed into law.
Licensed Clinical Social Workers & Opioid Antagonists (SB 3779): This legislation authorizes LSWs and LCSWs to administer and carry opioid antagonists (e.g., Narcan) as part of their professional scope of practice and provides legal protections for these clinicians. While this act is fully permissible, clinicians choosing to carry and administer opioid antagonists must complete a training course and ensure safe storage of the medication. Passed both Houses.
Streamlined Exams (HB 5353): Currently, social workers who have completed their mandatory clinical hours must submit their application to the department and wait for authorization, which is granted only after the application is fully processed. Upon enactment of this bill, the department will conduct a preliminary review and authorize candidates to take the exam while the comprehensive application processing continues. This change aims to shorten the time between application submission and exam authorization. Signed into law.
Children’s Behavioral Health Transformation Initiative (SB 726): Directs ISBE to assess readiness for universal mental health screenings in public schools and enhances data sharing for behavioral health crisis indicators. Passed both houses.
Gender Identity-Correct Info (HB 5507): Amends the Code of Civil Procedure. Creates a process that Illinois residents may use to seek an Illinois judicial order making findings of fact to change a government-issued document from another state or country so that they may petition the issuing jurisdiction to change such a document. Signed into law.
Fees for Payment from Insurers (SB 2735): Requires insurers to fully disclose all available payment methods for clinicians. If any of these methods include a fee, the insurer must notify the clinician prior to payment and provide information on alternative fee-free payment methods. Signed into law.
Haircare for Youth in Care (HB 5097): Requires DCFS to create a haircare treatment plan and provide trainings for caregivers for haircare that preserves the child's desired connection to the child's race, culture, gender, religion, and identity. Passed both houses.
DCFS Youth In Care Scholarships and Waiver Funding (SB 3138): Removes the GPA requirement for students on scholarship and changes it to in good standing with the university. Also adds a funding resource for students with financial needs on the tuition waiver program. Passed both houses.
Budget Highlights
Due to budget constraints, most investments received sustained funding or only minimal increases. This trend is expected to continue next year as the budget process is anticipated to become more challenging.
Early Action Mental Health on Campus: Maintains funding for mental health services on public university and community college campuses at $13M.
Pretrial Success Act: Allocates $3.5M for a pilot program providing behavioral health services to individuals released from pretrial detention.
Human Services Professional Loan Repayment Program: Provides $5M for loan repayment assistance to human services professionals working at community-based agencies. Administered by the Illinois Student Assistance Commission.
School Social Work PSL Scholarship/ School Social Worker and Municipal Social Worker Loan Forgiveness Grant: Provides another $6M for MSWs to go back to school to get their PSL endorsement to work in schools as school social workers; also provides student loan forgiveness for school social workers and municipal social workers who still have student loans.
Ongoing NASW-IL Legislative Efforts
Social Work Compact Legislation: One of our significant efforts this session was the introduction of the Social Work Compact bill. Despite our diligent efforts, it did not pass due to several complex issues. The chapter submitted concise language to the legislative reference bureau and identified Illinois State Representative Lindsey LaPointe as a sponsor, who subsequently filed the legislation. The status of the bill can be viewed here. Should there be no progress on the bill before the end of the year, we will reintroduce it in early January. NASW officially supports the passage of this legislation and remains dedicated to its success in Illinois.
Significant issues hindering the bill include a veto threat from the governor on all compacts due to concerns about potential unintended consequences following the US Supreme Court's ruling on Dobbs v. Jackson Women’s Health Organization. The compact requires licensees to comply with inquiries from compact states, raising fears that states might seek information about individuals who received abortion counseling or gender-affirming care in Illinois. This concern is validated by the Missouri Attorney General's efforts to compel Illinois–licensed social workers to disclose information about their work with gender-affirming care patients in Missouri. Noncompliance could result in the loss of compact licensure.
Other concerns include mandatory background checks, data storage, and potential data sharing with immigration services like ICE. With the upcoming political election, this issue could become more pronounced.
Additional problematic aspects of the compact include the authority of an unelected compact commission, appointed by governors, to establish rules that effectively become state laws. The commission does not require its members to be social workers, nor that their rules align with the social work code of ethics. With predominantly conservative states in the compact, there is a risk of the compact being used to advance a political agenda contrary to the profession's values.
The NASW-Illinois Chapter also seeks state-level protections against the potential workforce shift resulting from the compact, which could drive reimbursement rates down. While the compact facilitates continuity of care and multi-jurisdictional licensure, it also enables insurance companies and venture capitalists to refer Illinois patients to clinicians in states with lower reimbursement rates, undermining Illinois social workers. For-profit entities (like BetterHelp) could exploit the compact to reduce rates and divert Illinois clients to more profitable settings. The advancement of AI mental health is only going to put further gas on this outsourcing mental health fire. Conversely, clinicians might prioritize self-pay clients and insurance in higher reimbursement states, detracting from Illinois' safety net system.
In summary, several issues need resolution. The NASW-Illinois Chapter has engaged in numerous meetings with the governor's office, ACLU, legislators, and coalition partners (including Illinois counselors pursuing a similar compact) to discuss potential amendments to the compact or other legislation to mitigate unintended consequences.
We are committed to continuing these discussions to neutralize opposition and secure the bill's passage. While the opposition understands the compact's significance to the profession, the current political and judicial climate complicates its passage.
Artificial Intelligence: During this legislative session, several bills were introduced concerning the use of artificial intelligence (AI) in mental health. These proposals included provisions that could have criminalized social workers. The NASW-Illinois Chapter successfully pushed back against these measures, emphasizing the importance of regulating AI itself rather than penalizing clinicians.
While the chapter supports the regulation of AI in mental health, our position is clear—AI should be the focus of regulation, not clinicians. We have significant concerns about the potential roles of AI in the mental health field, including the creation of un-reviewed therapy notes, treatment plans, and making determinations about patient care.
There is also significant apprehension about the potential for AI to completely replace clinicians, a trend we are already seeing in text-based apps. This outcome is made even more possible due to the extensive amount of data from therapy sessions being fed into algorithms without the knowledge or permission of clients via products like AI therapy note-takers. This practice could lead to AI-driven therapy that lacks the personalized, human touch essential to effective mental health treatment. Such developments risk undermining the quality of care provided to patients as AI systems may not fully capture the nuances and complexities of individual patient needs and experiences. AI technologies, while innovative, must be carefully managed to ensure they complement rather than replace the essential human element in mental health care. We are committed to advocating for policies that regulate AI's use in mental health responsibly, ensuring that clinicians retain their vital role in providing compassionate and individualized care.
Looking Ahead
Despite the progress made, significant work remains to ensure comprehensive behavioral health access for all Illinois residents. Given the current political environment, our collective efforts to protect the rights and benefits of our clients must be even stronger. The NASW-Illinois Chapter, a collective of social workers dedicated to effecting change, remains committed to advocating for a stable, well-compensated workforce and continued structural improvements to meet the needs of our members and community. We deeply appreciate your ongoing support and engagement in these efforts. Your volunteer time and memberships are invaluable to our mission, and we couldn't achieve our goals without them.
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