On February 2, 2022 Governor Pritzker unveiled his State Fiscal Year 2023 (FY23) budget proposal. Despite state revenues still rebounding from losses incurred during the height of the COVID-19 pandemic, the governor maintained his original campaign commitment to not balance the budget on the back of the health and human services system. Third Horizon Strategies Senior Director Sara Howe sat down with IABH CEO Jud DeLoss to get his take on the proposed budget’s impact on the state addiction and mental health system.
SH: Over the years, the state’s addiction and mental health budget has taken some significant hits. How happy are you with the governor’s proposal for FY23? Can you share some of the areas you are most pleased to see?
JD: We were very pleased to see that the governor, Department of Human Services (DHS) Secretary Hou, and Department of Healthcare and Family Services (HFS) Director Eagleson made mental health (MH) and substance use disorder (SUD) prevention, treatment, and recovery a priority for FY23. One of the most critical items IABH has long fought for is rate increases to keep pace with growing healthcare costs. In his address, the governor announced an additional $140M in behavioral health funding for rate increases and supports. This increase is crucial to ensure the state keeps pace with the demand for services and also addresses the significant workforce shortage in behavioral health care.
SH: The governor also announced the creation of a new chief behavioral health officer. What would this position do and how would it help ensure addiction and mental health care remain a priority in the state?
JD: The idea of a chief behavioral health officer is not new. However, previous proposals suggested that this role would have oversight of the DHS programs, but nothing outside DHS. The association had objected to this, as a high percent of MH and SUD services are paid by Medicaid, under the HFS. This new proposed position will now be positioned in the Governor Pritzker’s Office and would not just oversee DHS but also HFS. IABH is tremendously pleased with the addition of a watchdog with powers to ensure that behavioral health is treated fairly and equitably, but also recognizing the longstanding partnership IABH and its members share with the governor’s office, DHS, and HFS.
SH: Speaking of DHS, the department still has broad oversight of both MH and SUD services and still receives significant federal block grant and discretionary funds. How did MH and SUD services fair in this year’s DHS budget proposal?
JD: IABH has tracked the DHS budget for the last 20+ years. As you noted above, there have been some incredibly lean years where the system struggled to maintain services levels – which were still way below the need. We are very pleased to see the trend of cutting vital behavioral health services change to investing in these services. Our FY23 analysis shows another tremendous year for DHS’ MH and SUD funding. We show an increase of 24 percent ($9.8M) in funding for Addiction Treatment Services grants. Prevention also received a whopping 37 percent ($410K) increase in funding, building upon last year’s appropriation. The governor and secretary are also delivering on their promise to utilize 20 percent of Cannabis Tax Revenues for MH and SUD providers by budgeting an increase of $58M over last year from those tax proceeds to behavioral health. Overall, SUPR (Substance Use Prevention and Recovery) funding increased 28 percent ($74.7M) over last year’s appropriations. DMH’s budget also demonstrates tremendous growth, with a 4 percent ($11.2M) increase in GRF (General Research Funding). Overall, DMH (Department of Mental Health) funding was up 1 percent ($6.2M) over last year’s appropriations.
SH: You also noted that MH and SUD services are frequently paid for by Medicaid expenditures. How did behavioral health fare in the HFS budget proposal?
JD: HFS’ budget included a $2.17B increase in medical assistance funding from all sources. In the past decade, we have seen Medicaid take on a larger share of MH and SUD expenditures. In keeping with that growth, a larger portion of MH and SUD funding now falls under HFS rather than DHS. Accordingly, the $140M increase for behavioral health reimbursement is reflected in the HFS budget.
SH: Now that the governor has delivered his proposal, what is next for the General Assembly and how will IABH position itself to impact the final outcome?
JD: With the governor’s address now complete, the business of budget making begins in earnest. In the coming weeks, each chamber will hold appropriation hearings to hear from DHS and HFS leadership, as well as advocates about the impact the governor’s proposed budget on DHS and HFS operations and services. Legislators will also want to know how the proposed budget would impact providers and their ability to deliver their services. IABH will provide testimony at these hearings and will continue to inform the legislature of the importance of prioritizing MH and SUD funding. As we know all too well, if we do not pay for behavioral health services on the front end, we will pay much more in higher healthcare, child welfare, and public safety expenditures. IABH remains committed to ensuring all who need of prevention, treatment, and recovery services can receive services in a timely and effective manner!
Learn more about IABH (Illinois Association for Behavioral Health) here.