The document discusses children's mental health coverage issues in Illinois Medicaid and private insurance. It provides an overview of the federal and Illinois policy landscape, including the Affordable Care Act, Medicaid, CHIP and Illinois' AllKids program. It identifies several barriers to children receiving mental health care, such as application processes, immigration concerns, managed care issues, provider payments and regulations. It also describes advocacy efforts regarding integrated health homes and ways legal assistance organizations can help address coverage problems through the HelpHub resource.

1. Illinois Children’s Mental Health Coverage
Eligibility, Coverage, and Access Issues in Medicaid and Insurance
December 6, 2018

2. The Sargent Shriver Center National Center on Poverty Law provides
national leadership in advancing laws and policies that secure justice
to improve the lives and opportunities of people living in poverty.
2

3. Agenda
• Federal Landscape
• Illinois Children’s Medicaid Program
• Current Eligibility Issues in Medicaid and Insurance
• Children’s Mental Health Issues
• Identification of Barriers and Policy Priorities
• Discussion

4. Federal ACA/Medicaid/CHIP Landscape
• ACA Repeal and Replace is off the table with an
incoming House Democratic Leadership
• Medicaid caps and block grants are also extremely
unlikely
• CHIP Reauthorized for 10 years
• Action is in the federal administration; courts; and
House oversight committees

5. Federal Landscape (Continued)
• House budget negotiations could also potentially add some positive $
towards programs like ACA Navigators
• Could be some compromise legislation on drug pricing and pre-
existing conditions
• ACA Sabotage efforts to the Marketplace must be counteracted at
state level
• Public Charge Proposed Regulation.
Join PIFIllinois@povertylaw.org for more information and visit
https://protectingimmigrantfamilies.org

6. Overview of IL Medicaid and CHIP
• Illinois AllKids program is a blended Medicaid/CHIP: 318% FPL and
Spenddown for Children with Higher Incomes
• No citizenship/immigration requirements
• EPSDT – Healthy Kids Program
• Kids Presumptive Eligibility
• Cohen Case and Temporary Coverage for Delayed Applications
• Medicaid Managed Care
• Short Term Insurance Legislation

7. Illinois Administration Transition
• Transition Committees that may consider children’s mental health
include Budget, Health, Equity, Education
• Committees asking for top priorities
• Issues raised by POCIL include Medicaid Real Time Eligibility;
Automated Medicaid Renewals; Strategies to reduce administrative
burden and churn
• Issues raised by other coalitions include funding mental health care
initiatives; streamlining mental health billing; Crisis Intervention;
Integrated Health Homes; school health and Medicaid

8. Integrated Health Homes: Recent Advocacy
• Coalition of providers, consumer advocates, provider associations
submitted letter to HFS on joint concerns
• Major concerns include timeline, lack of consumer education,
disruption of case management services, interruption of care
relationships, rates, caseload requirements
• Meeting with HFS was held last week to discuss concerns
• HFS issued Provider Notice delaying implementation until after rules
are finalized:
https://www.illinois.gov/hfs/MedicalProviders/notices/Pages/prn181
130b.aspx

9. Identified Barriers to Children’s Mental Health
Care
• Medicaid Application and Renewal Process
• Immigration Concerns
• Medicaid Managed Care Administrative Challenges
• Provider Payment Delays
• Inadequate Reimbursement and Funding
• Illinois Administrative Regulations including Rule 132
• Frequent changes in billing for crisis intervention services and
implementation plans for IHHs

10. HelpHub Helps Professionals with Medicaid Issues
• http://helphub.povertylaw.org
10
16 Click Here!

11. How Can HelpHub Help Your Staff?
HelpHub will directly link you to experts on health care (Medicaid,
Marketplace, Medicare), public benefits, tax implications of Obamacare,
immigrant eligibility, legal aid issues and more so that you can help your
clients/community members.
HelpHub is a way to highlight problems and issues you are seeing in your
community with regard to health care access. Also, it serves as a feedback
loop to state and federal government as coverage provisions of the ACA,
Medicaid managed care and other new systems roll out.
HelpHub connects you to others working on similar issues across the state.
You can also post events and resources to share.
11

12. How To Ask a Question on HelpHub
12
7
1. Click “Ask”
to type your
question
2. Select tags
3. An expert or
other assister
will answer

13. Consumer Information
Hub: GetCareIllinois.org

14. Stephanie Altman
67 E. Madison St., Suite 2000
Chicago IL, 60603
312.263.3830
stephaniealtman@povertylaw.org
povertylaw.org