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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4448

Introduced 1/20/2026, by Rep. Robyn Gabel

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-48.5 new

Provides that the Act may be referred to as the Safe Place to Go Act.
Amends the Medical Assistance Article of the Illinois Public Aid Code.
Requires the Department of Healthcare and Family Services, in
collaboration with the Department of Human Services' Division of
Behavioral Health and Recovery, to apply for a Medicaid State Plan
amendment or federal waiver within 12 months after the effective date of
the amendatory Act to draw federal financial participation for crisis
triage and stabilization services provided by behavioral health urgent
care centers to support adults or children 5 years of age and older who are
in an active mental health crisis and adults 18 years of age and older in a
substance use crisis. Sets forth the services provided by behavioral
health urgent care centers that shall be covered, including, but not
limited to, crisis triage services, crisis stabilization services, and
medication monitoring. Contains provisions concerning the use of the
Illinois Mental Health Crisis Assessment Tool to determine an individual's
eligibility or medical need for crisis stabilization services; telehealth
and on-site services; safe sobering services; linkages to enable rapid
transition to next level of care; length of stay; the development of a
single bundle rate for crisis triage services and 2 separate per diem
reimbursement rates for crisis stabilization services and safe sobering
services; no prior authorization requirements; and the establishment of a
working group to provide meaningful input on the establishment,
operations, staffing, and financing of behavioral health urgent care
centers. Requires the Department to adopt rules within 6 months after
federal approval of its State Plan amendment or federal waiver
application, if granted. Effective immediately.
LRB104 17345 KTG 30769 b

A BILL FOR

HB4448
LRB104 17345 KTG 30769 b
1

AN ACT concerning public aid.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 1.
Reference to Act.
This Act may be referred to as
5
the Safe Place to Go Act.

6

Section 5.
The Illinois Public Aid Code is amended by
7
adding Section 5-48.5 as follows:

8

(305 ILCS 5/5-48.5 new)
9

Sec. 5-48.5.
Behavioral health urgent care center
10
services; coverage for services.
11

(a) Findings. The General Assembly finds the following:
12

(1) Studies show that one in 3 high school students
13

and half of female students report persistent feelings of
14

hopelessness, and over 365,000 Illinois children and
15

adolescents have a current diagnosis of anxiety or
16

depression or another behavioral health diagnosis. Over
17

50,000,000 Americans - one in 5 adults - have a mental
18

health condition.
19

(2) Behavioral health crises require effective
20

specialized care, yet hospital emergency rooms remain the
21

primary place to go for a person experiencing a mental
22

health or substance use crisis even though hospital

HB4448
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LRB104 17345 KTG 30769 b
1

emergency rooms are generally not equipped or staffed to
2

effectively treat a behavioral crisis.
3

(3) Hospitals are designed to treat acute medical
4

emergencies rather than address specialized behavioral
5

health needs during a crisis.
6

(4) Studies show that hospital emergency room boarding
7

times are 3 times longer for someone in a behavioral
8

health crisis than in other medical crises, forcing
9

behavioral health patients to wait hours, days, and even
10

weeks in a hospital emergency room without receiving the
11

appropriate treatment to stabilize their symptoms.
12

(5) Long hospital emergency room wait times leave
13

behavioral patients decompensating in waiting rooms and
14

hallways, tie up critical emergency room resources and
15

staff, and increase unnecessary healthcare costs.
16

(6) According to the Department of Public Health,
17

Illinois youth between the ages of 3 and 17 experienced
18

over 17,000 emergency room visits annually for a mental
19

health or substance use crisis between 2018 and 2022.
20

(7) Nationally, it is estimated that an average of
21

13,200,000 adults turn to hospital emergency rooms for a
22

behavioral health crisis.
23

(8) Approximately two-thirds of youth hospitalized in
24

Illinois for mental health or substance use crises are
25

covered by public insurance, primarily Medicaid, according
26

to the Department of Public Health.

HB4448
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LRB104 17345 KTG 30769 b
1

(9) Illinois must develop an alternative place to go -
2

behavioral health urgent care centers - for people in a
3

behavioral crisis, rather than relegating them to hospital
4

emergency rooms.
5

(10) While Living Rooms staffed by people with lived
6

expertise are an important part of the behavioral health
7

continuum, Living Rooms are not staffed to provide the
8

full range of crisis services an active crisis may need to
9

avoid an emergency room visit.
10

(11) As Illinois develops the crisis continuum,
11

including 988 (someone to call) and mobile crisis response
12

(someone to respond), it must also develop safe, healing,
13

specialized places to go (such as behavioral health urgent
14

care centers) during a behavioral health crisis to avoid
15

unnecessary emergency room visits or hospitalizations.
16

(b) Definitions. As used in this Section, "behavioral
17
health urgent care center" means a community-based facility,
18
or portion of a facility, certified by the Department of
19
Healthcare and Family Services where mental health and
20
substance use crisis services are accessible 24 hours a day, 7
21
days a week for purposes of addressing the crisis, reducing
22
acute symptoms and connecting individuals to the appropriate
23
level of care and follow-up. Services provided by a behavioral
24
health urgent care center are ones that are voluntary and
25
indicated for a person experiencing an active behavioral
26
health crisis who needs a safe, compassionate place to support

HB4448
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LRB104 17345 KTG 30769 b
1
acute crisis resolution; connection to appropriate levels of
2
care and follow-up; and does not need a hospital level of care.
3
Services are also trauma-informed and offer both observation
4
and therapeutic support. Behavioral health urgent care center
5
services are intended to be consistent with the U.S.
6
Department of Health and Human Services, Substance Abuse and
7
Mental Health Services Administration's 2025 National
8
Guidelines for a Behavioral Health Coordinated System of
9
Crisis Care for community-based mental health and substance
10
use crisis services. Hospital-based facilities are not
11
eligible to be certified as a behavioral health urgent care
12
center.
13

(c) Coverage for behavioral health urgent care center
14
services for people experiencing a behavioral health crisis.
15
In collaboration with the Department of Human Services'
16
Division of Behavioral Health and Recovery, the Department of
17
Healthcare and Family Services, as the sole State Medicaid
18
agency, shall apply to the federal Centers for Medicare and
19
Medicaid Services for a Medicaid State Plan amendment or
20
federal waiver within 12 months after the effective date of
21
this amendatory Act of the 104th General Assembly to draw
22
federal financial participation for crisis triage and
23
stabilization services provided by behavioral health urgent
24
care centers to support adults or children 5 years of age and
25
older who are in an active mental health crisis and adults 18
26
years of age and older in a substance use crisis.

HB4448
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LRB104 17345 KTG 30769 b
1

(1) Behavioral health urgent care center; core
2

services. All services provided by a behavioral health
3

urgent care center shall be individualized and voluntary,
4

and shall include, but not be limited to, the following:
5

(A) Crisis triage services:
6

(i) Assessment. A mental health crisis
7

assessment utilizing the Illinois Mental Health
8

Crisis Assessment Tool, a substance use level of
9

care assessment, or a nursing assessment if
10

clinically indicated.
11

(ii) Crisis intervention.
12

(iii) Peer support.
13

(B) Crisis stabilization services:
14

(i) Crisis observation.
15

(ii) Crisis intervention and safety planning.
16

(iii) Crisis counseling.
17

(iv) Care coordination.
18

(v) Case management.
19

(vi) Individual and family therapy.
20

(vii) Peer support.
21

(viii) Mental health and substance use
22

education.
23

(ix) Overdose prevention.
24

(x) Discharge planning to the appropriate
25

level of care or services.
26

(C) Prescribing, evaluating, or monitoring mental

HB4448
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LRB104 17345 KTG 30769 b
1

health or substance use treatment medications.
2

(2) Stabilization services. Eligibility or medical
3

necessity for crisis stabilization services outlined in
4

subparagraph (B) shall be based on the results of the
5

Illinois Mental Health Crisis Assessment Tool or the
6

substance level of care assessment.
7

(3) On-site services. All crisis triage services and
8

crisis stabilization services provided by the behavioral
9

health urgent care center shall be provided on-site and
10

in-person. Prescribing, evaluating, or monitoring mental
11

health and substance use treatment medications may occur
12

via telehealth.
13

(4) A safe place to go for someone in a substance use
14

crisis. Behavioral health urgent care centers may provide,
15

but are not required to provide, safe sobering services
16

for up to 24 hours for adults 18 years of age or older who
17

are under the influence of alcohol or drugs to provide
18

monitoring and oversight of adults in a substance use
19

crisis in a supervised and supportive environment. Safe
20

sobering is not meant to achieve abstinence or the full
21

removal of alcohol or other drugs from the system, but to
22

decrease the amount of intoxicating substance in a safe
23

setting with a recovery-oriented framework.
24

(A) A behavioral health urgent care center that
25

provides safe sobering services must have access to
26

24-hour on-call emergency medical technicians to

HB4448
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LRB104 17345 KTG 30769 b
1

ensure the safety of adults who are receiving safe
2

sobering services.
3

(B) Safe sobering services in a behavioral health
4

urgent care center may be located within the same unit
5

or program of ASAM Level 3.7 Medically Monitored
6

Intensive Inpatient Services for adults to enable a
7

seamless transition to this level of care for adults
8

who choose to engage in medically necessary withdrawal
9

management services.
10

(5) Linkages to enable rapid transition to the next
11

level of care. Rapid connection to the appropriate levels
12

of care or follow-up services to facilitate post-crisis
13

care, including short-term crisis residential services,
14

services addressing the social determinants of health, and
15

overdose prevention, shall be a primary goal of behavioral
16

health urgent care centers.
17

(6) Length of stay. An individual may receive mental
18

health stabilization services or safe sobering services
19

for up to, but not longer than, 24 hours in a behavioral
20

health urgent care center to address an active mental
21

health crisis or substance use crisis.
22

(7) Reimbursement for behavioral health urgent care
23

center services.
24

(A) Crisis triage services. The Department of
25

Healthcare and Family Services shall develop one
26

bundled rate to cover the full cost of the crisis

HB4448
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LRB104 17345 KTG 30769 b
1

triage services listed in subparagraph (A) of
2

paragraph (1).
3

(B) Crisis stabilization services. The Department
4

of Healthcare and Family Services shall develop 2
5

separate per diem reimbursement rates to cover the
6

full cost of crisis stabilization services listed in
7

subparagraph (B) of paragraph (1) and shall look to
8

how other states, such as New York and Virginia, have
9

developed such rates. A short-term rate shall cover
10

the services provided for up to 4 hours in a behavioral
11

health urgent care center. A full rate shall apply for
12

services delivered for more than 4 hours and up to 24
13

hours.
14

(C) Safe sobering services. The Department of
15

Healthcare and Family Services, in partnership with
16

the Department of Human Services' Division of
17

Behavioral Health and Recovery, shall develop 2
18

separate per diem reimbursement rates to cover the
19

full cost of safe sobering services. A short-term rate
20

shall cover safe sobering services provided for up to
21

4 hours in a behavioral health urgent care center. A
22

full rate shall apply for safe sobering services
23

delivered for more than 4 hours and up to 24 hours.
24

(D) Medication prescribing, evaluation, or
25

monitoring. Reimbursement for prescribing, evaluating,
26

or monitoring mental health or substance use treatment

HB4448
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LRB104 17345 KTG 30769 b
1

medications shall be done utilizing the existing
2

Current Procedural Terminology codes for such
3

services.
4

(8) No prior authorization. Prior authorization shall
5

not be required or utilized for any of the mental health or
6

substance use services provided by a behavioral health
7

urgent care center.
8

(d) Stakeholder input. The Department of Healthcare and
9
Family Services, in partnership with the Department of Human
10
Services' Division of Behavioral Health and Recovery, shall
11
establish a workgroup within 6 months after the effective date
12
of this amendatory Act of the 104th General Assembly that
13
includes community-based mental health and substance use
14
providers that have established facilities or units similar to
15
a behavioral health urgent care center, trade associations
16
representing community-based mental health and substance use
17
providers, people with lived expertise, and other stakeholders
18
to provide meaningful input on the establishment, operations,
19
staffing, and financing of behavioral health urgent care
20
centers. The workgroup shall meet at least once a month for at
21
least 8 months prior to the Department of Healthcare and
22
Family Services' application to the Centers for Medicare and
23
Medicaid Services for federal financial participation for
24
services provided by a behavioral health urgent care center.
25

(e) Rulemaking authority. If federal approval is granted,
26
the Department of Healthcare and Family Services shall file

HB4448
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LRB104 17345 KTG 30769 b
1
any rules necessary for implementation of this Section within
2
6 months after federal approval.

3

Section 99.
Effective date.
This Act takes effect upon
4
becoming law.

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