New Jersey Association of Mental Health and Addiction Agencies

March 13, 2018

Budget Needs to Strengthen the Foundation of the Community-Based Behavioral Health Care System

Among a number of initiatives and investments to strengthen New Jersey and its residents, Governor Phil Murphy announced a $100 million investment to address the opioid epidemic. As opioid addiction and other substance use disorders commonly occur along with mental illnesses, the New Jersey Association of Mental Health and Addiction Agencies, Inc. (NJAMHAA) applauds the plans to use this funding to increase access to quality, community-based integrated behavioral health care. However, additional significant investment is also needed for the entire community-based behavioral health system, which serves as the safety net for 500,000 of New Jersey's most vulnerable children and adults: those with mental health and/or substance use disorders.

These services have been proven effective in helping people manage and recover from their illnesses, achieve personal goals, and reduce other health and social service costs. To ensure access to these valuable services, NJAMHAA is advocating for the State Budget in FY2019 and beyond to provide sufficient funding for the community-based behavioral health system.

Many outpatient programs are currently operating under significant deficits following their transition this fiscal year to a fee-for-service (FFS) reimbursement system. Organizations had cut staff, including psychiatrists, and otherwise changed their business models to reduce their budgets in preparation for FFS. There is nowhere left to cut; program closures have occurred and more are anticipated.

New Jersey must implement the FFS oversight study of rates that was mandated by law last year, and put in place safety net funding to keep programs fiscally viable until it is concluded and adequate rates are assured. It is also important that rate increases be accompanied by regular adjustments based on inflationary factors to sustain their adequacy.

"Investing sufficiently in community-based services is the right thing to do for the state's fiscal viability, as well as the health and well-being of New Jersey residents," said Debra L. Wentz, PhD, President and CEO of NJAMHAA.

Children's rates need to be included in the FFS study. In particular, rates for specialty staff such as Board Certified Behavior Analysts and Intensive In-Home Behavioral and Family Support Services staff are inadequate, and need to be recalculated to compensate for travel and training costs.

"During this time of increasing demand for both mental health and substance use treatment, investment is needed to sustain, strengthen and expand services. "The demand for mental health and substance use treatment has always exceeded system capacity, resulting in long wait times for appointments, turning to emergency rooms for some, and a total lack of treatment for others," Dr.
Wentz said.

The Early Intervention Support Services model, currently available in only 11 counties, must be expanded statewide and Screening Center programs should be expanded to support more mobile and satellite services. Funding should be made available to sustain the very successful federal demonstration Certified Clinical Behavioral Health Clinics if federal funding is not extended. And capital funding is essential to allow behavioral health providers to develop integrated care models.

"In the midst of an opioid crisis and ever-increasing rates of suicide, not only must all existing substance use treatment and mental health initiatives be maintained, but also expanded to provide timely access to quality services across the behavioral health continuum to all New Jerseyans," Dr. Wentz concluded.

Click here for more details on budgetary, as well as legislative and administrative, recommend-ations for supporting the community-based behavioral health system and the value this system provides.