New Jersey Association of Mental Health and Addiction Agencies

Current Advocacy Issues

One pager – NJAMHAA FY2021/FY2022 priorities

Vaccines: Please see our New Jersey COVID-19 Information Hub

State Issues with Pending Legislation

• Statuses are as of March 4, 2021.
• References to “see page …” indicate coverage in NJAMHAA’s 2021 advocacy piece, Building a Bridge to a Better Future.

Workforce (See pages 3 and 4)

NJAMHAA continues to advocate for several budgetary, policy and legislative changes to support the behavioral health workforce.  These include several recommendations to assist providers in being competitive in the wages they offer, such as funding to cover the costs of minimum wage increases and a formula index that will adjust rates and contracts for inflation, as well as regulatory changes such as allowing Psychiatric Advanced Practice Nurses (APNs) to lead PACT teams. 

There is legislation that would allow Psychiatric APNs sign screening certificates.

S882/A1781- Cryan/Munoz: These bills are the latest to be introduced that would allow a Psychiatric APN to sign a Screening Certificate.  NJAMHAA and other stakeholders were successful in getting several amendments passed in prior sessions and those amendments are incorporated into the current bills. NJAMHAA is working on one final amendment with the sponsors and will then work to have these bills posted in Committee.

Fee-for-Service Supplemental Funding (See page 5)

A1361 – Benson, Murphy, Vainieri Huttle: Having secured a budget line for fee-for-service (FFS) supplemental funding in the FY2019 budget through the budget resolution process which was retained in the FY2020 and FY2021 budgets, NJAMHAA continues to advocate for the nominal amount of $500,000 to be increased to $25 million.  This funding is intended to cover deficits under FFS until such time as the independent study of rates is concluded and adequate rates established.

Early Intervention Support Services (EISS) Expansion (See page 5)

S2176  - Vitale, Singleton: First introduced in January 2017 at NJAMHAA’s request, this bill would expand EISS to all 21 counties.  EISS is currently operating in only 11 counties.  Amendments made in the prior legislative session (2018-2019) that would require EISS programs to have a written affiliation with at least one Screening Center and that would have the expansion phased in are incorporated into this bill, which does not currently have an Assembly companion.  The older version of the bill, without the amendments, has also been introduced this session (S1137 – Vitale/A1242 – Schaer, Benson, Johnson, Downey). 

Testimony to Assembly Health and Senior Services Committee – September 13, 2018

Permanent Telehealth Changes (See page 7)

A4179/A4200 S2559 – Downey, Conaway, Benson, Houghtaling, Karabinchak/Gopal, Gill:  The original bill has been substituted by A4200 in the Assembly.  In NJAMHAA’s testimony and other advocacy efforts, we sought to have the bill amended to ensure that clients may receive telehealth services in their homes or other place of their choosing.  This change appears in the amended Senate bill that was passed by the Senate Health and Human Services Committee on 1/14/21; it now must be added to the Assembly bill.  In both the Senate and Assembly, the bill is currently referred to the respective Appropriations Committee.

Testimony to Assembly Health Committee – June 23, 2020

Testimony to the Senate Health, Human Services and Senior Services Committee – Oct. 27, 2020

Motor Vehicle Registration Fee Exemption

S138/A1444  Holzapfel, Singer/DeCroce, Benson:  These bills are not currently listed as companion bills on the Legislature’s website since the Senate bill already includes the amendment NJAMHAA secured last session that adds non-profit behavioral health providers (and all non-profits) to the list of those organizations that are exempt from motor vehicle registration fees.  Non-profits had been exempt for over 70 years until the law providing exemptions was reinterpreted under the last Administration.  NJAMHAA is working with the Assembly sponsor to have their bill amended to match the Senate bill, after which we expect it to promptly get a hearing in the Transportation Committee which is chaired by Assemblyman Benson, who is also a primary sponsor of this bill.

Testimony to Senate Transportation Committee – June 11, 2018

State Issues in Need of Legislation

NJAMHAA is currently in the midst of having several bills written and introduced to address some of our priority items:

• A bill to allow Psychiatric Advance Practice Nurses to fill the role of Psychiatrists on Programs for Assertive Community Treatment (PACT) Teams. A Senate sponsor has been secured for this legislation. (See page 4)
• A bill to establish a formula for automatic upward rate and contract adjustments that is indexed to actual costs.  An Assembly sponsor has been secured for this legislation. (See page 4)
• While strictly a budget item that we hope to see added to the governor’s proposed FY2022 budget by the Legislature, NJAMHAA is also working to have a bill introduced to double the funding of the SBYSP to expand it to many more schools.  An Assembly sponsor has already been secured. (See page 6)

State Budget

FY2022 Budget

Written Testimony for Department of Human Services Listening Session - Dec. 14, 2020

Budget Priorities

• Close the deficit gap caused by the Division of Mental Health and Addiction Services’ (DMHAS) transition to fee-for-service reimbursement with a $25 million investment (until such time that rates are adjusted to cover the actual costs of care). (See page 5)

• Double the School Based Youth Services Program (SBYSP) appropriation for a total $30 million state investment in readily accessible comprehensive services for middle and high school students. (See page 6)

• Appropriate funds to cover the increased costs under mandated minimum wage requirements as they are implemented, including other salary increases needed to prevent the compression of wage scales. (See pages 3 and 4)

Other Budget Recommendations

• Expand Early Intervention Support Services (EISS) ($3 million). (See page 5)

• Appropriate $1.5 million to support the Screening Center early intervention grant program.* (See page 5)

• Appropriate $10 million as an initial investment into facility resources for behavioral health providers to further develop integrated care. (See page 9)

• Appropriate $10 million for mental health providers and renew the $6 million appropriation for substance use treatment providers to upgrade, implement and maintain interoperable EHRs. (See page 8)

*Legislation that NJAMHAA spearheaded to establish a grant program for Screening Centers to expand community outreach through expanded mobile response, satellite offices or other approaches was signed into law in January 2020, but without funding. 

Other State Issues

NJAMHAA White Paper:  COVID-19 Recovery and Reinvention: Behavioral Health Sector

1115 Waiver Renewal

New Jersey’s 1115 Waiver renewal application must be sent to the Centers for Medicare and Medicaid (CMS) in June 2021.  NJAMHAA submitted input for the renewal in November 2020.  The Division of Medical Assistance and Health Services (DMAHS) will release a detailed concept paper in the spring with a public comment period and public hearings to follow.

CMS will open a public comment period in the summer, then negotiate a final renewal with DMAHS.  The new waiver demonstration period will begin on July 1, 2022.

NJAMHAA will be monitoring this process, continuing to provide input and keeping members informed of their opportunity to do so.

Federal Issues

With a new Administration, there is a great deal of activity at the federal level that impacts NJAMHAA members and those they serve.  Budgets, telehealth provisions, COVID relief packages, healthcare changes and more, including new and changing regulations and initiatives.

The list below represents priority legislation that NJAMHAA is monitoring.

Federal Legislation NJAMHAA Supports

Medicaid Reentry Act. HR955/S285  Representatives Paul Tonko (D-NY) and Mike Turner (R-OH)/Senators Tammy Baldwin (D-WI) and Mike Braun (R-IN): The bill requires states to make Medicaid available for incarcerated individuals no less than 30 days prior to release, ensuring more coordinated behavioral & other health care for people reentering communities, a measure made more critical than ever right now during the pandemic.

Mental Health Access Improvement Act. HR945/S286  Representatives Mike Thompson (D-CA) and John Katko (R-NY)/Senators Debbie Stabenow (D-MI) and John Barrasso (R-WY): The bills would extend Medicare coverage to marriage and family therapists, and mental health counselors and the services they provide, including discharge plans for post-hospital services.

Mental Health Services for Students Act (Bill number pending, Rep. Grace Napolitano (D-CA), sponsor.) The bill would provide $200 million in competitive grants for public schools nationwide to partner with local mental health professionals to establish comprehensive mental health services for students. While schools work to navigate this pandemic, they need the resources to create a mental health plan to reach their students during this stressful time. The legislative text is nearly identical to the version of the Mental Health Services for Students Act passed unanimously by the US House of Representatives in the 116th Congress. The single change increases funding from $130,000,000 to $200,000,000. The bill has over 30 cosponsors.

Suicide Prevention Lifeline Improvement Act. (Bill number pending; Representative John Katko (R-NY), sponsor.) This bill expands the requirements for the National Suicide Prevention Lifeline Program, requiring SAMHSA to: (1) develop a plan to ensure the provision of high-quality service, (2) strengthen data-sharing agreements to facilitate the transmission of epidemiological data from the program to the Centers for Disease Control and Prevention, and (3) implement a pilot program focused on using other communications platforms (e.g., social media and texting) for suicide prevention. The bill is identical to a version of the measure that was passed unanimously by the US House of Representatives on 9/29/20 in the 116th Congress.

The Virtual Peer Support Act. S 157 Senator Catherine Cortez Mastro (D-NV): The bill, being reintroduced in this Congress, is designed to help boost the capacity of peer behavioral health support programs by transitioning them to an online setting. To that end, under the bill, SAMHSA would receive $50 million to make grants to eligible organizations to implement new, virtual peer support programs and to expand existing online services to meet community needs.

Telehealth Modernization Act.This bill was just recently reintroduced, though no bill number is yet available.  It modifies requirements relating to coverage of telehealth services under Medicare.  Specifically, the bill extends certain flexibilities that were initially authorized during the public health emergency relating to COVID-19. Among other things, the bill allows (1) rural health clinics and federally qualified health centers to serve as the distant site (i.e., the location of the health care practitioner); (2) the home of a beneficiary to serve as the originating site (i.e., the location of the beneficiary) for all services (rather than for only certain services); and (3) all types of practitioners to furnish telehealth services, as determined by the Centers for Medicare & Medicaid Services.

Federal Budget

Congress passed the FY2021 budget late in December, as they previously were operating under a Continuing Resolution (the FY2021 budget year began on October 1st).  The budget bill was tied to the December COVID relief package, highlighted below.  The $1.4 trillion omnibus budget continued what had been passed in September, with the No Surprises Act, designed to prevent patients from receiving surprise medical bills, included.

The $4.25 billion allocated to the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide increased mental health and substance abuse services and support, included:

• $1.65 billion for the Substance Abuse and Prevention Treatment Block Grant;
• $1.65 billion for the Mental Health Services Block Grant;
• $600 million for Certified Community Behavioral Health Clinics;
• $50 million for suicide prevention programs;
• $50 million for Project AWARE to support school-based mental health for children; 
• $240 million for emergency grants to States; and
• $10 million for the National Child Traumatic Stress Network.

Not less than $125 million of the funds provided to SAMHSA must be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes across a variety of programs.

You may read a full summary of the Omnibus Budget here.

COVID Relief Packages

March 2020

The largest relief package last year was the CARES Act.  This bill established the Paycheck Protection Program and Provider Relief Fund, among many other provisions.  You can read a summary of all of the Act’s provisions here.

December 2020

As noted above, another relief package was attached to the Omnibus Budget passed in December 2020.  Those provisions are included in this summary of the Omnibus Budget.

March 2021

The current package being negotiated is the American Rescue Plan.  The current version would:

• Provide $1,400 stimulus checks to supplement the $600 checks awarded in the last COVID-19 relief package, including, for the first time, payments to adult dependents.
• Speed vaccine distribution ($20 billion), open federal vaccination sites and increase testing capacity across the country ($50 billion).
• Extend emergency unemployment benefits through September 2021 and increase the federal supplement to weekly state unemployment payments to $400.
• Expand paid family and sick leave through September 30, 2021.
• Provide $350 billion to support state, county, and city recovery from massive COVID-related service costs.
• Require employers to provide up to 14 weeks of paid sick leave for family members to care for relatives with COVID-19, with firms up to 500 employees receiving up to $1,500 per employee to offset these costs.
• Extend the Child Tax Credit, the Earned Income Tax Credit, and the Premium Tax Credit.
• Extend the SNAP Program to reduce hunger through September 2021.
• Provide $25 billion for rent relief, and a moratorium on evictions and foreclosures through September 2021.
• Make $4.2 billion available for SAMHSA and HRSA to expand behavioral health services.