Transition of mental health and addiction services to the Department of Health (DOH).

Lawmakers Plan Joint Hearing on Christie’s Reorganization of Mental Health Services

Democratic lawmakers said Tuesday that Gov. Chris Christie’s plan to transfer mental health and addiction services from the state Department of Human Services to the Department of Health needs a public hearing process.

“This reorganization plan has not been vetted by the Legislature and, more importantly, by the families and providers who will be directly impacted,” said Assemblywoman Valerie Vainieri Huttle, who chairs her chamber’s Human Services Committee. Huttle and Sen. Joseph Vitale, chair of the Senate health committee, are planning a joint hearing on the issue in the coming weeks.

Christie, in a memo dated June 29, proposed the transfer of the entire Division of Mental Health and Addiction Services. With an annual budget of just under $1 billion, the division employs around 200 people to oversee mental health and substance abuse treatment and prevention efforts, including residential, inpatient and outpatient services, as well as the state’s four psychiatric hospitals.

The reorganization will become effective within 60 days, unless the Legislature passes concurrent resolutions opposing the move.

Christie has made efforts to fight opioid addiction and reduce stigma around addiction as the cornerstone of his final year in office. He was also appointed the chair of a national commission on opioids by President Donald Trump. The group is expected to release a draft report later this month.

In the memo, Christie says the transfer is necessary to “improve health care, remove bureaucratic obstacles to the integration of physical and behavioral health care, and effectively address substance use disorder as the public health crisis that it is.”

Vitale said he hopes to hear from administration officials before the hearing.Health Commissioner Cathleen Bennett said in a statement her agency was “eager to continue its work in population health and providing holistic care to individuals.”

The integration of physical and mental health services has been a long-running challenge for the state agencies. A 2016 report from researchers at Seton Hall University, funded by the Nicholson Foundation, found New Jersey providers sometimes face outdated and inconsistent guidance from the two agencies when it comes to licensing and reimbursement for integrated care.

With more than 11,000 employees, the Department of Human Services is the largest state agency in terms of size and budget and is responsible for administering the state’s $15 billion Medicaid program. The Department of Health has fewer than 1,100 employees.

Vitale and Huttle said they both support the goal of integration, but are worried about the speed at which the governor wants to transition. “I’m just questioning the governor’s plan to do it now — the intent and the reasoning behind it.” I think that a major change could significantly impact these critical services,” Huttle said.

The move also comes at a time of increased uncertainty for certain community mental health providers as they shift from fixed-cost contracts with the state’s Medicaid program to fee-for-service reimbursements. Some providers have testified at recent budget hearings that they will no longer have the same cushion they had under the previous system, since the new rates rates won’t cover overheard, administration and staffing costs or the shortfall from caring for people without insurance.

“We think that undertaking another major systemic change while there is already such uncertainty and difficulty could be a significant disruption,” said Debra Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies. “We’re excited about the long-term prospect but apprehensive and concerned about the timing.” Read Christie’s reorganization plan here. As reported by Politico.

Governor Announces Transition of Mental Health and Addiction Services to Department of Health

Please see the following announcement sent by Department of Health Commissioner, Cathleen Bennett:

The Governor has issued an Executive Reorganization Plan that will transfer the Division of Mental Health and Addiction Services in the Department of Human Services to the Department of Health (DOH).   Transferring mental health and addiction services to DOH is necessary to improve health care, remove bureaucratic obstacles to the integration of physical, mental and behavioral health care, and effectively address substance use disorder as the public health crisis that it is.

This reorganization recognizes that the DOH focus on population health, which involves helping healthy New Jerseyans stay well, preventing those individuals at risk from getting sick, and keeping those individuals with chronic health conditions from becoming sicker, is the right focus and especially the right focus for integration of physical health, behavioral health and mental health.

Research demonstrates that integrating mental, behavioral and physical health care is the most effective way to treat the “whole person;” yet for historical reasons, health care is too often fragmented into separate components: physical; mental; and substance use disorder. In the absence of integrated health care, persons with serious mental illness often suffer from physical health conditions that go unaddressed.

This reorganization recognizes that mental health and behavioral health problems in general, and opioid addiction in particular, need to be treated as illnesses no different than infectious diseases such as Zika virus or chronic conditions such as hypertension, heart disease, diabetes or obesity. All are best addressed by preventive measures. Only through such a public health approach can we overcome the stigma that for too long has characterized efforts to treat addiction as something that must be cordoned off from the rest of health care.

People with serious behavioral health conditions suffer for lack of access to primary care, while people with mild to moderate behavioral health conditions, often unconnected to behavioral health care, could benefit from access to care in primary care settings.

This plan will take effect 60 calendar days after the date of filing with the Secretary of State and Office of Administrative Law.