Wednesday, March 22, 2017

Advocacy and Knowledge Building Are Always Critical for Providers and other Stakeholders
Join NJAMHAA at its Annual Conference March 29-30, 2017 for Information, Insights & Inspiration

Now is the time to exercise your lungs and advocate against the repeal and replacement of the Affordable Care Act as loudly as you can. If the American Health Care Act is passed, hundreds of thousands of individuals will lose coverage, which for many, was recently gained as a result of the Medicaid expansion.

It is also a good time to take a breath and a refreshing break – while continuing to reinforce your effectiveness as a behavioral health provider and advocate. It is natural to feel overextended and stressed with so many important issues to focus on, so NJAMHAA has a solution: Attend our Annual Conference, Collaboration and Innovation: A Formula for Success, on March 29 and 30, 2017 to take a rejuvenating, yet still productive break from your highly demanding daily responsibilities.

The conference is not just something else to do. It is designed to make everything you do even better. You and the individuals you serve will benefit tremendously because you will not only get the latest updates from Washington in real time, but also will gain a wealth of information and insights that are timely and valuable for your ongoing work with individuals who depend on your services to achieve a high quality of life.

You will not want to miss:

* Working with a New Administration: In his keynote presentation on Day 1, Ron Manderscheid, PhD, Executive Director of the National Association of County Behavioral Health and Developmental Disability Directors, will provide his insights on the likely impact of changes to national policy, including the Affordable Care Act, Medicare and Medicaid. He will also share his perspective on the direction of healthcare policy for the near and long term, as well as guidelines for preparing for the coming changes.

* Five Pillars - The Pathway to Improving the Delivery of Mental Health Services in Education: An Interview with Amy Kennedy: In this plenary session, Amy Kennedy, MS, Education Director for the Kennedy Forum, will share findings from her research in early identification of and intervention for mental health concerns in children, the use of brain fitness and mindfulness within school systems in order to foster and improve mental wellness, and developing prevention programs that utilize and promote students’ social and emotional learning.

* Innovation in Behavioral Health Management, Reimbursement and Delivery: For the Day 2 keynote presentation, Brian Wheelan, MBA, Chief Strategy Officer and Executive Vice President at Beacon Health Options, will share the successes and challenges that have come from collaborations with provider organizations in both risk and non-risk based arrangements.

* The Changing Role of Hospitals: Leaders from Carrier Clinic, Hackensack, UMC Mountainside and the Camden Coalition of Healthcare Providers will discuss their successes from programs and changes they have implemented, as well as their current or planned efforts to better serve those with mental health and/or substance use disorders. They will also focus on the need for collaboration between hospitals and community-based providers.

* Plus: Workshops to meet every training need: Topics are organized by tracks – General Clinical/Adult Mental Health; Substance Use Disorders and Treatment; Children and Youth; and Organizational.

Get Even More Inspired at the Courage & Compassion Awards Reception

The best way to attract and retain staff is to make them feel valued. We all know of the amazing work that frontline providers and organizations’ leaders do every day and we are delighted to present Courage & Compassion Awards to several of them at our annual awards and networking reception.

Please join us to honor providers, as well as state legislators and media representatives who support the mental health, substance use and developmental disabilities systems.

Your participation in the reception is included in your Day 1 conference registration.

Click here to register now!

Wednesday, February 22, 2017

Helpful Advice for Small Organizations Managing Huge Demands and Challenges

In small organizations, we get so busy – as evidenced by the several weeks since my last blog. I agree with Mary Gay Abbott-Young, a NJAMHAA Board member and CEO of the Rescue Mission of Trenton, that in smaller organizations, leaders and other staff wear so many hats, which makes it is difficult to get to many things. As a result, the expectations seem unrealistic. This leads to the question: What do small service provider organizations need to do to survive?

Most days, I would describe my role at NJAMHAA as being an octopus that also has to stand on its head to manage the multiple – and growing – demands. While this makes my career exciting and never boring, it becomes very challenging. In terms of advocating strongly and constantly on many issues; meeting regulatory standards; staying on top of what is happening in the behavioral health field, related industries and the state and federal governments that affects our members’ abilities to provide services; and keeping up with daily operations and serving members/clients, both the NJAMHAA staff and our members face a gargantuan task every day.

“Small” in the behavioral health field does not necessarily mean being as small as NJAMHAA’s staff. Small provider agencies in this environment could have budgets of $10 to $15 million. On our staff, we have fewer than five individuals delivering member services, advocating, and developing and presenting conferences and other training events to NJAMHAA’s 160 organizational members and their 61,000 employees. That’s a lot of demand on a few people! And the employees at our member provider agencies contend with similar challenges.

In this environment, as demands are increasing while resources are declining, here are some ideas from Mary Gay and Jim Lape, a Past NJAMHAA Board President who recently retired from his position as Trinitas Regional Medical Center’s Vice President of Behavioral Health and Senior Services:

Mary Gay poses the following questions for providers in small agencies to consider: Does your agency need to become larger to survive or is the key to partner with other provider organizations? Does “bigger” necessarily mean better services? How can we act as a community of providers?

According to Jim, agencies need to be bigger, but they do not necessarily need to merge with other organizations. However, there is pressure to consolidate in all sectors to achieve economies of scale. What is essential is their participation in larger networks.

Jim emphasized that smaller agencies must be as strong as they possibly can be in order to be attractive to networks and larger entities. To do this, they need to manage costs by being as lean as possible, especially on the administrative side, and explore opportunities to outsource some functions, such as information technology, human resources and billing. They also need to offer special valued services to maximize their revenues – perhaps by facilitating groups, especially around medication management, and specific types of groups that would meet the needs of their communities, such as trauma-focused and dialectical behavioral therapies.

Jim added that mental health providers need to focus on the broad range of mental health disorders, not just serious mental illnesses. In addition, since money will flow from the federal and state governments to health plans when Medicaid is managed – which will probably begin within the next year or two – it is also important for agencies to have relationships with health plans and provide solutions for populations that are being insured.

The many changes taking place can seem overwhelming, especially when they appear to be at odds with providers’ mission to serve everyone in need – a population that continues to grow. I hope this advice from long-time, expert providers of both mental health and substance use services brings encouragement to all of our members.

Wednesday, January 11, 2017

NJAMHAA Applauds Governor Christie’s Commitment to Providing Substance Use Treatment, Eliminating Stigma

In seventh State of the State address, Governor Chris Christie highlighted his successful initiatives and ongoing commitment to increase access to substance use treatment services for the estimated 985,000 New Jersey residents in need.

Governor Christie has been raising awareness that addiction is a disease and that individuals with addictions should not be stigmatized. Not only did he reinforce these facts during his powerful State of the State address, but he also announced new exciting and much-needed initiatives. His diverse strategies are inspiring and exactly what is needed to address these complicated issues that are leading to tragedy in thousands of lives throughout our state and nation.

Gov. Christie announced the establishment of the Governor’s Task Force for Drug Abuse Control; a continued investment for mental health and substance use treatment services with the addition of $127 million in the Division of Mental Health and Addiction Services’ FY 2018 State Budget, as well as $12 million to open 200 beds for 18- and 19-year-olds to be served by the Children’s System of Care; “implementing a robust curriculum tailored to every age group, beginning in kindergarten”; investment of $5 million to expand the Pediatric Behavioral Health Hub; increase of funding by $1 million to expand recovery dorms at colleges and universities; establishment of sober living homes throughout the state to support ongoing recovery after graduation; development of legislation that will prohibit insurance companies from denying or requiring pre-authorization for the first six months of inpatient or outpatient substance use treatment; and the creation of a new hotline and website (1-844-REACH-NJ;, which are now in operation to further support individuals’ efforts to identify treatment providers and begin treatment.

The Governor also directed Elizabeth Connolly, Acting Commissioner, Department of Human Services, to call upon Seema Verma, the new Administrator of the Centers for Medicare and Medicaid Services, to eliminate the Institutions for Mental Disease (IMD) exclusion, which prevents states from drawing down federal funds for any person served in a facility with more than 16 beds.

The numerous efforts that Gov. Christie has undertaken over the past couple of years with the goal of increasing access to substance use treatment include expansion of the Drug Court, which requires individuals who commit nonviolent drug crimes to begin treatment, in order to avoid further overcrowding the jails; expansion of the Recovery Coach programs, through which individuals in recovery of substance use disorders work with individuals who are revived from heroin overdoses that would otherwise be fatal and encourage them to enter treatment; the dedication of the majority of $20 million in State funds and $100 million from the federal Medicaid drawdown to increase Medicaid reimbursement rates for substance use treatment; and the establishment of the Facing Addiction Task Force, chaired by Pastor Joe Carter of The New Hope Baptist Church in Newark and former Governor Jim McGreevey to address addiction from many angles: prevention, treatment, helping individuals reintegrate into the community after they complete treatment or are released from jail or prison, and supporting individuals in recovery with housing, health care and employment.

These initiatives are greatly appreciated. However, as Governor Christie himself stated, much more needs to be done as addictions, as well as co-occurring mental health disorders, are highly prevalent throughout New Jersey. Substance use disorders cannot be treated in a vacuum. Integrated care is essential and it has been proven to be much more effective than treating either illness in a silo.
We greatly appreciate Governor Christie’s focus on the opioid and heroin crisis. In order to most effectively combat this crisis, mental illnesses must also be treated. We look forward to working with Governor Christie and his staff to expand and ensure access to services that address both of these chronic illnesses.

Thursday, December 22, 2016

Holiday Message: Help Someone to Improve their Life

As we are in the midst of the holiday season, which is always promoted as the season of giving, I want to point out that often it is harder to save a life and meet an individual’s needs than it is to talk in systemic terms and support a cause.

At this time of year, our e-mail inboxes and regular mailboxes get filled with requests for donations from a variety of organizations, all of which serve invaluable purposes and have a significant positive impact on people’s lives. For some who receive these requests, it’s easy to make monetary donations to such organizations. While these contributions are certainly valuable, in many cases, this is the only time the charitable organizations are supported.

This holiday season, each of us should reach out and go above and beyond to help somebody. We should not think of it as work. In fact, helping other people is highly rewarding and has positive mental health benefits for individuals who volunteer their support. This is my goal throughout the holiday season, as well as the entire year.

Of course, NJAMHAA member providers do help many individuals and families every day throughout the year – every year – and their services are invaluable, as they enable individuals to improve their physical and mental health, pursue education, secure employment, escape homelessness and strengthen their relationships with family members and friends.

I send heartfelt gratitude to all the staff at NJAMHAA member agencies. Your tremendous contributions to New Jersey residents’ quality of life is truly inspiring and most appreciated.

All I want for the holidays is to spread the message: “Help someone to improve their life.”

I wish everyone safe holidays and a wonderful New Year!

Wednesday, October 19, 2016

U.S. Surgeon General’s Groundbreaking Report Sets the Stage for Eliminating Stigma, Preventing and Treating Substance Use Disorders
More than 20 million people across the nation have substance use disorders (SUDs) and the numbers of overdose deaths from several types of drugs have, on average, tripled between 2001 and 2014, according to the National Institute on Drug Abuse. Although treatments for all types of SUDs have been proven to be effective, only about 10 percent of individuals receive any type of specialty treatment. These statistics reinforce the timeliness and importance of the groundbreaking report, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, which Vivek H. Murthy, MD, MBA, Vice Admiral, U.S. Public Health Service Surgeon General, released on November 17, 2016.

Dr. Murthy’s statement that addiction is not a character flaw or a moral failing is powerful and will help foster progress in the ongoing battle against stigma, which, along with lack of insurance, is the most common reason why people do not seek treatment when they need it. The details on the neurological framework of addiction in the Report, proving it is a disease of the brain, also helps fight stigma by providing necessary education and understanding.

We are pleased that this is in line with Governor Christie’s public statements about addiction being a disease and making substance use treatment a priority for New Jersey. The political will to expand access to services is essential, and it is very heartening to know that leaders in both our state and federal governments are focused on addressing this critical health need that has grown to be a public health crisis.

The Surgeon General’s Report details biological and other factors that increase risk for substance use, misuse and addiction and highlights programs that aim to not only mitigate risk factors, but also reinforce protective factors. These factors are the same for depression, bullying and risky behaviors, and they are predictive factors of addiction and other behavioral health challenges. This reinforces the importance of prevention and early intervention, as such efforts are designed to have a far-reaching impact on individuals’ lives.

Notably, the Report acknowledges and expounds upon the many paths to recovery and the need for ongoing recovery support services. This reinforces the fact that the medical model is not sufficient for treating SUDs because these illnesses rarely, if ever, follow a linear path toward resolution. Unexpected stressors in individuals’ lives could trigger symptoms and relapse at any time. Therefore, the full continuum of services must always be available to everyone at every stage of treatment and recovery.

The Report illustrates the U.S. Department of Health and Human Services’ (HHS’) dedication to leverage opportunities identified in ongoing efforts for healthcare and criminal justice reform, information technologies, research and resulting clinical advances to expand access to effective prevention and treatment services. The report’s emphasis on integrating physical health care and substance use services, as well as a public health approach, is greatly appreciated and clearly demonstrates the Surgeon General’s and his team’s knowledge of what works and what is needed to truly address the addiction crisis throughout our country. Sixty percent of individuals with SUD’s also have mental illnesses and in this population, only 48 percent receive treatment for either disorder. Integrated care is necessary to address both of these disorders, as well as physical co-morbidities that are common in this group and often not treated. The lack of treatment for these multiple health conditions leads to a greatly declining quality of life and tremendous need for costly healthcare services. All of this can and must be prevented.

The Report also contains a call to action and recommends specific endeavors different groups of individuals – parents, families, educators, healthcare professionals, public policy makers, researchers and all community members – can undertake to help ensure access to SUD treatment for those in need and to help prevent others from developing SUDs.

Addressing the addiction crisis absolutely requires a team effort and we admire Dr. Murthy for taking the lead in convening experts from HHS, the Substance Abuse and Mental Health and Services Administration and other areas of the field and rallying all stakeholders nationwide to work together on this critical issue. All of us at NJAMHAA look forward to our ongoing partnerships with federal and state leaders, our members and other stakeholders to give individuals with SUDs opportunities to achieve recovery and help others protect themselves from the dangers of alcohol and other drugs.
Lives Are at Stake; Changes Must Be Made

I’m going to Europe this fall and I’m always struck by the fact that throughout Europe and especially in France, they always have strikes and demonstrations. Since I joined NJAMHAA 21 ½ years ago, I’ve seen that while we agree it is effective to show what the mental health and substance community provides and how much it is depended on, there has never been a strike because providers are mission driven and would never hold back services even for a day from the children and adults who rely on them.

Community-based mental health providers are moving to a fee-for-service (FFS) reimbursement system with some rates that won’t work and the simultaneous removal of State contract dollars, as we have been demonstrating – without going on strike. Data from providers throughout New Jersey indicate that tens of thousands of individuals will lose services if FFS rates are not increased and if contract dollars are not continued while providers make the transition, which should be extended.

So, it is realistic – and frightening – to ask, “What if providers had to close their doors not for a day, but forever, because they were no longer viable?” This has been the experience in other states throughout the country, including Massachusetts, Michigan and Kansas. The move to Medicaid managed care and the concurrent termination of contracts with State dollars resulted in programs and even entire agencies closing, which led to individuals’ mental illnesses and substance use disorders becoming worse and requiring much more expensive treatment in emergency rooms and inpatient hospital units. If positive changes are not made for New Jersey’s FFS system, these same tragedies – which have been occurring due to the long history of insufficient funding – will inevitably occur to a greater degree. Such tragedies can and must be prevented.

Our member providers are so committed to those they serve that they are doing all they can as they face the multiple challenges inherent in the time frame in which FFS is being implemented. However, there is still a limit to what they can do with limited funds. It’s my hope that State legislators and policymakers will invest more State dollars in the community mental health and substance use system to ensure that all children and adults – whether they have Medicaid or they are underinsured or uninsured – so that even though providers refuse to quit, the FFS system won’t have such a devastating impact that it would seem as if providers had gone on indefinite strike.

As a good friend of  mine, Randy Hall, eloquently stated, “People seldom change when they see the light; they only change when they feel the heat.” Our State leaders need to feel the heat, to know what’s at stake: people’s lives.

While the unquantifiable cost of people’s lives is certainly a compelling reason on its own, the quantifiable fiscal cost is also of great concern and cannot be ignored. The cost of community services must be viewed as an investment that yields a tremendous return. Community services cost hundreds of thousands of dollars less than hospital services and save the State millions of dollars every year in prevented emergency room visits, hospitalizations, homelessness and incarceration.

People’s lives and the State’s fiscal situation represent a lot of “heat” that should incite positive change to strengthen and maintain the safety net that is our community mental health and substance use system.

Thursday, October 6, 2016

Ensuring that Everyone who Needs Help Can Get Help

The summer passed so quickly and we jumped into fall at full speed as the transition to fee-for-service (FFS) had been and continues to be on everyone’s mind.

Ever since I began receiving feedback from members that some of the FFS rates won’t work, I’ve been asking myself every night, “What will it really take to ensure not only that no one loses services as we go through the system transformation, but also that we can expand services as there is so much unmet need?”

Of course, we are continuing to persevere in our advocacy and we are employing a variety of strategies, including recent videos, We Have a Potential Problem and The Number of People in Need Continues to Increase , on YouTube. The videos, as well as our press releases and letters to editors, have resulted in substantial media coverage. Highlights include a page 1 article in the Star-Ledger, several articles in NJ Spotlight, a feature in Mental Health Weekly and interviews on NJTV News. We have had some impact on FFS rates and the transition to FFS. We are also making significant strides toward eliminating stigma and discrimination.

The momentum keeps building. As others have been worrying along with me around the clock, which is evident by the nonstop communications, the potential loss of services for tens of thousands of individuals is of grave concern. This concern has prompted much positive action by our staff and members, including advocacy to legislators in writing and in person, a petition (click here to sign on before October 19th) and legislative breakfasts being held this month in Bergen and Essex Counties.

I fully support all of these efforts. They augment the advocacy that our staff and I do on behalf of all our members. I think there will be a solution and we will be heard if every individual at every member organization, as well as all clients and their family members, become actively engaged in advocacy. I believe that if we all join voices on this issue, leaders will know that services are needed and valuable.

We are glad the State Senate Health, Human Services and Senior Citizens Committee unanimously passed a bill for independent oversight of the FFS system operation and rates, and we anticipate an Assembly hearing on this legislation on November 14, 2016. We strongly encourage our members to make a strong showing at this hearing with clients and their family members. Stay tuned for details.

Debra L. Wentz, Ph.D.
President and CEO
New Jersey Association of Mental Health and Addiction Agencies, Inc. (NJAMHAA)