Wednesday, January 24, 2018

New Administration Presents Opportunities to Strengthen the Behavioral Health System

With the new administration in place, there are many unknowns and we look forward to hearing more from Governor Phil Murphy about his plans concerning the state’s community-based services for children and adults with mental illnesses, substance use disorders, intellectual/developmental disabilities and co-occurring health conditions.

Undoubtedly, there will be opportunities. For example, during the inauguration, Gov. Murphy acknowledge the importance of services to address the opioid crisis, other substance use disorders and mental illnesses. I feel confident that Gov. Murphy will support services to address all of the health conditions that are prevalent in the populations our members serve.

Of course, many funding needs must be met and regulatory issues need to be resolved to ensure access to the life-saving services our members provide. While the service delivery landscape is being restructured, we will continue to advocate for increased reimbursement rates; support for workforce development; inclusion of social determinants of health, such as housing, supported education and supported employment, in healthcare models; and full enforcement of parity.

Specifically, the behavioral health system needs higher capacity in partial care, outpatient and residential programs. Rate increases are needed to meet this need. Rates and policies for Community Support Services need to be improved so that these programs can continue to be available to individuals in need. The Division of Mental Health and Addiction Services has been examining this more closely. Additional funding is also needed to continue and expand supported employment and other services that enable individuals in recovery from mental illnesses and substance use disorders to rebuild their lives.

There needs to be a huge infusion of new funding because the suicide rate in New Jersey is continuing to increase and the shortage of psychiatrists, APNs and clinicians makes it difficult to serve everyone in need. One in four individuals has a mental illness and many also have substance use disorders. This underscores the critical importance of ensuring prompt access to high-quality services.

There needs to be assurance that current programs continue with adequate reimbursement rates that have inflationary factors incorporated to keep pace with the cost of living. In addition, funding for expansion of programs is necessary so that everyone in need of services has access to them.

Equally important are continued and increased efforts to eliminate stigma about both substance use disorders and mental illnesses. Stigma stops people from coming forward and seeking help that can save their lives and greatly improve their quality of life.

Wednesday, December 20, 2017


Take Care of Yourself as you Take Care of Others
 
While the holiday season is a time of joy for many people, it is also a difficult time for many others. Just as NJAMHAA members are dedicated to helping individuals throughout the state to cope with holiday blues, as well as chronic depression and other behavioral health challenges, NJAMHAA is committed to supporting members through the challenges of the many changes that the behavioral healthcare system is undergoing.

We always take charge and are constantly working on your behalf. As there is a lot to be concerned about and advocate for, we are at the forefront. For example, we are actively representing NJAMHAA members on Governor-elect Phil Murphy’s Transition Team’s Healthcare Committee and the Department of Health’s Integrated Health Advisory Council.

With so much in policy being in flux and unpredictable, it is natural to feel stressed and anxious. You may want to consider adapting these tips for coping with holiday blues in your efforts to manage the changes in the behavioral healthcare system:

       Acknowledge your feelings: You are not alone and you should not suppress anxiety you may be feeling.

       Reach out: Building on the previous point, reach out to your coworkers and colleagues in other agencies to share concerns.

o   I strongly encourage all of you to participate in Practice Groups and Membership Meetings to gain and share innovative ideas and collaborate on advocacy strategies.

      
Plan ahead: Make the most of NJAMHAA’s training opportunities to plan for major changes that will be taking place, such as value-based purchasing, and explore potential partnerships to ensure your agencies’ ongoing viability.      

All of us at NJAMHAA thank you for your commitment to improving the quality of life for hundreds of thousands of people, and we wish all of you enjoyable holidays and a wonderful New Year.
 

Tuesday, November 7, 2017


Make “Reach Out and Touch Someone” a Reality Again

Some of you might remember the Bell and AT&T ads in the 1980s that encouraged people to “reach out and touch someone” by using their telephone service. Not only the ads and the types of phones in use at the time, but also the broader message, are practically extinct.

Today, we constantly contend with an endless proliferation of communication in various forms and on multiple devices. We give ourselves a sense of being engaged when really, we are missing life and watching it go by. Rather, we are not even watching because that would mean “unacceptable” down time that would interfere with our focus on what constantly arrives on our cell phones, iPads and computers.

As we come up on the holiday season, I recommend that we take a real break from devices and really connect in person…although this may seem novel, especially to Millennial and post-Millennial generations.

Overall – not just during the holidays – I advocate for a lot less technology and a lot more face-to-face communication, whether it’s at work, at home or with friends. We need to realize that in-person conversations are well worth the time and make the most sense.

People accuse me and others of needing more work-life balance. I love balance in life and I have many interests beyond work despite my passion for and commitment to what I do in my role at NJAMHAA. However, electronic communication in multiple forms demands my attention, especially from my constituents. For years now, almost “ad nauseum”, there have been articles about managing e-mail by ignoring it. I cannot follow that advice. My family, friends and work are too important.

However, I am making an early New Year’s resolution to strive for not only greater work-life balance, but also tech-body balance, as the Harvard Business Review featured earlier this year. Charlotte Lieberman, the author of this article, made many compelling statements. Here is one that particularly struck me: “A 2016 survey from Deloitte found that Americans collectively check their phones 8 billion times per day. The average for individual Americans was 46 checks per day, including during leisure time – watching TV, spending time with friends, eating dinner.” Lieberman added that many people check their phones when they’re in bathrooms! Even I haven’t gotten to that extreme – and I will not go there.

Lieberman also talked about the physical toll that technology can cause: for example, neck strain from looking at screens for long periods of time and aching wrists from an inordinate amount of scrolling and typing.

Other articles have underscored how today’s youth are so over-engaged in technology of various forms, that they have lost the real art of communication and, despite being “connected” have developed feelings of isolation and loneliness. Obviously, a social media-only friend is not the same as a real friend who gives you a hug.

Beyond the impacts on our physical, mental and emotional health, we also need to be careful for our safety. Cybersecurity risks abound, as we know from data breaches that have been reported in the news – online, of course (as well as “old-fashioned” newspapers). Social media also presents safety risks: users do not know who they are communicating with and, unfortunately, not everyone has good intentions.

I hope all of you have safe and enjoyable holidays and make “reach out and touch someone” a reality again with in-person contact with friends and family.

Wednesday, September 27, 2017

“Why Should I Worry Now about Value-Based Purchasing to Keep My Organization Strong?”

There has not been a dull moment in the behavioral healthcare field for quite a while and there will not be one for a very long time, if ever.

Community-based providers continue to adjust to fee-for-service reimbursement while they brace themselves for the transition of mental health and substance use services from the Department of Human Services to the Department of Health. Meanwhile, the federal government continues debates about the Affordable Care Act and the Centers for Medicare and Medicaid Services is moving forward with implementing value-based purchasing.

With all the changes happening, you may be wondering, “Why should I worry about value-based purchasing now?”

The answer is: Because it is not a question of “if”; it is a question of “when”. And with emphasis on integrated care, it will happen sooner, rather than later.

To be in a strong position in the future, it is imperative that all providers begin preparing now for value-based purchasing. You need to get ahead of the game to be ready for this major change!

As part of our mission to help providers plan for the future, NJAMHAA will host a critical training event – Staying Ahead of the Game: Beyond Fee-For-Service Reimbursement – Roundtable Summit on Integration and Value-Based Purchasing – on October 3, 2017 from 9:00 a.m. to 4:00 p.m. at the Robert Wood Johnson Wellness Center, 3100 Quakerbridge Rd., Hamilton Township, NJ 08619.

Value-based purchasing calls for more mature relationships between health plan representatives and providers. This summit will provide the ingredients for developing relationships with payers and getting your organizations ready to deliver integrated services in the value-based purchasing system. It is important to remember that every value-based contract will be different – and this summit will help you prepare for operating under these contracts.

To help providers gain the most from this roundtable and to continue preparing for value-based purchasing, NJAMHAA will provide a FREE online provider-readiness tool to each individual who registers for this essential training event. If you were to hire a consultant to develop such a tool, you would pay 100’s – if not 1,000s – of dollars!

This survey is not transferable outside your organization and responses will be kept confidential. It is also proprietary; please do not share the link to it with others.

After the summit, we will send the aggregated results of the assessment tool responses, along with commentary from James Lape, MA, MBA, FACHE, Consultant and Former NJAMHAA Board President, who will be facilitating this event.

The transition of health care to value-based purchasing is inevitable! Providers must take action to bridge the gap from volume to value.

Click here to register today! Then, you will soon receive the link to the free provider-readiness tool!

NJAMHAA thanks our event sponsors: Aetna Better Health of New Jersey, Amerigroup Corporation, Beacon Health Options, Horizon NJ Health and Optum.

Friday, July 28, 2017

Moving Parts


NJAMHAA is always on the move, advocating on behalf of our member providers and the individuals who depend on their services as many systemic changes are taking place and still more are being proposed.

In early July, the second cohort of mental health providers transitioned to fee-for-service (FFS) reimbursement; some providers of Community Support Services (CSS) also started FFS reimbursement for these programs; Governor Christie proposed a reorganization of mental health and substance use services by moving them the Department of Human Services (DHS)/Division of Mental Health and Addiction Services (DMHAS) to the Department of Health (DOH); we have a gubernatorial election coming up soon. On the federal level, there are daily changes and ongoing concerns about the federal healthcare law. As recently as early the morning of July 28th, the Senate rejected the GOP’s “skinny” version of their Affordable Care Act (ACA) repeal bill, and shortly before the vote had introduced a new bill, the Health Care Freedom Act.

NJAMHAA is also on the move – literally. On July 31st, we will be in our new office, only two buildings away from our previous location. Regardless of the distance, it is, of course, a huge, time-consuming project. And as we undergo this change, we continue to keep our ear to the ground, listening to your concerns, which we share, and remaining as active as ever in our advocacy.

Regarding FFS, we are continuing to advocate for safety-net funding, which is the focus of the Community Mental Health Safety Net Act (S3121/A4827). We are also staying on top of the challenges CSS providers are encountering in the implementation of this program.

With a new administration starting in January 2018, which will be here before we know it, we took proactive measures and have met with both gubernatorial candidates.

We are equally proactive in voicing concerns about Gov. Christie’s proposal to move mental health and substance use services from DMHAS to DOH. In my testimony before the Assembly Human Services Committee and the Senate Health, Human Services and Senior Citizens Committee, I stated that the timing (with the FFS transition still under way) and rapidity of implementing this major change (the plan is to complete it by the end of next month) are problematic. I also pointed out that DMHAS and the Division of Medical Assistance and Health Services (Medicaid) should not be separated because Medicaid pays for most mental health and substance use services.

This plan can be forestalled only if the Senate and Assembly pass a concurrent resolution opposing the reorganization, which Assemblywoman Vainieri Huttle has drafted for a vote on July 31, 2017. Whichever way the vote goes, NJAMHAA will meet with DOH Commissioner Cathleen Bennett, DHS Acting Commissioner Elizabeth Connolly and the DHS Division leaders, as we have been doing on a regular basis, to advocate for removing regulatory barriers, and ensuring integrated care and services, and adequate resources to ensure access for everyone in need.

Of course, NJAMHAA is also actively advocating on the federal level, striving to ensure continuation of the Medicaid expansion and preservation of other positive aspects of the ACA. While we can celebrate the defeat of the “skinny” bill – and we should celebrate – it is not a time to let down our guard as unfortunately, we can anticipate future attempts to repeal and weaken the provisions of the ACA, as well as funding for Medicaid and Medicare.

NJAMHAA has impact! And we give credit to many of our members for providing their insights and experiences to maximize the effectiveness of our advocacy.

We look forward to continuing our critical and powerful partnership! Please continue – or begin – to participate in Membership and Practice Group meetings to contribute to the content and influence of our advocacy. For details, contact Shauna Moses, Vice President of Public Affairs and Member Services, at 609-838-5488, ext. 204, or smoses@njamhaa.org. (You can also contact Shauna if you are not yet a NJAMHAA member.)

Remember! These meetings will be held at our new office at 3635 Quakerbridge Road, Suite 35, Mercerville, NJ.

Our phone (609-838-5488) and fax (609-838-5489) numbers and e-mail addresses will not change.

Monday, June 26, 2017

Safety Net Funding for Mental Health Services Remains Imperative

Following is an excerpt of an opinion-editorial piece that was recently published by the Star-Ledger on www.nj.com:

The state Legislature will soon release its budget for fiscal year 2018.  It is imperative that it include safety net funding for community-based providers as their mental health services are transitioned to a fee-for-service reimbursement system.

This funding is critical to ensuring that tens of thousands of New Jerseyans do not lose access to services that will leave them at risk of health complications requiring much more costly treatment in emergency departments and hospital inpatient units.

Keeping providers fiscally viable so they can maintain patient access to care, as well as continuity and quality of care, will not only save thousands of lives, but will also save the state millions of dollars.

Lives are at stake. The state needs to make the wise investment of safety net funding now to prevent the exorbitant financial costs and the unconscionable costs to lives that will occur without it. We urge all New Jerseyans to support this critical funding.

Click here to read this entire article.

Monday, June 12, 2017


NJAMHAA’s Advocacy Builds Potential for New Legislation and Funding Increases

This year, NJAMHAA has surpassed its own record in being nonstop active and effective in advocacy. Most recently and notably, our communication with state legislators and policymakers has led to the introduction of a fee-for-service (FFS) oversight bill and legislation for safety-net funding. In addition, we provided substantial input on legislation to expand screening centers and Early Intervention Support Services, which was recently passed by the Senate Health, Human Services and Senior Citizens Committee. We also submitted budget resolutions for FFS safety net funding, a 5% Cost of Living Adjustment on remaining contracts, and increased rates for Care Management Organizations for the FY 2018 State Budget, all of which are circulating in both the Assembly and Senate.

Our partnership with members is a key factor in the impact we are having. We rely on our members’ experiences and insights on the impact of regulations, legislation and reimbursement changes, as well as clients’ success stories, to maximize our effectiveness.

Success stories are particularly effective in local advocacy and I urge all of our members to share these compelling examples of their services’ value with their local legislators. Illustrations of how funding restrictions and regulatory changes can harm individuals and families are equally poignant.

Everyone can have an impact.

All of our member providers do have impact through the vital services they provide every day. An inspiring example of all NJAMHAA providers’ personal dedication is Lou Schwarcz, former President and CEO of the Mental Health Association of Morris County. Lou has made the admirable decision to step down from his position and achieve a merger with the Mental Health Association of Essex County to ensure that clients do not lose services and that most of the MHAMC staff remains employed. I look forward to honoring Lou with the Unparalleled Leadership in Serving New Jersey’s Mental Health Community Award during our upcoming Membership Meeting.