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.

Tuesday, May 23, 2017


Blog

 

NJAMHAA Has Impact and Depends on Members for Insights

“NJAMHAA’s role and impact in the field of mental health has been tremendous and with the landscape becoming more complex, it can only be more important moving into the future,” said Anthony DiFabio, PsyD, Chief Executive Officer of Robins’ Nest and long-time NJAMHAA member.

Changes are always happening – that’s the increasingly complex landscape Dr. DiFabio refers to and it presents many challenges for providers of not only mental health care, but also substance use and developmental disabilities services.

Most notably and most concerning, nowadays, are the transition to fee-for-service (FFS) reimbursement for providers of mental health care and substance use treatment for children and adults. On the federal level, the possible repeal and inadequate replacement of the Affordable Care Act and proposed significant funding cuts to Medicaid.

To address these major issues and many others that affect our members’ abilities to provide services to everyone in need, NJAMHAA regularly meets and corresponds with State Legislators and key policymakers (e.g., Departments of Human Services and Children & Families) and our Congressional delegates. We demonstrate the value of our members’ life-saving and life-enhancing services and reinforce the critical need to ensure access to these services. We communicate this message even farther through traditional and social media. We undertake these initiatives as part of our constant pursuit of our mission:

To promote the value of its members as the highest quality behavioral healthcare providers for the residents of New Jersey through advocacy and professional development.

For professional development, we offer numerous training opportunities throughout the year.

Our advocacy has had a significant impact and we are the recognized leader in advocacy and achievement for New Jersey’s community mental health, substance use and developmental disabilities system. Highlights of our advocacy achievements include:

       Significant input into the FFS oversight legislation, its passage and signing into law
       Increase of several FFS reimbursement rates for mental health, substance use and Community Support Services (CSS), most notably the doubling of medication monitoring rates
       Option for transition dates for mental healthcare and CSS providers
       Substantial input that was used in the development of proposed legislation for safety net funding for mental health agencies transitioning to FFS on July 1, 2017, and expansion of screening centers and Early Intervention Support Services
       Preservation of funding for mental health and substance use services, including many children's behavioral health services, in the FY 2017 State Budget: All of the new funding proposed by the Governor was maintained.
       For the FY 2018 State Budget, Gov. Christie cited funding increases for mental health, addiction and developmental disabilities services, and we continue to advocate to help ensure State Legislators vote in favor of this funding.

On the federal level, our advocacy contributed to the passage of the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act, which includes a $1 billion, two-year appropriation (almost $12 million to New Jersey for two years) to fight the opioid crisis.

The effectiveness of our advocacy is a result, in large part, to our members’ active involvement. They share their perceptions of and experiences with changes in funding, regulations and laws, as well as their clients’ success stories. We incorporate this invaluable information int­­o our advocacy, our communication with traditional media representatives and on social media.

Please click here to learn more about how NJAMHAA membership can reinforce your organization and career, and how your involvement can help strengthen New Jersey’s mental health, substance use and developmental disabilities system.

Thursday, April 20, 2017


Protect your Data, Clients and Business: Attend Cybersecurity Conference April 27, 2017

No one is immune to cyberattacks, especially in health care, the most targeted industry sector for cybercriminals.

More than 90 million cyberattacks occurred in 2016 and this number could double this year.

This means steps must be taken now to protect your data, clients and business!

NJAMHAA’s Information Technology (IT) Project has secured expert presenters on cybersecurity and other related, equally critical topics for its annual conference, Be Connected, Stay Protected: Cybersecurity and the Internet of Things, which will be held on April 27, 2017 at the National Conference Center, Holiday Inn in East Windsor, NJ.

At least one representative from every healthcare provider organization should attend this conference to gain invaluable information and resources to protect their data, clients and business. Ideally, at least two individuals from each agency should participate: an IT staff person and a CEO/Executive Director, as these learning opportunities are critical for both IT and non-IT staff.
 
Program highlights include:

       Keynote presentation, Mobile Apps for Mental Health: Privacy and Security Issues: Learn from leaders from the Center for Behavioral Intervention Technologies at Northwestern University, Feinberg School of Medicine about how digital mental health tools have the potential to transform the way behavioral health treatment is provided.

       You’ve Been Hacked – Now What?:  The CEO’s of GreyCastle Security and Foothold Technology will carve out the pathway for you to follow, in the event you have been exposed to such a crime.

       Business Continuity Planning and Implementation: More Important Now than Ever!: Hear about actual case studies and learn what you should be doing to keep yourself in business during a catastrophic time.

       Building a Trust Based Internet of Things [IoT] for Business Critical Applications: Gain an overview of the eight steps to connect and protect IoT devices in today’s networks.

       Compliance through Penetration Testing:. Do you do this? You should be! The Health Insurance Portability and Accountability Act (HIPAA) requires annual risk assessments of providers’ network infrastructures. Learn how to get started with a cybersecurity compliance program.

         2017 Cybersecurity Landscape and HIPAA Compliance:  Learn about the current cyber threats that you need to protect your organization from, as well as the IT solutions and best practices to manage risk AND remain compliant without breaking the bank.

There’s much more! Visit http://www.njamhaa.org/events#IT to read all program details and register online

Monday, April 3, 2017


National Healthcare Law: A Sigh of Relief, yet Need for Ongoing and Strong Advocacy

While we have a lot to celebrate and there was a deep sigh of relief for the time being when the American Health Care Act vote was canceled, we would be ill advised to assume that everything is fine and business will continue as usual. We know there are battles on different fronts on the near horizon.

There is much political motivation to weaken the provisions of the Affordable Care Act that will negatively impact providers of mental healthcare and substance use treatment services and will be irreparably harmful to those they serve. We must continue to advocate strongly for parity to be reinforced and for the Essential Health Benefits to be maintained.

We must not get complacent or feel the problem has been kicked down the road and we can focus only on immediate matters. While the vote on the national healthcare law has been held off, there is a lot of repositioning going on behind the scenes. We need to do everything possible to direct the legislative and regulatory changes to be positive for providers and the individuals they serve.

This is a lot like a boxing match: We are back in our corners for now. The fight has not been won yet.

We must persevere with strong, consistent advocacy.

Let’s get right back in the ring! Write and call your Congressional representatives to solidify their support for a healthcare law that will ensure coverage and access to services for everyone in need, for all health conditions. Click here to access NJAMHAA’s Legislative Handbook, which provides all the contact information you need.

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; ReachNJ.gov), 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.