NJAMHAA Members Help Address Public Health Crises; Many More Resources Needed

The New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA) is proud of its member providers who offer treatment and support services to help individuals with substance use and/or mental health disorders achieve recovery. While these services have always been and will continue to be invaluable, the importance of having access to them when needed is underscored by the Center for Disease Control and Prevention’s (CDC’s) recent report about the overall life expectancy nationwide declining by nearly four months since 2014. This decline is largely attributed to significant increases in overdose deaths from opioids and fentanyl (a synthetic opioid) and suicides.

The rate of drug-overdose deaths escalated between 2015 and 2017, and the increase was most significant among adults aged 25 to 54 years, according to the CDC. Most of these deaths were associated with use of fentanyl and other synthetic opioids. In 2017 alone, deaths from synthetic opioids increased by 45%, killing more than 70,000 Americans– the highest number in a single year to date.

Also in 2017, the national suicide rate increased by 3.7%, the CDC reported. Most of the suicides and drug-related deaths are of young to middle-aged adults. However, all age groups are at risk and tragically, resources are not sufficient for any population.

These staggering numbers underscore the critical need for expanded access to treatment for both substance use and mental health disorders. In fact, the majority of individuals with addictions also have mental illnesses. Our state and nation cannot afford to focus on just one type of illness. Care must be integrated to address not only addictions and mental health disorders, but also physical illnesses, which are also highly prevalent and frequently not treated among individuals with substance use and mental health disorders, leading to mortality decades earlier than the general population.

NJAMHAA will continue to serve as a spokesperson for the behavioral health industry, advocating on the state and federal levels for greatly expanded resources that are needed to address these public health crises.

Everyone Should Focus On and Contribute to Suicide Prevention

Suicide is the 10^th leading cause of death in the U.S. On average, there are 123 suicides each day across the nation. This adds up to nearly 45,000 deaths each year. And for every suicide, 25 other individuals attempt to take their lives.

According to research published by the Centers for Disease Control and Prevention earlier this year, an increasing number of teenagers reported in 2017 feeling sad or hopeless, having suicidal thoughts and missing school due to fear of violence or bullying, compared to the number sharing such experiences in 2007. In addition, one in five students reported being bullied in school; and one in 10 females and one in 28 males reported being physically forced to have sex.

These statistics are alarming and they give us reason to pause. What strikes me the most is that behind each statistic is a very real human life, a person with a family, friends and colleagues. Whether famous like Kate Spade, Robin Williams or Anthony Bourdain or unknown, each life matters to us all.

Many underlying factors can lead to the development of mental illnesses and risk of suicide. The American Foundation for Suicide Prevention sums it up well: “It most often occurs when stressors exceed current coping abilities of someone suffering from a mental health condition.”

Some stressors are associated with extensive screen time – use of apps, video games and social media. Although they offer several benefits, they can also have negative impacts on the health of children and adolescents. Social media may lead to cyber bullying and, certainly, in-person bullying is a major concern for the emotional and social development of our youth.

All of us – parents, teachers, healthcare providers – whatever our roles may be – can and should do everything we can to maximize children and adolescents’ protective factors, minimize risk and ensure access to mental health and other services when they are needed.

NJAMHAA Providers Manage Challenges of Meeting Increasing Demand and Systemic Changes

While striving to meet the increasing demand for mental health care, substance use disorder (SUD) treatment and support services, such as housing, education and supported employment, NJAMHAA’s member providers are also focused on the changing environment and trying to make their business models work. These are two tremendous challenges, considering the staggering prevalence of mental illnesses and SUDs – which affect not only the individuals with these disorders, but also their loved ones, in their everyday lives – and the large-scale changes taking place in Medicaid and other aspects of the behavioral health system. This inspires me to continually advocate for an external environment in which providers are well reimbursed so there is unimpeded access to care whenever and wherever children and adults need it.

While we are busy advocating for sufficient funds to overcome barriers and create an environment that ensures access, we also provide technical assistance, training and information to help members transition through systemic changes. For example, last year, many programs’ reimbursement was changed from contracts to fee-for-service and while members continue to adjust to the inherent challenges, they need to prepare for the upcoming transition to value-based purchasing of services.

At the same time that we help prepare providers for these changes that affect fiscal and other aspects of business operations, we focus on making sure that they are delivering the highest level of care through evidence based practices. We give them tools to help people most effectively. For example, Alberta Montano-DiFabio, ScD, LCADC, CCS, CCJS, a long-time expert in providing trauma-informed SUD treatment and President of Crowning Achievements LLC in South Jersey, recently delivered a deeply informative and engaging presentation on trauma-informed care to our Adult Mental Health Practice Group.

There is no shortage of trauma, which is a major factor in the development of mental illnesses and SUDs. Dr. Montano-DiFabio underscored how important it is for providers to really understand each person they are serving, focus on each client’s strengths and develop truly individualized treatment plans. She also identified these principles for providing trauma-informed care: physical and psychological safety for staff and clients; trustworthiness and transparency; peer support and mutual self-help; collaboration; empowerment of clients’ voices and abilities; and recognition of cultural and gender issues.

Trauma-informed care is one example of the high-quality services that NJAMHAA providers deliver. We help them receive training on the most advanced clinical models and advocate for sufficient funding and other external environmental factors to ensure they can provide the most effective services and enable all children and adults to achieve life-enhancing health outcomes.

NJAMHAA Partners with Health Maintenance Organizations and many Others to Support Member Providers

In 2011, NJAMHAA created the Health Maintenance Organization (HMO) Council to ensure a robust network of providers and continuity of medically necessary care for beneficiaries with chronic conditions. Throughout this time, the HMO Council has been a dynamic group consisting of HMOs, NJAMHAA member providers and representatives from the Division of Medical Assistance and Health Services and the Division of Mental Health and Addiction Services. We engage in productive discussions about timely issues that involve HMOs and affect providers and access to their services.

The current hot topic that the HMO Council, as well as other groups that NJAMHAA facilitates, is focusing on is the upcoming changes to HMOs’ coverage of behavioral health services: Beginning July 1, 2018, HMOs will cover acute, hospital-based mental health services for all Medicaid beneficiaries and substance use services for individuals who are receiving Managed Long Term Services and Supports, people with intellectual/developmental disabilities and individuals who are covered by the Full Integrated Dually Eligible Special Needs Plan.

The inevitable change from fee-for-service reimbursement to value-based payments that is coming is another important topic that the HMO Council has been discussing and will continue to address. Presentations during meetings, as well as dedicated training outside of these meetings, are helping providers prepare for this major change, and more training will be developed as needed.

There is certainly a learning curve involved with any change and NJAMHAA understands it can be overwhelming, especially with multiple major changes being planned and implemented simultaneously. NJAMHAA aims to help minimize the stress associated with these changes by arranging for experts to provide valuable information and guidance. Stay tuned for learning opportunities through our website (www.njamhaa.org/events) and social media.

We have open lines of communication with many individuals at HMOs, the state and many other organizations. People with expertise in various areas that are important to our members work with us to provide what is needed to help ensure our members’ success.

NJAMHAA is your partner and through our collaboration with the HMOs, the state and experts in the field, you can develop an extremely strong network! Stay informed about all that NJAMHAA offers and share opportunities with your coworkers!

Can You Afford to Pay $7.35 Million for a Data Breach?

Yes, you! Can you afford the risks of a data breach? The average cost is $7.35 million.

All businesses of all sizes are at risk.

Hacker attacks occur every 39 seconds.

One in five businesses experienced downtime for at least 25 hours due to ransomware. Can you and your staff – and the individuals you serve – afford this loss in time?

Cybersecurity Training Is Essential for All Staff

To minimize this risk, all staff – not just employees who focus mainly on information technology (IT) – need to be trained. NJAMHAA’s IT Project offers solutions: Training at its upcoming Annual Conference, Invasion of the Data Snatchers, on May 8, 2018 at the Pines Manor in Edison, NJ.

Cybersecurity specific presentations include Demystifying Hacking; Cyber-Threat Management: Awareness, Prevention, Recovery and Coverage; Network Security beyond the Firewall; and 2018 Cybersecurity Best Practices & Managing HIPAA Compliance on a Budget.

This conference also offers valuable information for executive, human resources, fiscal and other staff! Presentations will include a keynote on The Moneyball CIO – Learning the Science of IT Decision Making and workshops on Employment Law Overview, Taking the Anxiety Out of Interoperability, EHR Lessons Learned in a Fee-for-Service Environment, Implementing Employee Incentive Programs to Help Drive Higher Engagement, Leveraging Technology to Capture Outcomes and Demonstrate Value: Practical Approaches to Moving to Value-Based Care and Engaging Clients through your Website.

Maximize the security and effectiveness of your business! Visit http://njamhaa.org/events#IT today for more details and to register for this essential training!

NJAMHAA Is Proud to Honor Those who Contribute to New Jerseyans' Quality of Life

I am very inspired and my heart is warmed by the many ways in which frontline providers and agency leaders throughout the New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA) empower individuals to recover from mental illnesses and substance use disorders, manage developmental disabilities and, as a result, achieve their potential in many ways. They demonstrate leadership, compassion, talent and dedication that contribute tremendously to quality of life for children and adults throughout our state.

I am equally delighted to recognize individuals in the State Legislature, media and other organizations for their initiatives to address issues that impact providers’ abilities to deliver care and individuals’ access to services.

With much excitement, I look forward to our annual Courage & Compassion Awards Reception, which will be held on April 10, 2018 at the end of the first day of our Annual Conference, Creating Balance through Integrated Care. I am honored to share with you that this year’s award recipients are:

▪        Tamra Ackerman, LSW, Community Case Manager, Jewish Family Service & Children’s Center of Clifton/Passaic: Outstanding Direct Care Provider in Case Management

▪        Patricia H. Delgado, RN, BSN, Nursing Services Coordinator, SERV Behavioral Health System: Outstanding Direct Care Provider in Nursing
▪        Kimberly Govak, Program Coordinator, Living Proof Recovery Center, Center for Family Services: Outstanding Peer Leadership
▪        Linda Mur, PhD, Associate Vice President, Adult Behavioral Health and Substance Use Disorder Services, Center for Family Services: Outstanding Leadership in Substance Use Disorder Services
▪        Carolyn A. Perry, MA, LPC, ACS, Mental Health Services Director, Community Hope: Outstanding Leadership in Mental Health Services
▪        Carrier Clinic: Outstanding Provider
▪        U.S. Senator Cory Booker: Federal Leadership in Criminal Justice Reform
▪        New Jersey Senator Ronald Rice (D-28^th District), State Senator of the Year
▪        New Jersey State Assemblyman Daniel R. Benson (D-14^th District): State Assembly Member of the Year
▪        Katie Jennings, Reporter, Politico: Media and Government: Focus on Addictions
▪        Kevin and Maryann Meara, Founders, City of Angels: Inspirational Role Models
▪        Ray Castro, Director of Health Policy, New Jersey Policy Perspective: Excellence in Policy Research
▪        Valerie Mielke, MSW, State Leadership in Mental Health and Addiction Services
▪        Jeremy Timberman, IT Production Specialist, NJAMHAA, Employee of the Year

Every individual not only at these organizations, but also all NJAMHAA member organizations and throughout the behavioral health stakeholder community, is truly a hero!

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.