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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 21^st 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.

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.
 

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)