Resolution Cites Lack of Planning, Details & Consultation with Stakeholders; Now Awaits Senate Consideration
By a vote of 42-25, the General Assembly on Monday approved a measure sponsored by Assembly Democrats Valerie Vainieri Huttle, Tim Eustace, Cleopatra Tucker, Angela McKnight and Daniel Benson to block Gov. Christie’s plan to transfer the functions of the state’s mental health and addiction services from the Department of Human Services to the Department of Health.
Last week, the Assembly Human Services Committee, chaired by Vainieri Huttle, held a joint hearing on the plan with the Senate Health, Human Services and Senior Citizens Committee at which time representatives from over 20 organizations and stakeholders expressed concerns regarding the content, potential effects, and timing of the planned reorganization.
“I wholeheartedly agree that mental health and substance abuse diagnoses are indeed health issues and that primary physical healthcare must be integrated with mental healthcare and addiction treatment,” said Vainieri Huttle (D-Bergen). “However, the hasty, unilateral approach the administration has employed in going about this leaves little confidence that this is being undertaken in the right manner. Mental health and addiction experts who testified at the joint legislative hearing we held last week adamantly agree that this is not a viable way to make this happen.”
To that end, the resolution (ACR-254) opposes Gov. Christie’s Reorganization Plan No. 001-2017, issued on June 29, 2017, which would transfer the Division of Mental Health and Addiction Services (DMHAS), and all of the state’s mental health and addiction prevention and treatment functions, powers, and duties from the Department of Human Services (DHS) to the Department of Health (DOH).
The resolution also notes that the reorganization plan lacks a detailed integration strategy or policy change corresponding to the stated purpose of healthcare integration, which undermines the progress made to date in behavioral and physical healthcare integration and could significantly disrupt the delivery of critical behavioral health and addiction services to individuals in need.
“Following extensive testimony on the reorganization plan, great uncertainty remains as to the actual implementation of the plan, whether consumer-level integration will be achieved by it and the effects the proposed reorganization will have on some of our most vulnerable individuals who receive these services, as well as the provider agencies and employees,” said Eustace (D-Bergen/Passaic).
Another primary concern is the fact that approximately 50 to 70 percent of individuals with developmental disabilities, including autism, have co-occurring behavioral health disorders, yet the reorganization plan does not address the maintenance of coordinated care for individuals with developmental disabilities and would force these individuals to have to deal with two different departments to procure these services.
“This transfer could profoundly and immediately affect vulnerable individuals living with mental health and substance abuse disorders and their families,” said Tucker (D-Essex). “Yet these individuals, the service providers, and the legislature did not have any opportunity to evaluate and consider the proposed transfer prior to the governor filing the reorganization plan.”
The resolution also notes that many individuals receiving services for mental health and addiction do so through the state’s Medicaid program, which is administered by DHS. A significant consequence of the proposed reorganization is that service providers would have to coordinate the administration of services with one department, DOH, and coordinate the payment of services with another department, DHS.
“Separating behavioral health services from the department that administers Medicaid, the source of funds for many of those services, could be detrimental to individuals receiving those services, and introduces another level of bureaucracy that must be navigated, potentially leading to service and payment disruptions,” said McKnight (D-Hudson).
Additionally, DHS provides necessary support and services to individuals with mental health and addiction disorders, social services such as the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, Work First New Jersey assistance, and supportive housing and employment assistance. Maintaining and improving integration of these services with healthcare is critical to successful treatment and recovery.
“The timing of this proposed transfer is also of concern given that mental health and addiction services providers are in the midst of transitioning to a fee-for-service payment system, which has proven challenging,” said Benson (D-Mercer/Middlesex). “If this proposed reorganization causes additional chaos for the provider community it could harm patients even more by forcing the closure of agencies or reducing access to affordable services.”
Furthermore, DOH is inexperienced in the direct operation of specialized psychiatric hospitals, which is a concern given the state’s recent resolution of the Olmstead settlement agreement for mental healthcare and the progress made toward de-institutionalization.
Lastly, the resolution notes that DHS has comparatively more experience and expertise in administering the provision of services to large populations, while DOH has significant regulatory expertise and comparatively less experience concerning the provision of services, which is of particular concern given the opioid addiction crisis that is occurring in New Jersey and around the country.
“In order to safeguard the health and best interests of everyone in this state, any transfer of mental health and addiction prevention and treatment must be undertaken carefully, deliberately, and after appropriate consultation and review, all of which are lacking from the Governor’s proposed plan,” added Vainieri Huttle.
The resolution notes that for all of the aforementioned reasons, the Legislature therefore disapproves of the reorganization plan.
Should the resolution pass both houses, the reorganization plan will not take effect. The measure now awaits consideration by the Senate before it would go into effect.