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Murphy Urged to Undo One Christie Health Reform, Aggressively Monitor Others

Human services experts propose reforms including tax credit for low-income parents and better pay for front-line workers

New Jersey Human Services Commissioner Jennifer Velez.
Credit: NJTV
Jennifer Velez, senior vice present for community and behavioral health at RWJ/Barnabas

The new team in Trenton should aggressively monitor some human services program reforms initiated under the former Christie administration while reversing parts of others, a panel of experts has recommended. It has also advised the new administration to create a tax credit to help low-income parents and to invest at least $62 million to boost pay for front-line workers and improve access to childcare.

The recommendations are in the transition report on human services and child welfare, released late last month. The report also urges Gov. Phil Murphy to review WorkFirst NJ, the state’s welfare-to-work program, to ensure it is actually preparing participants for a productive future. It also calls for an assessment of the program’s accountability and transparency, and an analysis of the technology involved.

In addition, the 15-page document underscores the need to review the various programs targeted to assist individuals with disabilities, to improve efficiency and reduce redundancy, and an administration-wide assessment of materials to make sure they are culturally appropriate and available in multiple languages.

The transition report, one of a baker’s dozen drafted by unpaid policy advisers tapped to create a blueprint for the new Democratic administration, also urged Murphy to roll back elements of an administrative reorganization that Gov. Chris Christie launched just months before he left office. The former governor called for all mental health and substance use disorder services to be shifted from the DHS to the Department of Health, which licenses medical facilities and handles public health, in an effort to better integrate behavioral and physical care.

Undo major Christie initiative?

While the experts emphasized their support for the goals outlined in Christie’s reorganization, they noted the concerns raised by providers and other stakeholders during a hearing on the shift and urged Murphy to take executive action to transfer the agency, originally known as the Division of Mental Health and Addiction Services — or most of its functions — back to the DHS within the first 100 days of taking office. One of the agency’s functions, to license behavioral health providers, should remain within the DOH, the report noted. While some of the workers who moved their offices last fall could stay where they are, shifting the tasks back to Human Services would cost $100,000, the report estimated.

The transition report also cautioned the Murphy administration to carefully monitor another controversial Christie reform, the ongoing shift in how the state pays agencies that serve disabled individuals or provide mental health and substance abuse treatments. Christie signed a law to increase oversight of this shift from contract-based payments to a so-called fee-for-service model but did not appoint members to the monitoring agency; Murphy was urged to name these individuals quickly.

In addition, the policy recommendations call for a fresh assessment of the computer systems used in the Department of Human Services and the Department of Children and Families, which together oversee most welfare services. An effort a decade ago to upgrade their information technology to improve the processing of Medicaid and food stamp applications fell apart, costing the state nearly $10 million, the report noted.

The DHS, with an $11 billion budget, employs 14,000 people and oversees Medicaid, known as FamilyCare here, WorkFirst NJ, the state’s welfare program, and diverse services for seniors and individuals with disabilities. Child services — once handled by the Human Services division — were moved to their own department, DCF, in 2006 as part of a massive reform effort and the agency remains under a federal monitor. The transition report urges the Murphy administration to embrace and go beyond the recommendations outlined by the latest federal assessment.

Significant spending

“A strong, effective child welfare system requires a robust commitment to the safety of children and a focus on the many ways government and community partners can strengthen New Jersey's families,” the report notes. The human services transition team included a diverse group with experience in mental health and addiction services, assistance for individuals with disabilities, children’s health and development, sexual assault and women’s services. The group was chaired by a half-dozen leading academics and policy experts, including Jennifer Velez, a former commissioner at the DHS and now a senior vice president for community and behavioral health at RWJ/Barnabas, and Kevin Ryan, who led the DCF and is now president and CEO of Covenant House International.

While many of the recommendations involve staff time only — at least at first — the report calls for significant investment in several areas. This includes promptly spending $20 million included in the current budget — but not allocated — to boost wages for direct support professionals, front-line workers who care for individuals with disabilities and who often make little more than $10 an hour.

In addition, to support Murphy’s efforts to help low-income families become more economically stable, the report calls for committing another $42 million annually to support child-care centers and for reviewing the capacity and condition of the current system. An existing federal and state partnership helps fund care for some 65,000 Garden State children each month, but these subsidies have not been increased in a decade.

No price tags

Other proposals don’t come with a price tag, like the recommendation to institute a state income tax credit for low-income families.

The Garden State is home to some 400,000 children under six in families where all parents work, and a typical family with two children will spend $21,000 a year on child care — a quarter of its pre-tax income. The report urges Murphy’s team to study the laws created in nearly two dozen other state to create such a credit and report back on the potential options and financial impact within six months.

“The creation of a child and dependent care tax credit to help families burdened by child care costs is essential to ensure the best possible outcomes for our children’s futures, as well as support one of the largest industries in the state,” the report said, noting that child care generates $1.8 billion in direct revenue and employs some 51,000 people.

“Access to affordable and high-quality child care is crucial to women’s abilities to secure and maintain employment,” the report notes.

Other recommendations include establishing a hotline to address human trafficking reports; working with existing organizations to expand sex-assault and victims’ assistance; and doing more to recognize family caregivers who frequently provide essential services without reimbursement or other support. The report also calls for creating a resource center to help the scores of nonprofit organizations that support welfare programs in New Jersey and it urges working with state colleges to create and subsidize internships with these provider groups.

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