Governor Lays Out Plan for Combating Drug Addiction and Reducing Overdoses

Andrew Kitchenman | January 13, 2016 | Health Care
Proposals include $100M increase for treatment reimbursement, turning former prison into facility to help addicted inmates

Mid-State Correctional Facility in Fort Dix is dedicated to addiction treatment.
Fewer New Jerseyans would die from drug overdoses if more treatment providers were available.

In Tuesday’s State of the State address, Gov. Chris Christie called for increased spending of $100 million to reimburse providers of mental health and addiction treatment, which mental-health advocates said will go a long way toward addressing the problem.

“This is a top priority for me this year, as well as for the remainder of my administration,” Christie said of his focus on addiction treatment.

But it remains to be seen whether the spending proposal will survive the annual budget process – and whether it will become part of a comprehensive approach toward addressing the growing need for both inpatient and outpatient addiction treatment.

The $100 million expenditure is part of a multipronged strategy laid out by the governor, who also called for reopening the Mid-State Correctional Facility at Fort Dix as an addiction treatment facility for inmates.

Christie also called for expanding the “recovery coach” program in which recovering addicts help overdose victims who arrive in hospital emergency rooms.

The “recovery coaches” try to get the overdose victims into treatment programs as soon as they leave the ERs – a key period during which many relapse if they don’t receive follow-up treatment.

Christie also announced plans to expand funding for Medicaid Accountable Care Organizations, programs that strive to provide both medical and mental-health services to the patients who need them most.

The $100 million budget increase for Medicaid mental-health and addiction treatment would include both state and federal funding.

While Christie described it as a “doubling down” on the state’s commitment to treatment, the amount would be relatively small compared to total spending in the Department of Human Services, which includes Medicaid as well as other social service programs for people with disabilities or low incomes. Total DHS spending reached $18.7 billion in state and federal spending in this year’s budget.

But when only mental-health and addiction services are considered, the increase would be substantial.

Debra L. Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies, called the increase unprecedented and said it would save lives.

“It’s a rare day when the governor’s top priority and the priority of providers of services to a vulnerable population align,” Wentz said. “And that is what happened today.”

Reimbursement rates for addiction services have stagnated at roughly $68 per day for residential treatment. Wentz said she’s been reassured by sources within the governor’s office and the Department of Human Services that rates will increase 30 percent to 50 percent in at least some cases.

“This means that some people can get service sooner,” explaining that patients wait for treatment because providers can’t pay enough to attract and retain staff, Wentz said.

Several factors have increased demand for mental-health and addiction treatment in recent years, including a soaring number of opioid-addiction cases and an increase in Medicaid eligibility.

“You can have all kinds of initiatives but until you fund and really invest, it’s hard to deliver,” Wentz said.

He’ll have at least one Democratic legislative ally when it comes to the treatment proposals, with Assemblyman Herb J. Conaway (D-Burlington) embracing the approach after the address.

“Increasing reimbursements will increase access,” Conaway said, noting that when the state increased Medicaid reimbursements for pediatricians, more children received medical care.

Sen. Joseph F. Vitale also applauded the additional funding, adding that he aims to build on it in the coming months.

“Even in the budget the size of Human Services, $100 million is significant and it will help, for sure,” Vitale said.

But Vitale said the state must go further in helping people with addictions. He noted that many of the changes in recent years have been focused on inmates and those arrested for drug crimes.

For New Jerseyans in need of addiction treatment, it is “best if you are arrested and go through the criminal justice system, and that’s not the way it should be,” Vitale said, adding that he wants to expand access to inpatient treatment as part of a comprehensive plan this year.

One potential roadblock to appropriating money for addiction treatment is the ongoing fight over pension funding, which Christie identified as an obstacle to spending in a variety of areas, including healthcare.

Wentz said she hopes the increased spending for addiction will have bipartisan support, adding that she’s prepared to lobby every legislator over the issue.

Former Gov. James E. McGreevey called Christie’s emphasis on treatment “tremendous,” praising both the prison-conversion plan and the proposed expansion of the “recovery coach” program, which began in Ocean County, to six more yet-to-be-identified counties.

“I mean, we’re in the midst of a full-fledged crisis, this crisis is neither Republican nor Democratic, and the governor recognizes this, and has put the full weight, measure of his office, behind these initiatives,” said McGreevey, who runs Jersey City’s prisoner re-entry program.

Christie cited research by the Rutgers Center for State Health Policy, which found that of the 1 percent of Medicaid patients who require the most costly treatment, 86 percent have mental health issues, addictions, or both. He said giving more state funding to Medicaid ACOs could improve the coordination between medical and behavioral healthcare.

“Through a modest increase in funding, we can reduce unnecessary stays in hospital and avoid crowding up the ER,” Christie said.

Dr. Jeffrey Brenner, executive director of the Camden Coalition of Healthcare Providers, said Christie’s move to add state funding for Medicaid ACOs would put these organizations “on a stable trajectory.”

“It gives us an opportunity to figure out how medical care works together with behavioral health and housing,” for the most vulnerable, complex, and expensive patients, said Brenner, whose organization is one of three Medicaid ACOs in the state.

While the Camden organization has a stable budget, Brenner said additional state funding “is a really clear signal for those who’ve been funding us for years that the state” sees the value of the coalition’s work.

Brenner said the additional state money would be a “game changer” for the Medicaid ACOs in Trenton and Newark, which have faced significant budget challenges.