Proposal Seeks to Expand Access to ‘Dual Diagnoses’ Treatment Beds

It’s not uncommon for people with substance-abuse problems to also suffer from behavioral-health issues; unfortunately, facilities that can treat both are rare

sad woman mental health
A growing awareness of addiction and mental illness as diseases often found in the same person, coupled with new efforts to ensure treatments are covered by insurance has in recent years led to a flood of people nationwide seeking treatment for behavioral health issues. But in New Jersey and elsewhere, these patients often struggle to find room in a quality program, especially one that involves inpatient care.

To help address this shortage a handful of Democratic lawmakers have introduced a bill that would streamline the state’s approval process for certain treatment facilities in an effort jump-start the creation of new inpatient options for those with both mental health and drug use issues, or “dual diagnoses” patients. According to the bill, there’s been no effort to expand facilities dedicated to these individuals in over a decade.

One-third to half of those dealing with drug or alcohol addiction also suffer from mental health issues, and vice versa; the co-occurrence of these diseases is even more common among former military members, those with lower-incomes, and individuals who have other physical maladies, according to the National Alliance on Mental Illness.

Introduced in December by Sen. Joseph Vitale (D-Middlesex), Assemblywomen Valerie Vainieri Huttle (D-Bergen) and Elizabeth Maher Muoio (D-Mercer), and Assemblyman Tim Eustace, (D-Passaic), the measure ([link:|
S-2844) is up for its first vote Monday in the Senate health committee, which Vitale chairs.

Vitale has led a number of efforts to help tackle New Jersey’s opiate epidemic and reduce other impacts of drug use, like the spread of HIV/AIDS and hepatitis, and has pledged to continue this push in the coming year. The issue has also been a priority for Gov. Chris Christie, and observers expect it will again feature prominently in his annual State of the State Address, scheduled for Tuesday.

However, the senator has said he still fields calls from families around the state who are desperate to find a treatment bed for someone they love. “The current opioid crisis highlights the need to expand treatment capacity in New Jersey,” the bill states.

But much work remains. A report released last year by the U.S. Surgeon General found one in seven Americans are impacted by drug addiction, but only 10 percent of these individuals get the help they need. In 2015, some 28,000 people sought treatment for substance-abuse issues in New Jersey, but more than 1,200 were lost to overdoses, according to federal data. Mental health issues are even more common, and quality treatment is also hard to find, experts agree.

As proposed, the new bill would change the law that governs the certificate of need, or CN, process to reduce the regulatory burdens surrounding “dual diagnoses” treatment facilities. Under current law, the Department of Health must approve a CN application for the creation or sale of a hospital, nursing home, or similar facility. The process, which can take years, has been criticized in the past for its pace and efficacy as a policy tool.

To prompt the development of new treatment beds, the bill would add “inpatient special psychiatric beds for patients with psychiatric/substance use disorder dual diagnoses” to the list of facilities that are already exempt from the CN process. This includes ambulatory-care facilities, community primary-care clinics, outpatient-addiction and mental-health services, and detox units that are part of an existing hospital.

“It is common for psychiatric diagnoses and substance-use disorders to co-occur in the same individual, but New Jersey lacks sufficient capacity to provide necessary treatment for these individuals,” the bill notes.

“Current law permits the development of substance-use disorder treatment beds without a certificate of need, but requires prior permission from the DOH to develop psychiatric or dual-diagnosis beds. There has been no call for applications for such a certificate of need in over a decade,” it states.

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