New Jersey is on track to significantly expand inpatient treatment capacity for some addicts, cementing one of the most ambitious goals Gov. Chris Christie outlined this year just two months before he is scheduled to leave office.
More than two-dozen hospitals and other healthcare providers have been granted permission to add a total of 81 beds to treat individuals with dual-diagnoses of mental illness and substance-use disorder, the governor’s office announced Friday.
The new beds, the most significant expansion in two decades, according to officials, must be ready for use within two years, according to the plans Christie outlined in late January, when he called for 900 new beds. The state Department of Health will issue another call for at least 53 more in the near future, they said.
Making good use of leftovers
Christie, a Republican who will be replaced in mid-January by Democratic Gov.-elect Phil Murphy, has prioritized anti-addiction efforts in the past year or so, including investing more than $200 million this year in new and expanded programs, to be funded by “lapsed” or leftover budget lines. The governor also led a White House panel that outlined dozens of ways the nation can reduce the flow of illegal drugs, improve recovery chances, and support long-term sobriety.
One common theme, on the state and national level, is the need for more treatment options — especially for those covered by Medicaid. The White House panel and others have called for the federal government to change the Medicaid rules to permit greater flexibility for inpatient-treatment coverage, something the Trump administration agreed to explore earlier this fall. More than 40,000 Medicaid members in New Jersey were receiving substance-abuse treatment in September.
In New Jersey, Christie made clear he wanted hospitals and other private providers to “do their part” too. He signed a law in February that significantly expanded insurance coverage for drug treatment and has worked to encourage more options for care and sober recovery. But the need for more beds has persisted, as tens of thousands of individuals are turned away from treatment each year.
Officials with the New Jersey Hospital Association have seen traffic increase significantly in the state’s emergency rooms, with more than half of the new patients having a mental health problem or drug addiction.
New Jersey licenses more than 2,300 psychiatric beds in hospitals and other acute-care facilities and another 3,000 community-based organizations that provide addiction care. The state also operates four public psychiatric hospitals, which now hold nearly 1,600 individuals with some of the most significant mental illnesses. Experts said at least half of those with drug addictions also experience mental health issues, or are considered “dual diagnoses.”
While the effort to expand bed space has suddenly picked up speed, lawmakers have tried for years to expand treatment capacity. Assemblyman Gary Schaer (D-Bergen), the budget chairman, has urged health officials to encourage hospitals to build more bed space, and Sen. Joseph Vitale (D-Middlesex), the longtime health chairman, has worked with colleagues to reduce the regulatory barriers to growth.
But it took the governor’s order earlier this year to trigger action, which is slated to increase capacity by 40 percent when the work is done and provide the first dedicated psychiatric beds in rural Salem County. Officials said it is based on national guidelines that call for 40 beds per 100,000 residents.
A total of 26 facilities were awarded the right to expand; this includes 19 now licensed as general acute-care hospitals, three existing, private psychiatric hospitals, and four operations that would involve building a new psychiatric hospital.
“There is an immediate need for inpatient care so people can get the treatment they need to get better and return to their communities,” Christie said. “We welcome these providers as partners in expanding much-needed mental health services.”
The process does not involve direct state funding, but requires the health department to request proposals from hospitals and other providers; those facilities will fund the work on their own, to be offset by insurance payments for the patients they treat.
The seven psychiatric hospitals will be required to set aside at least 5 percent of their beds for Medicaid or uninsured patients after the first year. (Acute care hospitals already must treat any patient, regardless of ability to pay.)
The new psychiatric facilities include:
The 22 applicants with existing facilities include: