Murphy’s Budget Plan Gives Massive Boost to Community-Based Services

Lilo H. Stainton | March 8, 2019 | Health Care
Advocates praise governor’s proposal to increase ‘long overdue’ funding to improve services for people with disabilities

Credit: Josh Appel/Unsplash
Disabled
Additional funds for a number of community-based healthcare initiatives that have long been priorities for advocates and lawmakers are included in Gov. Phil Murphy’s $38.4 billion state budget plan for fiscal year 2020.

Murphy’s proposed spending plan for FY2020, which begins in July, allots $800 million to programs and services that benefit individuals with developmental disabilities, state officials said, including many who receive healthcare benefits through Medicaid.

That funding includes a $22.5 million increase for programs designed to improve care for individuals with developmental disabilities and also mental health needs, something advocates said is desperately needed. These include efforts to improve emergency care and inpatient treatment, better coordinate healthcare services, and expand programs designed to keep these residents out of institutional facilities.

In addition, the governor included $20 million to boost pay for direct-service providers, or those who care for individuals with disabilities daily, a priority for Senate President Stephen Sweeney (D-Gloucester), whose colleagues must approve the plan for it to become law. Sweeney has managed to get this funding included in the last two state budgets as part of an effort to boost wages for this low-paid workforce, which is subject to significant turnover.

“Our budget will provide critical resources to allow individuals with both developmental disabilities and mental health challenges to thrive in their communities,” Murphy said in his budget speech Tuesday.

Improving life for vulnerable groups

While the public conversation about Murphy’s FY2020 budget has largely focused on the spending reductions used to help balance it — including $1.1 billion trimmed through changes to public-worker benefits and departmental reductions — some state officials and advocacy organizations were full of praise for certain changes on the spending side of the ledger.

On Thursday, Department of Human Services Commissioner Carole Johnson highlighted the administration’s effort to improve life for those with developmental disabilities and mental health issues, a population that is particularly vulnerable and depends on well-coordinated care. “New innovations are crucial and with this initiative we’re increasing our capacity to care for these individuals and give them the services they need,” she said.

Specifically, the new dollars in the budget proposal include $9.5 million — $7 million in state funds and $2.5 million in federal dollars — for three items: doubling the number of emergency beds with providers that are capable of treating individuals with developmental disabilities who are also facing a mental health crisis; launching a pilot program designed to better coordinate ongoing care for these residents; and conducting a statewide review of how medically complex patients like this are stabilized once they are in the hospital.

“These services are long overdue,” said Thomas Baffuto, executive director of the Arc of New Jersey, which advocates for and serves individuals with disabilities and their families, praising Murphy’s investment in these programs. Individuals with developmental disabilities and mental health concerns require “specialized services and attention, and this new funding will help provide the critical supports in response to the unique challenge facing individuals with dual diagnoses and their families,” he said. “We need this desperately.”

Other new funding in Murphy’s proposal includes $15.5 million for home and community-based services for individuals with developmental disabilities. “This is a public health issue that deserves more attention and additional support,” said Senate health committee chairman Joe Vitale (D-Middlesex), who praised the investments as did Assemblywoman Joann Downey (D-Middlesex), who chairs the human services committee.

Medicaid technology

In addition, Murphy’s proposal includes $4.4 million in state dollars for the Medicaid program to insure some 1.7 million low-income residents. And it includes
nearly $11 million to replace the software used to process claims for the Family Care system, as Medicaid is known in New Jersey. While the DHS has expanded public access to program data and made various enrollment changes, policy experts believe more can be done to improve the enrollment and tracking systems — much of which is dependent on improving technology.

The FY2020 budget also calls for $1 million of Medicaid funding to be allocated to building on the success of a doula program the state Department of Health launched last year, as part of $4.7 million in the current budget that has been dedicated toward improving maternity care. According to the DOH, some 40 doulas — or non-clinical birth coaches and maternal advocates — have been trained already, 63 women are participating in the program, and 19 babies have been born to mothers assessed by a doula.

“Community Health Workers and Doulas provide support and connections to resources that can greatly improve a women’s health and likelihood she will have an optimal birth,” said state Health Commissioner Dr. Shereef Elnahal, who has made a priority of improving New Jersey’s relatively poor maternal health outcomes, especially among black women, who are nearly four times as likely to die in childbirth as white mothers in the Garden State.