Op-Ed: Congress Must Save Program that Eases Access to Integrated Care

Joe Masciandaro | April 12, 2019 | Opinion
Funding for a key program that aids access to community-based behavioral health and addiction services is set to end soon, unless Congress acts

Joe Masciandaro
Our communities are facing a significant crisis in terms of access to comprehensive and integrated care. While statewide and national attention has focused largely on the opioid epidemic and overdose rates, it fails to address the prevalence of individuals with co-occurring disorders, or the combination of substance use disorders and serious mental illnesses.

In 2017, Congress created the Certified Community Behavioral Health Clinics (CCBHC) program to improve access to community-based behavioral health and addiction services, regardless of an individual’s ability to pay. New Jersey and seven other states participated in the CCBHC pilot program providing prompt, intensive, coordinated, and affordable care and treatment for thousands of individuals in crisis, many of whom are struggling with co-occurring disorders. The funding for the CCBHC program in Oregon and Oklahoma ended on March 31, 2019 and is set to end on June 30, 2019 in the remaining states, including New Jersey.

Congressional action is needed to authorize an extension of the CCBHC demonstration project to ensure that access to lifesaving treatment remains a reality for those in desperate need. Legislation was reintroduced on March 14 in hopes of ensuring CCBHCs can continue to provide rapid access to community-based addiction and behavioral health services. The bipartisan Excellence in Mental Health and Addiction Treatment Expansion Act (S.824/H.R.1767) would expand the CCBHC program to 11 new states and add two more years of critical funding for the eight states participating in the CCBHC program. Support of this legislation is crucial to ensuring CCBHCs can further equip communities with the vital resources needed to turn the tide on mental health and addiction crises, while further eroding the associated stigmas.

Individuals with co-occurring disorders represent a large percentage of emergency department admissions and are frequently readmitted due to a fragmented and uncoordinated care system that lacks the necessary follow-up and social support services that individuals with co-occurring disorders require. In Bergen County alone, 65 percent of emergency department admissions are individuals with co-occurring disorders who either voluntarily, or involuntarily, are being assessed for in-patient admission. Additionally, our jails and homeless shelters are quickly becoming the largest providers of mental healthcare as a result of the elimination of hundreds of thousands of in-patient beds nationally.

Care in non-emergency settings

CCBHCs are uniquely designed to treat substance use disorder and mental and behavioral issues concurrently, while providing care in non-emergency settings. Study after study on the impact of CCBHCs report very positive outcomes. CCBHCs are not only proven to save money by integrating primary and behavioral healthcare while expanding rapid access to treatment and supportive services, but they also decrease average wait times for clients to be seen, which is critical for someone in crisis. Last year alone, CCBHCs provided life-changing treatment and services to 400,000 individuals, 20 percent of whom never received treatment before. As one of the seven CCBHCs in New Jersey, CarePlus NJ saw an increase of 10,000 individuals last year in Bergen County alone. Since the launch of the CCBHC program, 68 percent of participating facilities have seen a decrease in patient wait times. In fact, after an initial call or referral, 78 percent of CCBHCs can offer an appointment within a week or less. This is in sharp contrast to the national average wait time of up to 48 days.

An end in funding for the CCBHC program will lead to significant program closures and an estimated 3,009 staff layoffs, including essential healthcare providers such as psychiatrists and other prescribers, addiction specialists, case managers, peers and other staff. As a result, we will see an immense reduction in access to mental health and substance use disorder treatment for the most vulnerable populations in our communities. It is estimated that if funding is not extended, over half of the 67 CCBHCs will have to close their doors to new patients seeking help. Allowing this program to “sunset” would result in a severe reduction in access to indispensable services and sweeping program closures throughout New Jersey. We cannot let this happen.

The CCBHC model has been proven. It works and it saves lives. I urge Congress to act quickly and pass this life-changing legislation.