She pushed New Jersey’s addiction treatment system to align with clinical best-practices; tweaked Medicaid to help poor residents pay for autism-related care, prevent diabetes or quit smoking; and invested heavily in child-care support for working families.
In ways large and small, state Department of Human Services Commissioner Carole Johnson has reshaped the way her department works to assist millions of poor, vulnerable and disabled New Jerseyans.
Last week Gov. Phil Murphy announced Johnson, whom he appointed to the post in January 2018, will leave the DHS on Friday,Jan. 15 to join the new presidential COVID-19 response team. Deputy Commissioner Sarah Adelman will become acting commissioner with her departure. President-elect Joe Biden tapped Johnson, an Obama administration veteran, to oversee the nationwide testing program when he takes office on Jan. 16.
Building a broad coalition
Johnson, a New Jersey native, has enjoyed support from diverse groups that work with the department, including mental health and addiction service providers and advocates for prisoners and their reentry into wider society. The DHS is the largest state agency — with an annual budget of more than $11 billion and some 14,000 staff — and it oversees Medicaid, or Family Care, which covers roughly 1.7 million residents, operates a network of sites that care for and house about 25,000 individuals with disabilities and runs programs that provide behavioral health care, senior services, food assistance and housing support.
“From day one, Carole Johnson has been one of our most valuable team members and a leading voice for serving New Jersey’s most vulnerable residents,” Murphy said in announcing her move. “We’re sad to see her depart the administration, but are excited that she’ll be taking a critical role serving President-elect Biden and Vice President-elect Harris in the White House as our nation continues to battle the COVID-19 pandemic.”
Helped craft Obamacare
Before joining the Murphy team, Johnson served as a domestic policy adviser on public health issues under former President Barack Obama, working on the federal Affordable Care Act, mental health and substance-abuse programs and aging issues. Her term also coincided with two potential pandemics, the emergence of Ebola and Zika.
Johnson did not immediately comment publicly on her appointment, but the news brought praise from some stakeholders and tributes from her DHS colleagues. Deborah Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies — providers that had struggled with former Gov. Chris Christie’s administration over funding reforms — said she was “thrilled, delighted and excited” about Johnson’s role on the Biden-Harris task force and said health care professionals “will miss her in that (DHS) role but know that we all will benefit with her at the helm nationally.”
“Carole Johnson deserves profuse gratitude and accolades for sustaining and even expanding services for New Jersey’s vulnerable children and adults during the worst public health crisis of our lifetime. Always she was sincere, thoughtful, knowledgeable, positive, compassionate and effective,” Wentz said, adding that her agency “admired and appreciated” Johnson’s leadership.
Johnson’s leadership in reforming addiction services was particularly profound. State support for opioid addiction had expanded significantly under Christie, who championed the cause in his later years in office, but he provided little support for medically assisted treatment, or MAT, considered the clinical gold standard in addressing opiate-based substance-use disorders.
But Johnson flipped the script, drafting two energetic, young doctors — Dr. Kaitlin Baston, at Cooper University Health, and Dr. Erin Zerbo, with Rutgers New Jersey Medical School — to serve as ambassadors and set up Centers for Excellence in Camden and Newark, respectively. These programs are designed to help more doctors get trained and credentialed to administer MAT, since a lack of providers had limited access to the treatment. The DHS also worked with county jails to expand MAT programs behind bars, where many inmates suffer from addiction issues.
Bringing MAT to Medicare
Changes Johnson oversaw in the Medicaid program also expanded coverage for MAT, peer counseling and other addiction services, as well as smoking cessation, diabetes prevention, autism services and hepatitis-C care. Other revisions to this public health insurance program were intended to reduce racial disparities in birth and maternal health — part of a multi-department effort led by first lady Tammy Murphy — by expanding coverage for prenatal care, midwife services and doulas. (With Black women more than four times more likely to die in childbirth as white mothers, New Jersey has one of the largest maternal mortality racial gaps in the nation.)
Under Johnson’s leadership, the DHS invested an additional $100 million in child-care subsidies for working families, raising infant support by 40% and cutting parent copays in half. During the coronavirus pandemic, the department provided free child-care services to essential workers in the spring and other assistance to working families whose children were learning remotely in the fall. The coronavirus also prompted the DHS to coordinate COVID-19 testing at facilities for disabled individuals, support legislative efforts to boost pay for frontline caregivers, arrange check-ins on elderly residents living alone and expand access to mental health services for health care professionals and the public.
In addition, during her term Johnson strove to make more social services accessible online, including food service benefits and shopping and information for homeless individuals.
“It has been an incredible honor to work with Commissioner Johnson as she led our dedicated team in tireless service to New Jersey residents over the last three years,” acting Commissioner Adelman said. “I hope to continue building on our efforts to serve New Jersey’s most vulnerable residents, as well as making services available to many who need support for the first time as a result of COVID-19.” She also pledged to make the transition as seamless as possible. “On behalf of Deputy Commissioner Elisa Neira, Chief of Staff Andrea Katz and the entire department, I will miss working with Commissioner Johnson and wish her the best in her new role.”