NJ health commissioner pushes integration plan for mental and physical health services

Anthony DiFabio, Board President of New Jersey Association of Mental Health and Addiction Agencies, listed several challenges from insufficient funding to regulatory upheaval, confronting his statewide association of mental health and addiction agencies.

“What we are experiencing right now is an incredible sea change in the area of behavioral health and integrated care,” said DiFabio.

With its services merged last year into the state Department of Health, providers at the annual conference listened eagerly to New Jersey’s new health commissioner, Shereef Elnahal, promote his vision, which prominently features a so-called single licensing plan approach to health care.

“Which is to provide under the same roof, primary care, addiction treatment and mental health care in an integrated way, where pass off care is seamless and where you have a comprehensive approach to your patients. And when these patients come in, it is best to do as much as possible for them, while you have them,” said Elnahal.

Elnahal expects to have licensing regulations ready by next February. He’s also focused on public health crises like the opioid epidemic and high infant mortality rates, where he believes care should be more data-driven — real-time information on opioid overdoses, for example. And, he says patients’ digitized health records should be available to all providers.

“This is really about quality of care and it’s about people’s lives. To have information seamlessly transferred from place to place really helps — and of course, in the mission of mental health treatment and addiction, you see this becoming important, as well,” said Elnahal.

Elnahal says 11 hospitals already share patient records, but some providers still feel queasy about providing full access to data.

“I mean, it’s your personal info, your health records. So, it’s important that they come up with a plan that not only works, but also protects everyone’s privacy,” said Patricia Vaughn, CEO of Vaughn Castle.

The commissioner says he’ll be sending surveys to providers. He wants to hear from them about what works best in their practices. And, he wants New Jersey to actively enroll more people who are eligible for Medicaid services under the Affordable Care Act, or ACA. One thing he’ll hear providers complain about — outpatient care continues to be underfunded under the new fee-for-service payment system the state adopted last July.

“The rates that have been set aside by the state, they just don’t cover the psychiatric services for medical monitoring, for psychiatric evaluation, and for ongoing treatment. Basically right now, every time that we see someone for a psychiatric hour, we probably lose in the neighborhood of $250 per hour,” said Greg Speed, president and CEO of Cape Counseling Services.

“We need to make sure the rates are adequate, so that they can stay operating, because the worst thing we would want is for more clinics to close because they’re not able to keep their doors open. That’s why this is a constant dialogue with our stakeholders,” said Elnahal.

The New Jersey Department of Health’s survey is expected to go out to all providers in a few weeks. The commissioner is likely to get an earful in response.

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