Christie’s addiction and mental health services change survives, despite opposition
Despite opposition from key Democratic lawmakers and skepticism among providers, Gov. Chris Christie’s plan to reorganize how the state oversees addiction and mental health services can move forward.
Christie informed the Legislature at the end of the June he planned to move that division from the Department of Human Services to the Department of Health, in the pursuit of better integration of physical and behavioral health care services.
Associations representing behavioral health care providers objected – largely due to the timing, as Christie leaves office in mid-January, though some questioned the wisdom of moving the services to a department that handles public health, and away from one that administers Medicaid.
The Legislature can block a reorganization plan but has just 60 days to do that. The Assembly voted July 31 to block the plan, and the Senate planned to do the same last Friday. However, it was unable to muster the votes for a rare summer session and canceled – then Monday, the deadline expired.
John Jacobi, a Seton Hall University health professor who co-wrote a 2016 report for the Nicholson Foundation that led to the reorganization, said the changes will take a long time to put in place.
“The work that would have to be done in order to accomplish what we have recommended is technical. It is extensive. And it would stretch over a period of a couple of years probably,” Jacobi said.
The change isn’t universally welcomed. Raymond Castro, director of health policy for New Jersey Policy Perspective, said transitions from one governor to the next are complicated enough without significant overhauls like this one.
“The governor’s plan represents one of the most radical changes in the organization of state government in a century,” Castro said.
Kimberley Higgs, executive director of the New Jersey Psychiatric Rehabilitation Association, said her group doesn’t necessarily oppose the change, only the timing.
“This might be the right thing to do. The right thing to do might be to create a whole ‘nother department. We don’t know yet because that assessment process has not occurred,” Higgs said.
Lawmakers with concerns about shifting those services to the Department of Health say they’ll monitor the transition and work with the next governor to reverse it, if needed.
Jacobi said patients will benefit if there’s a single license for caregivers and that such a change is only possible though a government reorganization.
“It’s a legacy problem,” Jacobi said. “It’s a problem of the regulations going back to a time when mental health and substance use disorder care were thought of differently and not in any integrated fashion.”
But Jacobi said that’s “only half the battle” in the quest for better behavioral health services.
“That will not happen if the financing system is not also addressed so that Medicaid reimbursement is available to caregivers who are providing services under a modern integrated form of care and not in the old-fashioned piecework system that the Medicaid system was designed to address,” he said.