Gov. Christie wants to transfer responsibility for New Jersey’s four state psychiatric hospitals, community-based mental health and addiction services, and other behavioral health programs from the Department of Human Services to the Department of Health this summer.
The surprise move – which has triggered concern among some lawmakers and advocates – would involve the relocation of more than 200 state workers and $975 million in state and federal funding for the Division of Mental Health and Addiction Services (DMHAS).
It would also shift oversight of programs that are expected to serve nearly 100,000 Garden State residents in the coming year and the responsibility for implementing dozens of laws designed to protect and treat some of its most vulnerable residents, according to a copy of the reorganization plan obtained by NJ Spotlight.
The plan is intended to enable patients to receive more complete and effective care by better integrating behavioral and physical health services, now overseen by two separate departments.
Christie has made a priority of anti-addiction efforts in his final year in office and signed an executive order in January declaring it to be a public health crisis.
Studies have shown that many patients with serious mental illness also suffer from chronic or other physical health challenges that can go undiagnosed and untreated in a bifurcated system.
The proposed shift will take effect in 60 days, following a period of public comment, unless the Assembly and Senate return to Trenton this summer and pass a concurrent resolution opposing it.
Several key lawmakers said they have serious concerns about the proposal and its timing, just six months before the two-term Republican governor will leave office. The Senate is scheduled to return for a vote on other business Thursday.
“No question mental health and substance addiction disorder are health issues,” said Assemblywoman Valerie Vainieri Huttle (D., Bergen), a champion for community mental health services. “However, I’m questioning the governor’s plan to move it,” she added, “especially without discussing this with the Legislature.”
Several mental health advocates also raised questions about the shift, which they fear will leave behavioral health providers and their patients without the support they need from the state.
“No one could argue with the philosophical underpinnings of this, but we do have some concerns,” said Debra Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies, which represents community-based providers statewide.
Currently, the Department of Health oversees public health programs such as immunization; licenses; and regulates hospitals and nursing homes; supports local health offices, and gathers data and coordinates efforts to address diseases or health disparities.
The department is slated to spend $1.6 billion this year and, with 1,100 employees, is one of the smaller state agencies, according to the plan.
Human Services is the state’s largest department, with some 11,000 workers and a roughly $12 billion budget – much of it from federal sources.
It operates Medicaid or FamilyCare; oversees programs and residential facilities for developmentally disabled, blind, deaf, and elderly residents; and coordinates a host of welfare programs, besides its work through DMHAS.
While the proposed move came as news to advocates last week, Christie’s office said both departments were involved with the proposal, which drew heavily from a Seton Hall University report last year.
The study faulted bureaucratic hurdles and a lack of coordination between the Departments of Human Services and Health for barriers in providing integrated care to vulnerable patients.
The reorganization plan appears to put several of the report’s recommendations into action and underscores how addiction services in particular should be combined with other initiatives overseen by the Department of Health. The plan also notes that the department recently received national accreditation for its public health work.
“Transferring the provision of mental health and addiction services to DOH is necessary to improve heath care, remove bureaucratic obstacles to the integration of physical and behavioral health care, and effectively address substance use disorder as the public health crisis that it is,” the proposal notes.
Health Commissioner Cathleen D. Bennett said the shift makes sense. “This reorganization recognizes that mental health and behavioral health problems in general, and opioid addiction in particular, need to be treated as illnesses no different than infectious diseases such as Zika virus,” she said.
The move also seemed appropriate to officials at Human Services.
“DHS has cultivated a robust behavioral health system of care that will evolve with and benefit from the public health and regulatory expertise offered by DOH,” spokeswoman Nicole Brossoie said.
But Carolyn Beauchamp, president and CEO of the Mental Health Association in New Jersey, said the two departments have vastly different roles: DOH plays a largely regulatory function, while DHS has vast experience running contract-based community programs.
“It doesn’t meet the people’s health-care needs,” Beauchamp said. “It will do nothing but slow [service delivery] down. I’m concerned that it will not serve our clients well.”
The potential shift also triggered concerns for some advocates for individuals with disabilities.
Among other things, Joe Young, executive director of Disability Rights New Jersey, said he was worried about the impact on people who receive services from DHS’s Division of Developmental Disabilities in addition to DMHAS; the department’s Medicaid office often gets involved as well. Young said more discussion is needed first.
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