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December 19, 2016

Mental Health Coalition Update

The NJ Mental Health Coalition held its regular monthly meeting at the offices of NASW-NJ and discussed a number of important behavioral health issues facing the citizens of New Jersey.

The Residential Health Care Facilities Bill, focused on community residences of the Division of Developmental Disabilities, addresses eviction of someone from a facility if s/he is a danger to oneself or others. It is essential that it be clear such a danger would arise from psychiatric illness. There was concern that when the Department of Community Affairs changed the language of the bill which may have undermined its intent.

Much of the meeting dealt with a letter to Valerie at Division of Mental Health and Addiction Services on the Fee for Service (FFS) transition. The letter was divided into four topics: Early Warning and Response, Resources to keep the system whole, Technical Assistance (TA), Evaluation and Oversight. 17 agencies will begin FFS on Jan. 1; others will begin on July 1. 

It was noted that small agencies would be hard-pressed to administer the billing under FFS. The Division is not providing much TA in this area. Assemblywoman Huttle has insisted the division would not let agencies fail.

There has been confusion in the past regarding Regulations on the definition of "license" and which professionals can be doing assessments. The Regulations do not adequately address the capability of LSW’s under supervision of an LCSW to do assessments and are, as a result, overly restrictive, thus making access to services more complicated. The Coalition called for advocacy on the Regulations related to social workers doing assessments and Individual Recovery Plans. 

Finally, there was discussion regarding substance abuse treatment being inadequate despite the current opiate crisis. In particular, the concern was about youth under 18 not getting referred for services. Beds are going unfilled because of a lack of referrals. The Interim Managing Entity (the administrative services organization, or ASO, for behavioral health) is supposed to be doing referrals but is not functioning as it should. There seems to be too great a concentration on inpatient treatment, which is not the right course for everyone. 

 

December 15, 2016

Mental Health Parity Update

Legislation affecting insurance for mental health and addiction will be introduced in the coming weeks in the New Jersey Legislature. Two Democratic Senators, Joseph Vitale and Robert Gordon, are being joined as co-prime sponsors of the bill by Republican Thomas Kean, the Senate Minority Leader. The bill will apply the standards of a federal law that requires insurers to provide coverage for behavioral health at the same level they do for physical illnesses.

Advocates believe that with the incoming administration vowing to repeal the Affordable Care Act, the state measure will be all the more necessary. Since enactment of the federal parity law, as it is known, there has been widespread non-compliance, as insurers have denied or limited behavioral health care to a far greater degree than than have for physical sickness. Many of the cases occur when insurers deem the care level prescribed by a treatment provider is not medically necessary. They often require a patient to fail at a lower care level before approving the higher level of care, a practice known as ‘fail-first.

New Jersey’s parity coalition is gathering names of people who have experience these denials to have them testify on the bill when it goes before legislative committees. A training on providing testimony is scheduled for mid-January. Heading the Denied Treatment effort is Valerie Furlong, whose two sons went through addictions and were denied care by their insurer. Ms. Furlong and her husband have spent countless hours and hundreds of thousands of dollars appealing the denials and paying for their sons’ treatment. Both young men are now in recovery.

The Denied Treatment initiative is setting up a Facebook Group, which will be closed and monitored.

In addition to the New Jersey behavioral health insurance effort, the Kennedy Forum, founded by former Congressman Patrick Kennedy, will hold a hearing on the insurance parity law on January 24 in Washington, D.C. Kennedy, who was the prime sponsor of the federal law, now lives part-time in New Jersey.  For more information on the event, go to: https://www.thekennedyforum.org/events/newfrontier

 

December 8, 2016

Taking a Stand Against the Repeal of the Affordable Care Act (ACA)

The NJ for Health Care Coalition is bracing for a fight to preserve the Affordable Care Act (ACA), which President-elect Donald Trump has said he will scrap in the first days of his administration. New Jersey Policy Perspective's (NJPP) Executive Director Ray Castro reported on approximately $3 billion the state would lose annually and the hundreds of thousands who would be left uninsured under a plan to repeal the ACA.

NJPP has issued findings on the human and economic costs of doing away with the ACA. Mr. Castro said the Republicans' ultimate plan is to have Medicaid shifted to block grants, which would prove to be a disaster for the public insurance program. Were this to take place, states and individuals would bear a far greater share of health care costs. To link to the full NJPP report, go to:

https://njforhealthcare.org/medicaidanalysis.pdf.

The Health Care Coalition plans to press the NJ Legislature to adopt a resolution opposing the health care law's repeal. It is also laying the groundwork to urge New Jersey's Congressional delegation to oppose the repeal. The Coalition is collecting stories from people who have benefited under the Affordable Care Act. To add your story, to go: https://docs.google.com/forms/d/e/1FAIpQLSddTC2Il2-kyWfMVTpbvc6JK7-uaOrxkAIUaGx2ouvEmQ0RWw/viewform.

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