Mary Jo Layton, The Record
Nearly 300 mental health advocates on Wednesday called for the state to maintain funding for outpatient services, saying the potential loss of more than $6 million in Bergen County alone will impact thousands of clients who can’t afford private psychiatric or addiction treatment.
Speakers warned of dire consequences in an already-burdened mental health system at the event in Washington Township. If services are cut, more patients will end up in hospitals, emergency rooms and in jail, experts warned.
“We need not to cut the funding. We need to increase the funding for people,” Bergen County Executive James Tedesco said.
The state plans to switch from a grant system that provided monthly lump sums to mental health providers to a model that pays a fee for each service as it is provided. Patients who can afford to pay for their own mental health care and seek treatment from private specialists will not be affected.
The new system, however, could cost four outpatient programs in Bergen County – which provide Medicaid-subsidized care — $6 million, potentially causing the programs to lose 60 psychiatrists, clinicians and other support staff, advocates said.
That means 5,500 clients would lose services — primarily medication monitoring — and 3,500 new clients could not get treatment, said Vicki Sidrow, president and CEO of Vantage Health Systems Inc., one of the agencies that provide outpatient services in Bergen County.
“We keep people stable and in their communities and out of the hospital,” Sidrow said. “I have been on the job 30 years and this is the worst funding crisis I have ever seen.”
Instead of signing a contract with a mental health provider and paying a set fee every month, the new state Medicaid plan will pay for each treatment, including counseling, hospital visits or other services. State officials say the money will stretch further under the new plan.
Advocates and counselors see it differently. They say there’s no cushion, which is provided in the current system, to pay for non-medical items, including repairs to a facility. All told, 20,000 people statewide will lose care, experts said.
“The state of New Jersey will be in a crisis if our mental health system crumbles,” said John Mitchell, member of the board of trustees for CarePlus NJ, a non-profit group that provides mental health and substance abuse outpatient treatment in Paramus, Fair Lawn, Hasbrouck Heights and Montclair.
One in four people suffers from mental illness and one in 17 has such extreme symptoms he or she cannot hold a job or attend school, experts said.
At Bergen Regional Medical Center, a linchpin in the state’s mental health system, the 319 psychiatric beds are at capacity, said Thomas Rosamilia, vice president of behavioral health services at the hospital. Once the new program starts in July 2017, thousands of outpatient clients throughout the state may not be able to afford medication monitoring or outpatient services and will turn to inpatient care, he said.
“Where will these people go?” Rosamilia said. Patients are already sitting on chairs for hours and spending days in the emergency department when there are no available beds at the Paramus facility, he said.
“We have been underfunded all along, but this only makes it worse,” he said. “We need more funding. Without that, it’s only going to be a catastrophe.”
In another sign of an already burdened system, the New Jersey Hospital Association released a report this week that found nearly half of the increase in emergency department volume in the past year can be attributed to mental health and substance abuse diagnoses.
Of the 3.2 million total emergency visits last year, more than 18 percent were behavioral health patients, the association concluded.
Assemblywoman Valerie Vainieri Huttle, D-Englewood, chairwoman of the Assembly Human Services Committee, said she has scheduled a hearing for Nov. 14 on a bill that for two years would track the effects of the fee-for-service change on mental health services. A companion bill in the Senate already has been released from committee.
“This is a trend happening across the country,” Huttle said after the session. “We want to find out the impact in mental health care when these changes take place.”
Particularly given the closure of state facilities and the shuttering or decrease in psychiatric services at many hospitals, Huttle said, she wants to ensure that people are getting proper care.
“The clients are in our community,” she said. “We need to make sure they have the appropriate services.”