The State of New Jersey has applied to the Centers for Medicare and Medicaid to approve significant changes in the way in manages Medicaid. Using a so-called “Section 1115 Comprehensive Waiver”, the State seeks changes to require all Medicaid recipients, including dual eligibles, to migrate from a fee-for-service model to a managed care organization model. Below are links to revelent sites and information that can put these changes into proper context.
Medicaid’s website, www.medicaid.gov, provides a broad array of information
This helpful brief from the Kaiser Commission on Medicaid and the Uninsured explains what a “Section 1115 Waiver” is.
The State of New Jersey has approached the Centers for Medicare and Medicaid Services to approve a waiver to its Medicaid contract with the Federal government that will change the health care insurance process for many Jerseyans with psychiatric disabilities. A significant part of the waiver is the proposed reform of the State’s handling of Medicaid benefits for its dual eligibles, who are to be assigned to managed care organizations (MCOs) that will better co-ordinate their care. (There are currently 23,000 duals already voluntarily enrolled in MCOs, while 117,000 now in a fee-for-service arrangement will be converted to MCOs in October 2011.)
NAMI New Jersey’s Legislative Director Phil Lubitz prepared this summary of the key points of New Jersey’s Section 1115 Demonstration Comprehensive Medicaid Waiver request.
Additional Medicaid resources can be found in the reading list of this PsychOdyssey Academy “course”.
This 64 page academic paper (2013) examines the implications of Medicaid’s major pending changes on the recoveries of New Jerseyans with schizophrenia. The author concludes that the changes will not improve recoveries and suggests that the Patient Protection and Affordability Act of 2010 missed a significant opportunity for major change to the U.S. behavioral health system.
New Jersey State Budget
A publication of the Center for Behavioral Health and Criminal Justice Research at Rutgers, this resource binder provides a partial listing of service and support services that are available in the local county. There are sections for employment, education, housing, medical and behavioral health services, public benefits, legal services, food and clothing, social support, transportation, and miscellaneous services. For each listing, there is an address, telephone number, hours of operation, and often a short description. This may be the best social services resource for Mercer County that PsychOdyssey has yet seen.
The mother of all NJ mental health system documents… 375 pages long! But it is a comprehensive review of all, and I mean all, the elements of the New Jersey mental health system, from State Hospitals to individual consumer peer counseling. Block grant funding amounts to all 120 community behavioral health agencies is also listed.
New Jersey Governor’s Task Force on Mental Health (2005). Final Report–New Jersey’s Long and Winding Road To Treatment, Wellness and Recovery (pp. 265). Trenton, NJ: State of New Jersey.
“This report represents movement of New Jersey’s mental health system away from a status quo characterized by stigma and isolation, towards a Treatment, Wellness and Recovery model. It identifies priority recommendations to achieve immediate relief for an overburdened and under- funded infrastructure. It also provides a blueprint for developing quality, consumer and family directed care and systems while including longer-term recommendations. These recommendations will continue to carry the momentum of change for New Jersey’s mental health system and for the mental health of our most precious resources, the people of New Jersey.”
Far too many people with mental illness become entangled in the criminal justice system. To assist family members or other individuals who might advocate for a person with a mental illness involved in the criminal justice system, NAMI NJ has prepared a guide, called Finding Our Way, Advocating for People with Mental Illness in the New Jersey Criminal Justice System. To see Finding Our Way, click here.
New Jersey Courts (www.njcourts.com) has developed an interesting and useful summary of New Jersey legal procedures for involuntary civil commitments, called Involuntary Civil Commitments–A Resource Binder. The document was prepared by a collaboration of the Division of Mental Health and Addiction Services of the NJ Department of Human Services, the Division of Mental Health and Guardianship Advocacy of the NJ Office of the Public Advocate, the Division of Law of the NJ Department of Law adn Public Safety, and the Civil Practice Division of hte Aministrative Office of the (NJ) Courts.
Treatment Advocacy Center and the National Sheriffs’ Association (2010). More Mentally Ill Persons Are In Jails and Prisons Than Hospitals–A Survey of the States.
A recent report jointly issued by The Treatment Advocacy Center and the National Sheriffs’ Association brings alarming news. There are now more mentally ill in prison than in psychiatric hospitals. Some details:
- There are 3 times more mentally ill persons in jail than in hospital
- 16% of prison inmates have a serious mental illness
- 40% of people with mental illness have been in jail at some time
- In 1955, there was 1 psychiatric bed for every 300 Americans. In 2005: 1 for 3,000.
- Such conditions today are as they were in the 1840s.
To overcome this travesty, the report proposes a) assisted outpatient treatment, b) mental health courts, surveys of the states, the linking of Federal block grants to better outcomes, and abolishing hte “institutions for mental disease” (IMD) Medicaid restriction.
Robert Wood Johnson Foundation (2010). “New Services for Released Prisoners With Mental Illness in Mercer County, N.J.”
In 2005, Greater Trenton Behavioral HealthCare launched an initiative to assist released prisoners in Mercer County, N.J., who suffered from mental illness and substance abuse problems. The project was funded under New Jersey Health Initiatives (NJHI), a national program of the Robert Wood Johnson Foundation (RWJF). GTBHC partnered with a range of organizations representing government, health care providers, the mentally ill and ex-offenders to:
- Implement a model for prisoner discharge planning and services geared to the needs of those with serious mental illness or substance abuse problems.
- Gather data useful in reevaluating statewide public policy for serving former prisoners with serious mental illness or substance abuse problems, including:
- The risk of hospitalization or re-incarceration
- The level of services needed
- Follow-through and adherence to treatments
To see the entire news report, click here.
Wolff, N., Epperson, M., & Fay, S. (2010). Policy Brief: Mental Health Probation Officers: Stopping Justice-Involvement before Incarceration, Center for Behavioral Health & Criminal Justice Research, Rutgers University.
Many with psychiatric disabilities become entangled in the legal system, even at the criminal level. As an intermediate step to the laudable and effective goal of mental health courts, mental health probation officers is a potentially powerful subject worthy of NAMI Mercer’s advocacy attention. Here is a useful brief on an important subject by experts at the Rutgers Center of Behavioral Health & Criminal Justice, where Professor Nancy Wolff is the director. The article is co-authored by Siobhan Fay, LPC, Coordinator of the Adult Probation Mental Health Program of the NJ State Judiciary.
Behavioral Healthcare [Magazine] (2011). Up to one in four incarcerations should be prevented.
The scandal of preventable incarceration of individuals with psychiatric disabilities continues to careen of out of control. The American Psychiatric Association estimates that 20% of all prisoners, about 550,000 individuals suffer from a severe mental illness. With the number of inpatient hospital psychiatric beds nationally now down to about 40,000 (from over half a million in the 1950s), prisons and jails have become a de facto–and wholly inadequate and inappropriate–long-term institutional care solution.
Family Support for Families of Persons with a Serious Mental Illness: 2012 New Jersey State Plan
Memo on New Jersey’s Children’s Behavioral Health System (May 10,2012)
The State’s mental health system is confusing enough just for adults. There is a separate system for children. This memo, which records a conversation with Pauline Maider, Executive Director, Mercer County Family Support Organization, gives an overview of it.