NJAMHAA - 2021 Advocacy Piece

COMMUNITY-BASED BEHAVIORAL HEALTH: Sustainability and Investment for a Better Future 23 T wenty-twenty has been a tumultuous year, more so for some. As the general population experiences historically high levels of anxiety, depression, substance abuse and other disorders, imagine the impact on those individuals who were already living with a serious mental illness or addiction. The community-based system of care has met the challenges presented by the COVID-19 pandemic with great determination, dedication, compassion and excellence. Often, providers’ ability to do so has been facilitated by state and federal actions that supported and/or allowed changes in how services are delivered. These ranged from fiscal support for technology, enhanced wages, and personal protective equipment, to temporary regulations on telehealth, billing units, provisional licensure, online consent, take-home medications for addictions and so much more. The innovations of necessity must not all be lost – many must be retained as a bridge to the future of behavioral health. As the pandemic continues to dominate our daily lives, the long-standing recruitment and retention issues faced by community-based behavioral health organizations have been exacerbated. While nursing and physician shortages have been nationally recognized for some time, the pandemic has produced an overall staffing shortage as individuals are impacted by the virus directly, by loss of loved ones, by new caregiving demands, including for children who are no longer in school and, not least, by fear of the virus that has led some to leave the field or fully exit the workforce. Organizations are unable to offer competitive wages as deficits caused by the transition to fee-for-service reimbursement are being carried for the fourth year now as inadequate rates remain for many programs. COVID-19 has also brought to the fore substantial fiscal deficiencies built into some program models, such as the Intensive Outpatient program for individuals with substance use disorders that prohibits providers from billing for three days of services delivered if one hour of family or individual therapy is not attended by a client. In the following pages, these and other challenges faced by New Jersey’s community-based behavioral healthcare system will be explored. These issues demand innovation in funding and regulation to build a bridge to the future for New Jersey’s community-based behavioral healthcare system. The recommendations that follow offer the cornerstone that the Legislature and Administration can use to begin building a future of health and wellness for all New Jerseyans! Recent research predicts that the pandemic alone will lead to as many as 75,000 deaths from alcohol and drug misuse and suicide. A Centers for Disease Control and Prevention survey suggests that the proportion of U.S. adults with symptoms of anxiety disorder and/or depressive disorder has quadrupled since the onset of the pandemic.