DMHAS Transformation - State of New Jersey

NJAMHAA Annual Conference
April 3, 2012
Lynn A. Kovich
Assistant Commissioner
DMHAS is undertaking multiple,
simultaneous advances:
 The goal is to build a continuum of services that
will meet the holistic needs of our consumers
 We are striving to create a system where
consumers can find the services they need from a
single point of entry.
The Merger
Hagedorn Closing
Medicaid Waiver-ASO/MBHO
Transitioning Adolescent Substance Abuse
Services to DCF
Governor's Proposed Drug Court Expansion
New table of organization since December
Efforts underway to co-locate the offices
Began cross-training our staff
Reviewing/developing merged policies and
Implementing various co-occurring initiatives
Hospital will be closed by June 30, 2012
Hagedorn Stakeholder Group has been
meeting monthly to review the steps taken
by the division to discharge patients, provide
guidance to employees, and power down the
Statistics on the closing can be found on the
DHS website under Hagedorn closure.
The Waiver was submitted last September. It is a
collection of reform initiatives designed to:
 sustain the program long-term as a safety-net for eligible
 rebalance resources to reflect the changing healthcare
 prepare the State to implement provisions of the federal
Affordable Care Act in 2014
DMHAS and Medicaid will procure the services of an
Administrative Services Organization (ASO) and
subsequent at-risk Managed Behavioral Health
Organization (MBHO) to be supported by FFP and
State match starting in FY 2014.
Implementation of the ASO provides opportunities for
increased FFP within the behavioral health system of care
by increasing the range of program services and
rebalancing fair market rates for Medicaid and statefunded programs.
The ASO also will allow DMHAS to transition from a cost
reimbursement to a fee-for-service contracting method.
This advance will include a braiding of federal block grant
and state dollars with Medicaid resources to support a
comprehensive array of treatment and recovery support
services for qualified program participants
Provides increased focus on populations with specific
needs, including SAI (Welfare to Work), Medication
Assisted Treatment Initiative (MATI), and consumers with
intellectual and developmental disabilities
Represents a shift away from institutional care towards
community-based care, with an emphasis on wellness and
Includes the integration of mental health and addiction
services and behavioral health and primary care services
through screening, intervention, and referral in both
systems as well as the creation of behavioral health homes
This initiative, once implemented, will improve
access, quality, and value within the state’s
behavioral health system of care
DMHAS and Medicaid have partnered to design,
procure, and implement the ASO/MBHO
according to the following timeline:
July 2012 – ASO/MBHO RFP Posted
January 2013 – RFP Awarded
January –April 2013- ASO/MBHO Readiness Review
July 2013 – ASO/MBHO implementation
DMHAS and DMAHS formed a Steering
Committee to elicit broad stakeholder input.
 The Steering Committee initiated a workgroup
process to inform recommendations at a more
detailed level with a focus on clinical practice,
access, financing, and performance standards.
 The workgroups met during February and March
 Final recommendations to DHS are expected in
April 2012.
DCF’s System of Care will provide a single
point of entry to a broad array of services.
 Adolescents with substance abuse disorders will
be transitioned into the service delivery system of
care within the DCF, Division of Child Behavioral
Health Services (DCBHS) in January 2013.
 All services for youth with intellectual and
developmental disabilities also will be integrated
into the DCBHS System of Care.
Integration was recommended by the Adolescent
Substance Abuse Task Force formed in July 2009 and
part of a work plan developed in September 2011 by a
joint workgroup from DHS/DMHAS and DCBHS.
We know that a single point of entry to integrated
care will help families access the behavioral health
and substance abuse services their children need.
This transition recognizes that adolescents with cooccurring mental health and substance use disorders
also may experience behavioral problems, skill
deficits, academic difficulties and family issues.
Transitioning adolescent addiction services to
DCBHS will offer quicker access to a broad array of
services and resources and will recognize the
importance of the whole family in achieving
 Integration also has the potential to allow the State
to leverage federal Medicaid funds and maximize
the service options available for youth with
substance abuse problems.
DMHAS convened a large stakeholder group on March 13,
2012 to discuss the strengths and challenges of the current
system to ensure open deliberation of the process.
An internal DMHAS and DCBHS workgroup also meets
regularly to focus on:
clinical screening/assessment tools
clinical continuing stay reviews
clinical services array
evidence based practice
access points
income eligibility
Rate setting
A smaller advisory group also was convened to assist
in moving the transition forward. This advisory group
will meet monthly through January 2013.
 Specifically, the advisory group will identify the guiding
principles for the transition, discuss fiscal concerns,
consider any impact to the counties, and determine what
agencies need to do to prepare for the transition.
The transition goal is to develop an integrated system
that will provide the opportunity to coordinate
services in an innovative way that will result in
increased efficiency and improved outcomes for
The purpose of this transition is to keep
 at home
 in school
 in the community
 focused on recovery
Governor Christie included in his FY 2013 Budget
Address a plan to expand Drug Court to ensure
non-violent offenders get addiction treatment.
The proposed budget would provide and initial
appropriation of $2.5 million for expansion.
DMHAS will work collaboratively with the
Department of Law and Public Safety and the
Governor’s Office to develop this initiative.
This Administration has made a commitment
to fund services for individuals with mental
illness and addiction disorders.
The Governor’s proposed FY’ 13 budget
 Mental health community growth of $13.683M
 Substance abuse community growth of $2.022M
The Department will be testifying on
Wednesday, April 4 before the Assembly
Budget Committee at 10 a.m. to report on
current programs and services and then at 3
p.m. with DCA, DCF and DHSS regarding the
restructuring of services as proposed in the
FY’13 budget.

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