ATTENTION ALL STAFF
Have you heard about the change to Fee-for-Service only reimbursement for behavioral health services in New Jersey?
Did you know that this is incredibly relevant to CarePlus, and to YOU as CarePlus employees?
The New Jersey Division of Mental Health and Addiction Services has announced the new reimbursement rates for service. The mental health and substance use treatment rates will go into effect on July 1, 2016.
What does this mean?
Although some of the rates have increased, they are still not sufficient to cover the full cost of services. What is worse is that by transitioning into a Fee-for-Service only
model of payment, behavioral health agencies such as CarePlus will be losing the state contract funding that allows us to run programs such as our Outpatient Department.
This is not only a threat to CarePlus and our employees, but it is also a threat to the community-based mental health system as a whole. Most importantly, it will be devastating for those individuals who will no longer have access to services.
We have written an advocacy letter and sent it to our local legislators as our first action step to reverse these policy changes. In the coming weeks, w
e will be taking further action alongside of statewide community-mental health providers.Please read the letter below.
We need staff involvement in these advocacy efforts so that we can inform clients, organize families, and take effective action.
You can contact Caitlyn
if you have any questions or concerns, or if you would like to learn more about
this important issue.
Your involvement is appreciated.
- A Note from Joe Masciandaro -
Besides all of the technical nuances as to the amounts of the rates, I think the main issue is that as "safety net" providers, we need to keep the investment of State dollars in the system.
Fee-for-Service will, eventually, necessitate the redesign of the delivery system, as providers change their business models, and I don't want the "losers" be the very vulnerable populations we serve... which is where this is heading.
Legislation requiring some form of "maintenance of effort" as costs are shifted to other payers (the Federal Governments and the Obamacare Plans) would be key in maintaining the "safety net" role.
A Letter to Our Legislators...
Dear Senator Gordon, Assemblyman Lagana, and Assemblyman Eustace:
As leaders in the Bergen County community-based mental health agencies, it is critical that we express our grave concerns and ask for your support in reversing the proposal of the Division of Mental Health and Addiction Services to shift from a Purchase-of-Services contract to a Fee-for-Service only model. We want to stress that we provide safety-net services within Bergen County, and the proposals as they currently exist will have a devastating effect on the Bergen County community.
We conducted an analysis of the financial ramifications on the operating budgets for our organizations. Our calculations showed that the numbers do not add up.
Community-based mental health centers will be forced to close programs, specifically outpatient services, if the state contracts are dissolved. Further, our analysis indicates a collective loss of $6-8 million dollars in psychiatric and mental health funding for our community-based outpatient programs if the new policies are put into effect on the designated date of January 1, 2017.
Please take note of some of the consequences that will ultimately result in the destabilization of the community-based mental health system and the disturbance of peace for many individuals in need of these services:
- CarePlus serves over 4,500 individuals in District 38, and their treatment will be endangered with the change to Fee for Service. The number of those whose services are in jeopardy is much larger when considering all of the districts in Bergen County and the multiple community-based mental health providers.
- There are over 3,500 individuals who receive medication services through CarePlus alone. Of those, 1,600 individuals are on medication-only services and are able to maintain a stable level of wellness in their treatment. The fact that the rate for medication monitoring did not increase demonstrates a lack of awareness of the importance of keeping these individuals stable and reducing costly hospitalizations.
- The new rates for psychiatric evaluations do not cover the cost of such services, and the suggestion of integrating tele-psychiatry is laughable for the same reason.
- Our housing system in Bergen County is stressed past its limit. It is hard to imagine the implications of creating yet another barrier for homeless individuals. We would be certain to see a rise in crime rates and inappropriate incarcerations, thus creating a greater strain on our criminal justice system.
- Bergen Regional Medical Center is under tremendous pressure as it is. Without the support of safety-net community-based mental health centers the future of the hospital is beyond burdensome, if not completely doomed.
- Bergen County has prided itself on being Stigma-Free, but these preventative efforts will be fruitless if the community-based mental health centers have to close these programs due to insufficient funding.
Our mental health system is struggling to keep its head above water, and the air that we are breathing is getting heavier. The safety-net funding we have received through state contracts has allowed for us to absorb a number of financial obstacles, but our resources have run dry. We are doing all that we can to prepare for this storm, but we unequivocally need your support in confronting these concerns on a legislative level.
We are requesting a meeting with you to discuss these issues at length so that we can come to a resolution. Our goal is to work constructively with the state to maintain the stability of the community-based mental health system and the many individuals that we serve.
Thank you for your attention and consideration in this important matter. We will be calling your offices to schedule meetings regarding this imperative issue.
HIPAA: What Are Your Professional Responsibilities?
2 Ethics CEUs
May 19, 2016 - 10:00 am - 12:00 pm
Mental Health First Aid
7.5 Clinical CEUs
June 6, 2016 - 9:00 am - 5:00 pm
"I wanted to share with you a message I received on Friday afternoon from a client. The client wished to express her utter appreciation for you; your kind approach to her, your patience, your welcoming/warm reception with her and your ability to always respond to her requests. She appreciates your follow up when she forgets her appointment time and described you to be compassionate, kind and organized. She concluded her message with giving you a five star rating for your service to her. She verbalized what we all witness every day from you. Thank you for putting yourself into your work!" - Ann Marie Zihal
Thank you for sharing, AMZ.
Way to go Kiki!
CarePlus Celebrates Nationally Ranked Staff and Client Satisfaction
Care Plus NJ ("CarePlus") ranked #1 in three areas in the 2015 Nationwide Survey conducted by Mental Health Corporations of American ("mhca"): overall client satisfaction with agencies having 5 or more programs, client satisfaction with vocational services and overall staff satisfaction.
CarePlus is 1 of 135 organizations that have received the invitation only membership with mhca. It is a prestigious acknowledgement to be a part of the network, which prides itself on consisting of only the highest quality behavioral healthcare organizations in the country. The mhca association of providers exists for the purpose of learning, collaborating and growing with eachother while leading the future of behavioral healthcare.
This position of leadership is familiar to the CarePlus team, who works to set the bar by providing exemplary care and taking innovative approaches to integrate services for healthy minds and healthy bodies. CarePlus has been one of the top three ranked organizations since it first became a member.
It is worth noting that CarePlus far exceeds 5 programs, tallying over 50. Services span across the children and family spectrum, through the severe mental illness and substance abuse populations and beyond offering opportunities for personal and professional growth for both staff and clients.
"The client satisfaction with vocational services is not a surprise because we have a very strong focus on the workforce development," explained Joe Masciandaro, CEO and President at CarePlus. "One of the driving forces for many of our clients is to reintegrate into the community after crises and hospitalizations. Employment is a major component in that, especially for those who want to attain and maintain independent living."
The extensiveness of the organization allows for CarePlus to serve many. In the 2015 fiscal year, CarePlus helped 17,721 individuals navigate the mental health system through their Admissions Department. Of those, 15,714 of those individuals were linked to services within the agency, and the remainder were referred to appropriate resources. That does not take into account clients that were enrolled in services before 2015. Such client engagement demands sufficient staffing and training.
"The positive feedback from clients is very fulfilling," continued Masciandaro. "We are also very proud about our staff satisfaction. Our teams are dedicated and passionate about their work. Their contentment in serving is directly connected to the positive client experience."
Save the Dates!
18th Annual Courage Awards Gala
at the Venetian in Garfield
5th Annual Golfers Give Back
Charity Golf Outing at White Beeches
Golf & Country Club in Haworth
Our final Gala meetings will be held on April 12th at 5pm and May 10th at 6 pm in the Board Room.
Your support is helpful and valued.
Contact Alexis for more information.
Humans of CarePlus
As a way of combating stigma and creating a better understanding of the work that staff and clients do at CarePlus, we will be launching a "Humans of CarePlus" Instagram account in May as a campaign for Mental Health Awareness month.
We need your help: if you are a staff member that would be willing to participate, or if you have a client that has a story to tell please contact Caitlyn.
We will be able to work with people who would like to remain anonymous, and think that this will be a very cool way to increase our culture of community and compassion.
Employee Assistance Program
Did you know that you have access to resources pertaining to everyday life right at your fingertips? Get educated on what is available to you through the CarePlus EAP. With this Employee Assistance Program, you will have access to information and resources for family, health, money and much more.
Login: CPNJ Password: 123
Webinar of the Month
"Home Buying 101"
Available On Demand
Starting 12pm Eastern Time
Is home ownership right for you? This online seminar will explore the advantages and disadvantages of home ownership.
If you have any questions, please contact Susan Bell in the Human Resources Department at email@example.com or call 201-843-5218, extension 5211.
CarePlus Partial Care Awarded for Outstanding Use of New Technology in Client Cloud Project
On March 2, the Partial Care Program and Care Plus NJ ("CarePlus") was awarded an IT Hero Award from the New Jersey Association of Mental Health and Addiction Agencies ("NJAMHAA") for Outstanding Use of New Technology.
CarePlus Partial Care Services are offered six hours a day, five days a week for adults with severe and persistent mental illness. The integrated approach to wellness addresses all aspects of health through a variety of skill-building groups and interactions a diverse range of healthcare professionals. The program was awarded because of the Client Cloud project and the Technology for Wellness group that was launched in 2015.
"It has been a vision of CarePlus' CEO, Joe Masciandaro, for the last few years to find a way to get technology in the hands of our clients," explained Shelby Klein, Vice President of Development at CarePlus. "At every leadership meeting, when innovation was discussed, he said the same thing: We need to enable the clients with technology so they can be engaged in their health and wellness."
The program started the Client Cloud project with grant funding from the Cardinal Health Foundation, which allowed for the purchase of Samsung tablets and Smart Boards to engage the first group of participants.
"We wanted to find a way to adopt a client facing technology that could supplement our integrated care model efforts and assist in reaching our goals of improving outcomes for our clients," Klein continued.
Read the full article here...
Good Care Collaborative Encourages Legislative Attention on Behavioral Health and Medicaid Reform
On March 4, 2016 the Good Care Collaborative ("GCC") held a site visit at Care Plus NJ, Inc. ("CarePlus") to highlight the CarePlus model of integrated care and to discuss the triumphs and barriers in providing a full spectrum of services to individuals with the most complex case management needs.
The event was organized by the GCC, which is a project of the Camden Coalition of Healthcare Providers. The GCC is a statewide coalition of consumer advocates, providers, payers and policy leaders on a mission to transform the New Jersey Medicaid system into a national model that delivers good care efficiently.
Mark Humowiecki, General Counsel and Director of External Affairs at the Camden Coalition began the morning by explaining the GCC vision and introducing Joe Masciandaro, CEO and President at CarePlus.
"We are here today, and we are working together as the GCC to ensure that people like Joe and the CarePlus team are able to continue to provide the most optimal and effective services," remarked Humowiecki.
Masciandaro welcomed the guests, who represented a number of organizations throughout the state, and proceeded to introduce Valerie Mielke, Assistant Commissioner for Division of Mental Health and Addiction Services.
Mielke touched on policies that were related to the concerns of those in attendance. The focus of the event was evident as Mielke praised the efforts of CarePlus in being the first in the state to create an effective Behavioral Health Home (BHH) model.
The state BHH model is unique in that it targets individuals who are high-utilizers in the Medicaid population. By providing adequate care coordination and case management, the CarePlus approach has been able to demonstrate positive outcomes and significant cost savings.
"Providing effective care is a lot like making a lasagna," Masciandaro explained figuratively. "You have each of the individual ingredients, and they're all great - but until they all come together it's not a lasagna. It's the same way with behavioral health care."
Masciandaro asserted the importance of the four pillars of integrated behavioral health care: primary care, mental health care, substance abuse treatment, and access to social services. A straight forward explanation of the CarePlus approach and outcomes was presented by Masciandaro and Kathy Bianco, VP of Clinical Services at CarePlus. Their presentation demonstrated how CarePlus addresses each of the four pillars through various programs and services available through the agency.
A patient-perspective panel followed the presentation, emphasizing the importance of the unique environment at CarePlus. Four staff members and one individual enrolled in the BHH services sat on the panel. The group noted that the on-site gym, primary care center and pharmacy were essential components in producing the positive outcomes. The compassion and trustworthiness of staff in their relationships with those enrolled in services was also highlighted.
In addition to reducing Emergency Room visits by 82% since 2009, the CarePlus approach helped individuals to make lifestyle changes though nutritional decisions, exercise and stress management. By taking a person-centered perspective, encouraging the individuals to take personal responsibility, setting goals, and creating action plans, CarePlus staff have been able to more actively engage those individuals in their unique wellness plan.
"Success looks different for each individual. It depends on what they are looking to achieve," explained Sean Sundberg, Director of Integrated Case Management Services and Health Management Solutions at CarePlus.
The CarePlus Health Management Solutions (HMS) team has a goal of expanding the reach of the BHH model beyond the Medicaid population so that more individuals can benefit. When asked about the difference between BHH and HMS, the panel clarified that the only difference is that the BHH model is only available for the Medicaid population whereas HMS is more encompassing.
The HMS model takes the same person-centered approach of building rapport, identifying goals, and establishing care coordination through the extensive list of programs and services available through CarePlus, community partners and external resources.
Masciandaro explained that reimbursement rates are one of the greatest threats to the sustainability of CarePlus approach. Another obstacle that other organizations may face in attempting to recreate the model involves licensing.
These barriers and other policy issues were brought to the surface during the legislative panel, consisting of Masciandaro; Joseph A. Lagana, Assemblyman for Legislative District 38; Gary S. Schaer, Assemblyman for Legislative District 36; and Jennifer Mancuso, Chief of Staff for the Office of Senator Robert Gordon, Legislative District 38.
Assemblyman Lagana acknowledged the fact that hospitals such as Bergen Regional Medical Center are facing hardships because of the Medicaid Institute for Mental Disease Exclusion which does not allow federal billing for residential mental health facilities with more than 16 beds. Assemblyman Schaer discussed the relevant policies that he is working on including the bed data dashboard, the Alameda model and Housing First. Mancuso touched on a bill that would require insurance payers to provide behavioral health coverage.
"The event was a good way to take the behavioral health conversation deeper," Masciandaro commented. "But there is a still a lot of policy work to be done so that our community-based organizations can afford to keep their doors open."
The CarePlus team is taking an innovative approach to create a statewide network of providers through Integra Health Management Solutions, LLC (Integra). Integra has been designed to act as an enhanced concierge service and provide integrated care, coordination and expertise for the most complex cases. The vision is to improve cost effectiveness, while ensuring compliance and quality.
It is important staff to familiarize themselves with the variety of program and services offered through CarePlus so that we can make appropriate referrals for those in need. For that reason, we are working on streamlining information and materials so that they are more easily accessible.
This involves appropriately updated Program Fact Sheets, comprehensive marketing folders, social media spotlights, and up to date information on the CarePlus website.
A new folder has been added to the M Drive so that staff can quickly access Program Information Sheets. These Fact Sheets can be found in the first folder in 999 General titled _FactSheets.
If you need any materials created, revised, or printed for your program or presentations you will need to utilize the electronic request form. This new system is being used to ensure timely and effective completion of projects.
You may have noticed recent Facebook posts highlighting some of our services. This is the part of our effort to market each of our programs to the community.
If you would like to put your team, group or program in the spotlight, contact the ACE team to make arrangements.
You can also send positive reviews and feedback for coworkers and clients that go above and beyond. If you have anything you would like to submit for the InsideLine, email your story and information to Caitlyn Yerves.
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What is STIGMA?
Posters and flyers are available to print from our website. Be sure to download it and share it with staff and clients!