Mental Health Care Providers to Get Less; Cape Counseling Projects $1.1-Million Deficit

CREST HAVEN – Cape Counseling Services projects a deficit of $1.1 million and an inability to serve over 1,500 clients, if the planned July 1 implementation by the state Department of Human Services, Division of Mental Health and Addiction Services of “fee-for-services” takes place.
That would place a “burden on the county…and its municipalities,” according to a resolution passed by freeholders May 9.
The two-page resolution urged, among other actions, the state to “put fiscal safeguards in place during the transition to fee-for-services or delay the July 1, 2017, implementation.”
The resolution noted that community-based providers of behavioral health services, such as Cape Counseling Services, assist “thousands of our county’s most vulnerable adults, children, and families with a full range of publically-funded programs each year.”
According to Greg Speed, chief executive officer of Cape Counseling, letters have been sent to about 5,500 clients who rely on the agency’s services. Speed noted that his agency gets $3.2 million annually from the state for outpatient programs, along with psychiatric and therapy services as well as drug and alcohol services. Each month the agency gets a 12th of that funding.
Fee-for-service will remove that “safety net,” Speed said. The problem is heightened when patients fail to arrive for appointments, he said. Many who require mental health services lack transportation to the facility, and thus a professional’s time is lost.
As an example, Speed cited $365 per hour for a psychiatrist. Under the fee-for-service rate plan, “we will lose about $140 in terms of lost revenue compared to what we have in the (present) contract.”
Without state action, which Speed said legislators are attempting to take, clients lacking the ability to pay would be refused service.
Such action, he fears, would have an adverse impact on physicians, hospitals and possibly the county jail. The resolution stated similar sentiments.
The present system allows Cape Counseling to treat clients regardless of their ability to pay. Should fee-for-service be implemented, those lacking funds would be referred to their primary care physician or Complete Care Health Network, Speed said.
“State dollars were a safety net,” said Speed. He added that the new fee-for-service plan does not take into consideration costs that agencies, such as Cape Counseling, must absorb, such as staff and building upkeep, that are not allowed as billable time.
Further, the resolution stated that “with the implementation of fee-for-service, mental health providers are projecting losses from $230,000 up to $1.3 million per agency annually because some services will no longer be reimbursable or rates are too low.”
“…People with serious mental illness miss doctor’s appointments 20 to 30 percent more often than the general public,” the resolution added. “Which would create a hardship for agencies in a fee-for-service system because staff must be paid.”
Additionally, freeholders asked peers in all 20 counties to take action by adopting similar resolutions. Speed cited some providers in North Jersey that began the fee-for-service Jan. 1. “Already they are $100,000 in the hole. The state tells you the feedback it is getting is really positive,” said Speed.
A copy of the resolution was to be sent to Gov. Chris Christie and 1st District legislators Sen. Jeff Van Drew and Assemblymen Robert Andrzejczak and R. Bruce Land.
Speed said Van Drew understands the situation, and was encouraged at the questions the senator asked at a recent Senate Budget and Appropriations Committee hearing. Speed cited a Senate bill (S3121) sponsored by Sens. Robert Gordon, Anthony Bucco and Robert Singer that would provide a $90-million cushion to ease providers into the fee-for-service system if clients are unable to pay.
He also cited an Assembly bill, (A4146) that would provide for monitoring and evaluation of transition of mental health and substance use disorder treatment service system.