Christie to review mental health services under violence plan

Posted: January 24, 2013

Gov. Christie vowed last week to review New Jersey's mental-health services as part of a "violence control" plan following the Sandy Hook school shooting.

Mental-health-care advocates say Christie could improve services by expanding programs that already exist, including Medicaid, and broadening the mental-health disorders covered under health insurance for state workers and public-school teachers.

New Jersey is one of only eight states that do not offer workers equal benefits for mental and physical ailments, said Paul Lubitz, associate director of the New Jersey chapter of the National Alliance on Mental Illness.

Although the state plan covers some mental disorders equally, it does not offer the same level of benefits for eating disorders, posttraumatic stress disorder, and drug and alcohol addiction. Since 1996, the state has given equal mental-health benefits only to "biologically based" disorders, a term that mental health professionals say is inaccurate.

Barbara, 62, of Morris County, told a state Senate committee last week how she and her husband used their savings and refinanced their house to pay for a year of residential treatment for their daughter, who has anorexia and bulimia.

Yet Barbara's son, who was diagnosed with diabetes, was fully covered for his illness.

"All his care, all his hospitalizations, all of it has been completely covered," said Barbara, who asked that her last name be withheld to protect her daughter's privacy.

The seven other states that do not offer equal mental-health benefits in state worker plans are Alabama, Alaska, Georgia, Michigan, Mississippi, Oklahoma, and West Virginia.

Those are "states that are thought of as the most regressive when it comes to health care," Lubitz said.

But even states that agree to offer their workers full mental-health benefits can have loopholes. Pennsylvania offers full parity, but many counties opt out of it, Lubitz said.

Last Wednesday, as a part of a package of executive orders, President Obama finalized regulations that advocates say should close loopholes in federal law on mental-health-care parity.

In Trenton, Sen. Joseph Vitale (D., Middlesex), chairman of the Health, Human Services and Senior Citizens Committee, has sponsored a bill that would require New Jersey to give its workers health insurance that equally covers all mental illnesses recognized in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Vitale's bill was moved from committee Jan. 14. It awaits action in the Assembly.

Members of Christie's press office said they were not aware of the specifics of Vitale's bill and therefore could not immediately comment.

Democrats recently called on Christie to "fully fund" another mental health program that Lubitz said could help people who pose a danger to themselves or others but refuse treatment. The involuntary outpatient commitment law allows the court to mandate people to outpatient treatment if a qualified mental-health professional determines they are a threat to themselves or others.

The bill, signed into law in 2009, was proposed in response to the 2002 murder of an 11-year-old Marlton boy by a man diagnosed with paranoid schizophrenia who had refused treatment. Christie put $2 million toward the program, which was estimated to cost $10 million to fully implement.

Human Services Commissioner Jennifer Velez said Tuesday that the program had taken time to establish, and the governor had given the department all the money it had requested. The bill had not been funded until Christie put $2 million toward it in fiscal year 2012. That money has lasted for two years, Velez said. It may not cost the full $10 million, she said.

"It was our best estimate at the time," she said. "We're really evaluating what the need is."

Christie put $5 million toward mental-health care in the budget that began July 1, Velez said, and that included an increase in community counseling and housing. The involuntary outpatient commitment program is just one part of what is needed to help more people receive mental health help, she said.

Democrats have urged Christie to expand Medicaid eligibility, an option under the federal Patient Protection and Affordable Care Act. The New Jersey Policy Institute, a left-leaning think tank, estimates that expanding eligibility for the health insurance program would give benefits to an additional 318,000 New Jerseyans, many of them working at wages too low to afford their to buy their own insurance.

Under the federal health care law, states can offer Medicaid to a larger group of people. Currently in New Jersey, a single person who makes $2,520 or less is eligible for the program. A family of four with an income of $30,657 or less is eligible.

Should Christie decide to expand the program, the new maximum income for a single person would be $15,414 annually. A family of four earning $31,808 or less would qualify under the expanded program.

The federal government would pay the full cost of the expansion for three years beginning in 2014. In 2017, the states would take on 5 percent of the cost of those additional Medicaid recipients, and by 2020 the state's cost would increase to 10 percent.

Currently, the cost of Medicaid is split evenly between the federal government and the state.

Contact Joelle Farrell at 856-779-3237 or or on Twitter at @joellefarrell.

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