THE MENTAL HEALTH ASSOCIATION IN NEW JERSEY
 SUBMITS TESTIMONY TO THE CHAIRPERSONS OF
 THE SENATE BUDGET AND APPROPRIATIONS COMMITTEE


Given March 18, 2003
County College of Morris
Randolph, New Jersey

Testimony Provided by
Cathy Chin
Mental Health Association in New Jersey

Good morning Co-Chairperson Bryant, Co-Chairperson Littell and members of the Senate Budget and Appropriations Committee. My name is Cathy Chin from the Mental Health Association in New Jersey a member of the Coalition for Vulnerable Citizens and the Mental Health Coalition.

Budgets represent moral and social choices, not just economic ones, the Governor’s proposed budget reflects a policy that the state bears responsibility for children and adults with mental illness, and will accept that responsibility even in difficult fiscal times. The Governor showed what he cares about and stands for and we thank him for taking this position.

While the budget did propose increases to Redirection II and the Partnership for Children, it proposed cuts to Medicaid, Family Care, and Housing. We are concerned that these cuts may negatively impact our constituents.

Redirection II

We fully support the Governor’s proposal to fund Redirection II. This program has been the result of strong advocacy on our part for many years to reform the state mental health system from one in which consumers are institutionalized in state hospitals, to one where less expensive services are present in the community. Consumers’ experience has been that in institutions, they rarely recover. However, in the community with the right supports, consumers thrive and recover.

If not fully funded, we can expect an increase in the number of unnecessary and costly hospitalizations, disruption to people’s lives, families, and work.

We urge you to retain Redirection II at the current proposed funding level and to resist proposals that would apply those state funds elsewhere.

Partnership for Children

We are grateful to know that the Governor’s proposed budget includes increased funding which will see a federal match of $1.3 million. This initiative has been successfully implemented in a number of the state’s counties, where it has helped families with children exhibiting mental health symptoms to provide the necessary coordination of parents, providers, teachers and case managers.

The Partnership also increases the amount of services. Nationwide, there is a serious dearth of the kind of settings and supervision children require to get better. There are usually two extreme alternatives. On one end there might be a weekly 1-hour appointment. On the other end is long-term residential treatment for a few. There’s not enough in between. And if problems are not identified early, those who have long-untreated illnesses become the most difficult and the most costly to treat.

Finally, DYFS, whose primary function is to protect children and the Partnership for Children, whose primary function is to provide the best system of care and services for emotionally disturbed children, go hand in hand. Both programs must be funded. Have one without the other and tragedies will continue to occur.

We strongly urge you to keep the Partnerships proposed budget funding level. Please help us to continue to build a more accessible, flexible and comprehensive foundation of care for children who show signs of mental illness.

Medicaid, Fee for Service

• Addition of $3.00 co-payment for all medications and outpatient visits. Mental health consumers in the community often exist on extremely tight budgets and take multiple medications. When forced to choose between drugs and visits to doctors, or housing and food, many make the decision to try to “go without them.” Invariably this decision leads to decompensation, destabilization and, many times, re-hospitalization.

• Addition of $25 co-payment for non-emergency uses of emergency rooms. There is a lack of services for mental health consumers in the community. This is why Redirection II is so important. When coping strategies don’t work and consumers have no other services to turn to emergency rooms are often the only place to go. During a psychiatric crisis, it may be difficult for the consumer to ascertain whether or not s/he is experiencing a true emergency. Mental health consumers must not be penalized for periods when their judgment is poor or for the lack of alternatives to emergency rooms.

• Elimination of dental coverage for adults. The drugs mental health consumers must take to manage their illness are extremely powerful and affect the body’s ability to maintain healthy teeth and gums.

• Preferred Drug List (PDLs). We are strongly opposed to limiting the prescriber’s use of mental health drugs. Psychiatric medications are non-interchangeable. For many, it has taken years of trial, error, symptoms and suffering to arrive at the right drug.

Continuing Community Services

Staff who spend the majority of their workday providing direct hands-on intervention to clients will not receive a Cost of Living Adjustment. Because of the 24% vacancy rate, they can’t always respond in a timely fashion to consumers in need. Continued staff shortages may mean more consumers will be hospitalized, incarcerated, or displaced.

Family Care

There is an overrepresentation of mental health related issues among the poor.

Like most of the uninsured, since they are not sick enough or poor enough to access the public mental health care system, they will not receive services, unless they pay out of pocket. Most will choose to “go without” and hope their symptoms will not escalate to the point where they will have access more expensive mental health care services. In addition, the economic and emotional disruption to their families and work life will compound a crisis.

Affordable Housing

$25 million in HMFA reserves will be given to the general treasury to offset the budget gap which would mean that about 1000 units of affordable housing would not be built this year.

People with mental illness who live in unstable environments and poor housing conditions have increased emergency room visits, symptoms of schizophrenia and depression, and in-patient hospitalizations.

Housing for consumers is, among other things, a preventative and cost-effective measure.

Our mental health system, both for children and adults, remains severely under-funded and has great difficulty meeting people’s needs. Children and adults with mental illness need the opportunity to heal in the “least restrictive setting,” need their direct care service workers to be well-trained and consistent in their lives, need Medicaid and Family Care structured and available so that they can access treatment services before a crisis, and need a decent and stable place to live.
 

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