THE MENTAL HEALTH ASSOCIATION IN NEW JERSEY
Assembly Appropriations Committee Testimony on A303

Good afternoon, Chairperson Watson Coleman, Vice Chairperson Pou and members of the Assembly Appropriations Committee. My name is Cathy Chin and I am the Legislative Advocate for the Mental Health Association in New Jersey, a statewide advocacy organization whose goal is to promote mental health and defeat mental illness. Thank you for this opportunity to speak on behalf of an issue that is of great concern to consumers of mental health services. I would also like to thank Assemblyman Gusciora for his efforts to improve the lives of mental health consumers in recovery and for his continued advocacy on behalf of people with mental illness.

The Mental Health Association in New Jersey is in full support of Assembly 303.

Presently 2,700 of the 3,700 patients admitted yearly to New Jersey State and county psychiatric hospitals are not covered by insurance. These 2,700 who do not have private insurance, whose private insurance has run out or who are Medicaid recipients, are liable for all costs associated with hospitalization and can expect a bill of $12,300 per month of stay. Unlike psychiatric units in community hospitals and all hospitalized medical treatment, mental health consumers are not eligible to receive Charity Care in state and county psychiatric hospitals. In addition, upon discharge from a state or county psychiatric hospital, the consumer or parent/guardian will immediately have a lien filed against them to satisfy the debt owed to the state for hospitalization.

We ask for uniformity in the assessment of responsibility for payment for treatment between private and public mental health institutions and between medical and psychiatric in-patient treatment.

We also ask that consumers, upon discharge from a psychiatric hospital, not have a lien automatically filed against them. That a lien only be used in the event of non-payment. We ask that mental health consumers be treated like everyone else who owes money or takes out a loan.

New Jersey’s Institutional Lien Laws were first conceived in 1918 when recovery for the bulk of chronic cases was largely beyond the realm of possibility and custodial care, rather than treatment, was the paramount function of the institutions.

Thankfully today, the prospects and possibilities for people with mental illness are significantly different. For most people with mental illness, recovery is not only a possibility, but a reality. Many mental health consumers are now able to secure employment as productive, taxpaying members of our communities. Imagine their surprise when, in preparation for a new job, they try to take out a loan to buy a car and find that they have a $30,000 lien from their institutionalization at a state mental hospital years ago. Liens have not only proven to be demoralizing, but also setbacks to recovery for people with mental illness and may ultimately increase rather than decrease their dependence on the state for services.

In 1918 placing a lien on property did not impede a patient’s treatment which often meant lifetime institutionalization. Today, liens are impeding the twenty-first century treatment goal of recovery and independence for people with mental illness.

As I understand the DHS Amendment to A303, a consumer either pays in full for treatment or can request a payment plan from a panel which has procedural guidelines which are left to individual interpretation and may be inconsistent over time.

At present mental health consumers can and some do ask for payment compromises from appropriate personnel in the hospital, county, or state. Though appreciative of the possibility for a manageable payment plan, results are individual and inconsistent.

As you know, there is no argument with payment for services. But payment must be based on a fair, standardized and publicized schedule. And because many consumers are at or near the poverty level, payment must be based on a sliding fee scale.

In closing, we feel in is incumbent upon the state to have a goal for people with mental illness that takes into consideration parity and recovery. We believe A303 is a step toward achieving a goal that is practical, humane and just.

 

Back to top