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Governor Murphy’s budget holds significant promise for the future of complex care in New Jersey

March 29, 2018
Camden Delivers patient holding her baby

By David Scholnick and Amy Yuen

When New Jersey Governor Phil Murphy released his much anticipated budget proposal on March 13, the Camden Coalition was pleased with his priorities in the areas of maternal health and treatment for opioid use disorder. Governor Murphy called for adding $244 million in public support to Medicaid, which now covers 1.8 million Garden State residents. He also pledged $100 million to the Division of Mental Health and Addiction Services and $7.5 million for women’s healthcare services at Planned Parenthood and other community clinics.

CEO Kathleen Noonan said that the plan holds significant promise for the future of complex care in New Jersey. “Governor Murphy’s budget proposal is a strong starting point to ensure better care for our state’s most vulnerable residents,” she said. “Our patients with the most medically and socially complex challenges include people with opioid addiction and women with chronic illness who are of maternal age. By expanding healthcare access to these groups, we can reduce avoidable hospital stays, emergency room visits, and lost lives. Addressing these issues will have a significant impact on the state’s overall health.”

Mortality rates related to pregnancy and opioid use are rising throughout the state. New Jersey is seeing growing racial disparities in maternal and infant mortality. It stands 35th in the country in pregnancy-related deaths. Communities statewide are also experiencing the devastating effects of the lingering opioid crisis; over the last decade, five thousand residents have died from heroin and opioid overdoses alone.

Here in Camden, we have been providing intensive, community-based care management for over 15 years to residents with multiple chronic illnesses, many of whom have also struggled with addiction. We also work closely with women in Camden of childbearing age who face such complex health and social challenges as chronic disease, homelessness, and addiction through our Camden Delivers program. Through our collaborative work to improve care for people with complex needs along with national and local partners such as the Addiction Medicine Program at Cooper Hospital, we have found that solutions to issues like the ones identified by Governor Murphy require community-based, data-driven models that address both health and social challenges.

 
A commitment to the principles of complex care

The governor’s budget proposal demonstrated a commitment to the principles of complex care, which depends on care coordination and access to comprehensive data. Complex care is flexible, interdisciplinary, evidence-based, and centered on the needs, goals, and circumstances of the individual. Our care management intervention, often referred to around the country as “the Camden model,” distinguished the Coalition as a pioneer in the field of complex care.

Another program that developed from our care management intervention is our Housing First program, which follows an evidence-based housing model that ends homelessness for individuals facing long-term housing challenges. Since the program’s inception, the New Jersey Department of Community Affairs has issued 65 housing vouchers, and the program has been associated with a more than 60% drop in emergency room and inpatient hospital use among its participants. Housing First is a lifeline for those struggling with chronic illness who once had patterns of high hospitalization and emergency room use.

Through our work in Camden, we have learned that a major barrier to tackling the complex health and social needs of our patients is the fragmentation of different sectors like healthcare, housing, criminal justice, and social services. To better understand the challenges faced by residents with recurring histories of hospitalization and incarceration and expand care management services to inmates at the Camden County jail, we recently initiated Camden RESET in collaboration with the Camden County Re-Entry Committee. The program uses data to identify and help patients gain the skills and support they need to improve their wellbeing by avoiding preventable hospital admissions and arrests. Still in its pilot stage, the program has already enrolled a dozen participants since launching in December 2017. If successful, Camden RESET will save taxpayer dollars allocated toward healthcare and incarceration while it gives returning citizens a hand up in managing their illnesses.

“I am optimistic that this budget will be a national example of how to reform healthcare for our most vulnerable residents,” said Kathleen. “Now is the time to bring data-driven, whole-person care to more people with complex health and social needs in New Jersey.”

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