Budgets, like tax codes, are not just fiscal documents with numbers. A budget reflects who has power, whose voice is heard, what needs are met. After the traumatic year we’ve been through, it’s good to see that we have money to spend to begin healing our State. When it comes to health care spending, it is good to see that the FY 2022-23 budget, more than any prior budget, provides help for those who really need it. The spending plan reflects a deep understanding of the complex issues in health care — and the steps we need to strengthen our health care system for all our State’s residents.
This budget emerges after a year in which we saw entrenched societal disparities play out tragically. The COVID-19 pandemic unequally affected people of color and those living in low-income communities. Which is why this budget is on target in its investments to improve maternal child health, primary care, and our public health system. While the budget includes much more on health care, I want to highlight a few of the items that the Quality Institute has supported. These are types of investments that we need, and we’re thankful our voices and the voices of our members were heard. Indeed, some of the budget items were included in our Emerging from COVID-19: An Action Plan for A Healthier State.
Increased funding to improve prenatal care for individuals who are undocumented. Previously, State funding to provide this prenatal care ran out within the first quarter of each fiscal year. Now the funding is increased to last the full fiscal year and expanded to include reproductive health, an essential element of perinatal care. The funding will support better prenatal care and critical services throughout the pregnancy and should lead to lower NICU utilization, thereby improving quality and lowering overall costs with this important investment. This will benefit about 10,000 individuals and their infants annually.
Expansion of post-partum coverage under Medicaid from 60 days to 365 days. Previously, coverage for pregnant individuals with incomes above 138 percent of the federal poverty line but below 200 percent ended 60 days after birth. This policy is short sighted given the health risks and needs during the first-year post-partum. This investment in post-partum care will enable these individuals to get the physical and mental health care they may need and give them time to transition to other insurance options.
Integrated Care for Kids. This innovative pilot program screens every child in Ocean and Monmouth Counties who is insured through NJ FamilyCare. Based on their needs, the child will receive wrap-around care from an integrated health care team and connection to community-based social services. The program’s goal is to give these kids a good start in life and enable them to thrive in their homes and communities.
Connecting Primary Care and Local Public Health – During the pandemic, we saw a disconnect between local public health and the health care system. The budget will fund the Department of Health in concert with other agencies and boards to establish and publicize best practices, including funding mechanisms, for local boards of health to actively engage with local primary care physicians and nurses to address public health at the local level and further public health campaigns. This work will support the relationships at the local level formed or enhanced throughout the pandemic and further efforts to address critical public health needs through community outreach and engagement.
Understanding Primary Care Spending – The State will now require disclosure and will annually report on the percentage of total medical expenditures that were spent on primary care services. The reporting applies to Medicaid and each of the State-funded employee and retiree plans. These data will help the State quantify how much it invests in primary care versus other health care spending. Having a strong primary care system reduces inequities and supports overall population health and wellness. As the State works to control health care spending and reduce insurance premium costs, it is important to better understand the details of overall health care spending.
Designing a High-Quality Team Based Primary Care Model – The State, through a collaboration of several departments, will conduct a market scan of State-funded, team-based primary care models currently in use in markets in the State that are funded in any part with State revenue. The State will use the scan to develop one or more models that will best serve New Jersey residents and transform primary care in the State. At the Quality Institute, we believe everyone should have access to and a relationship with a primary care provider.
A line in the budget is not the end of the work. This spending plan includes initiatives that different State departments must now move forward. The work will take people, focus, and leadership to turn these budget items into real change. We hope that the State is committed to implementing this important work. I know that the Quality Institute and you, our members, are here to help.