State creates one license for providers offering primary care, mental health and addiction services
Credit: (AP Photo/Thibault Camus)For at least a decade, health care providers, state regulators and advocates worked to rewrite the rules governing outpatient facilities – rules that barred providers from offering both physical and mental health treatment unless they followed a complex licensing and regulatory process.
Under this fragmented system, facilities offering primary care, mental health and addiction treatment services in a single location were required to use three separate licenses, each with different regulatory requirements. The rules also required providers to keep separate medical records when a patient received physical and behavioral health services and required patients to use separate entrances to medical buildings when receiving different types of health care.
As a result, patients were often forced to visit multiple places to receive complete care. Concerns about this patchwork response only grew in the wake of the COVID-19 pandemic, which increased rates of anxiety, depression and other mental health issues across the state.Now New Jersey has revised its license requirements for outpatient treatment, writing new rules to allow for integrated outpatient care, a move hailed as landmark reform.
“These rules put people first, by letting them walk through one door and receive all the care they need,” said Jeff Brown, a former acting state health commissioner. “That means less red tape for providers to meet their patients’ needs. And it means a simpler path to better outcomes for New Jerseyans.”
Health care works best, he said, when patients are treated as a whole person rather than “a collection of separate problems.”
New Jersey Health Care Quality Institute had long advocated for a single, integrated license for outpatient healthcare facilities and called the rules change a “significant and long-overdue” step toward delivering “truly whole-person care.”
“Ultimately, this approach supports better care coordination, improves the patient experience, and expands access to comprehensive services across the state,” Kate Shamszad, the vice president of policy at the nonprofit told NJ Spotlight News in a statement.The recent shift has also been backed by academics, including Ann Nguyen, a research professor with the Rutgers Center for State Health Policy who has studied integrated care efforts in New Jersey, a state where over 20% of patients in primary care have some behavioral or mental health condition and about one-third have a substance use disorder.
“The previous, outdated rules made it very difficult for a primary care doctor to also treat for behavioral health and addiction under the same roof, because the doctor would have needed to hold multiple facility licenses. And those licenses were not easy to obtain,” said Nguyen, who called the reform “tremendous for New Jersey.”
The integrated license is intended to benefit several types of outpatient facilities, including Federally Qualified Health Centers, outpatient mental health and substance use disorder providers and licensed primary care clinics, according to the state.
The newly adopted rules include key improvements, including provisions that allow facilities to maintain unified medical records for patients and eliminate requirements for separate physical spaces and entrances. The new rules also enable shared treatment spaces and expand access to withdrawal management services and medications for addiction treatment.
Brigitte D. Johnson, the president and CEO of Care Plus NJ, said she is hoping that the new rules will streamline the process of applying for a license and reduce the time it takes to receive a response on a licensure application.Care Plus NJ, a non-profit based in Paramus, provides behavioral health services, medical care and social services through dozens of facilities in northern New Jersey and is looking to expand. Johnson said she hopes the new rules will make it easier to expand services provided by the nonprofit in order to improve access to care for people in need.
Dawn Apgar, a former deputy commissioner for the state Department of Human Services, told NJ Spotlight News that this shift in policy is a “step in the right direction” but noted challenges could still remain in the implementation of the new rule.
“As a state official, it’s always difficult to make systemic changes, especially across departments. I have to applaud this administration for looking at inter-departmental collaboration,” said Apgar, now an associate professor at Seton Hall University.
“This is a great example of how state government is keeping up with the times in that we now recognize integrated care and it will hopefully continue to destigmatize mental health and substance use treatment,” said Apgar.
The rules will take effect once published in the New Jersey Register, according to the state, which is anticipated in February.
As a multimedia mental health reporter for NJ Spotlight News, Bobby focuses on underserved and rural communities throughout New Jersey via a partnership with Report for America. He earned a master’s in journalism from New York University in May 2022 and completed internships at The Scranton Times Tribune, his hometown newspaper, and New Mexico In Depth before joining NJ Spotlight News. Follow him on Twitter at @bobby_brier or send him an email at brierb@njspotlightnews.org.