HMH’s latest move on behavioral health could become model for the state, country

By Tom Bergeron
Neptune | Sep 23, 2019 at 3:00 am
Editor’s Desk

Bob Garrett remembers the moment well.

He and other key members of the Hackensack Meridian Health family were listening to noted mental health advocate Patrick Kennedy talk about not only the need for more services, but a better vehicle in which to provide them.

“It was about two years (ago) at a behavioral health symposium that was sponsored by Jersey Shore University Medical Center,” Garrett told ROI-NJ. “We had board members, community leaders, executives and physician leadership there.

“He talked about the staggering statistics around behavioral health and what it’s doing to our society. He was so inspirational that we felt we really needed to do something more. We felt we needed to step up.”

Garrett and HMH were in position to do just that.

The health system, always seemingly one step ahead, joined forces with Carrier Clinic soon thereafter. The combination, Garrett said at the time, would enable two leading health care organizations to find better ways to serve those with behavioral health needs.

The latest example of this was introduced last month, when HMH launched a medically integrated urgent care center with behavioral health at a facility across the street from Jersey Shore University Medical Center in Neptune City.

Garrett, speaking Friday at the official ribbon-cutting of the facility, said incorporating urgent care centers into behavioral health treatment is just another part of HMH’s comprehensive strategy to improve access to, better coordinate care and innovate treatment for people struggling with mental health issues and addiction.

The model is believed to be the first of its kind in the country.

Patients who utilize the new urgent care center will have access to a behavioral health team including mental health technicians, licensed clinical social workers, advance practice nurses and, if required, a psychiatrist through telemedicine.

HMH officials said these new behavioral health services will improve treatment the following ways:

  • Increase access to treatment for behavioral health patients in an appropriate setting;
  • Provide more timely care for people who may have to wait to see a specialist;
  • Reduce the burden on already stressed hospital emergency departments;
  • Provide more coordinated and comprehensive care to improve patient outcomes;
  • Address the stigma associated with mental health by affording patients a safe and confidential place to access the care they need;
  • Provide immediate access to more intensive care it necessary.

“I feel as if we’ve taken how we’re going to care for people with mental health issues to a different level,” Garrett said. “This coordinates a lot of care under one roof.

“It was so fragmented before. Some patients were going to the emergency department while some patients were waiting for individual psychiatrists to see them, sometimes weeks or months later, when they were in crisis.”

Urgent care centers, Garrett said, can offer a speed of service that emergency rooms — operating in a triage setup — often cannot.

“They have to compete in that setting with patients who have had heart attacks, patients who have had strokes, patients who have been in motor vehicle accidents,” he said. “Under one roof in urgent care, they literally can be seen within minutes by an advanced practice nurse and then, within minutes, get a psychiatric consultation with a psychiatrist through tele-psychiatry if that’s what is needed.

“We just think it makes so much common sense. It provides better access to care. And we believe it will result in better quality outcomes and will reduce costs for the overall health care system.”

HMH is not the only one who feels that way.

Garrett said all of the state’s major insurers — most notably Horizon Blue Cross Blue Shield of New Jersey — are on board.

Garrett does not have a timetable on how quickly the idea will roll out to the approximately three dozen other urgent care centers that HMH is connected to throughout the state. But, he said, it will be sooner rather than later.

“I wouldn’t be surprised if we can start to roll this out if not by the end of this year, certainly early next year,” he said.

Though the program is just a month old, Garrett said he already is getting calls from other health systems — in the state and across the country — who want to hear more about the program.

Kennedy, who spoke passionately about the subject at the ribbon-cutting, said he is thrilled to see so much movement on the issue.

The former eight-term congressman from Rhode Island who now resides in Brigantine said it’s time for behavioral health treatment to be the same as the treatment for other ailments.

“This is the biggest public health crisis you could imagine,” he told ROI-NJ. “And our response to it has really been anemic. I sponsored the Mental Health Parity and Addiction Equity Act when I was in Congress, and it said that we should no longer discriminate against patients who need mental health and addiction treatment.

“The challenge is how we begin to pay for mental health and addiction services in the same way as we would diabetes, cardiovascular disease and cancer. Other ailments are paid for in a whole series of interventions. That’s the kind of wrap-around services and chronic care management we need for behavioral health. That’s going to be the thing that keeps people from coming back to emergency rooms or getting arrested and ending up in our jails, which are full of people with untreated mental illnesses and addiction.

“The benefit of what Hackensack Meridian Health has done is that they’ve set up this whole continuity of care continuum where they have inpatient addiction care being built out, so people don’t have to fly to some other state to get the care. That kind of integration is what we really need. And it’s what this urgent care center demonstrates that we can do.”

Kennedy applauded the insurance companies for getting on board. But, he cautioned, health care providers need to lead the way correctly.

“We need to demand insurance companies pay, but we also need to demand that the providers provide quality care,” he said. “And frankly, paying for more care or more expensive care doesn’t necessarily guarantee better quality.”

Behavioral health remains a passion play for Kennedy. And he’s thrilled the one he made a few years back is having such an impact.

Garrett is as well.

“I gave Patrick a shout out for being there then and I’m giving them another shout out for being here today when we’re doing something again novel by opening the first behavioral health care or urgent care,” he said. “This is something we need to do.”