Christie unveils $200M, 25-initiative plan to fight N.J.’s opioid crisis

Gov. Chris Christie unveiled his plan to fight the opioid crisis in New Jersey on Tuesday afternoon, discussing some of the 25 new initiatives he will implement at a cost of approximately $200 million.

Speaking at Integrity House in Newark, Christie said the time has come to find and fund new initiatives to fight what he has declared a public health crisis in the state.

More so, he said, the programs will be funded by a diversion of state funds — budget elements he said will not impact other services or taxpayers.

“This will not involve any kind of significant reduction of any program, nor will it involve the need for an increase in taxes,” he said.

Calling it the last major spending initiative of his eight years as governor, Christie said it was the most important because it impacts all members of society — and their families and friends — regardless of social-economic status.

The initiatives, he said, not only will be different from those tried before, but judged — and funded — on their effectiveness more than their intention.

“We want to get to evidence-based treatment and evidence-based prevention,” he said. “You’re going to have to show us that you are getting results. We no longer are going to fund programs — whether they are treatment programs or prevention programs — that don’t provide results, just because they make us feel good.

“What makes ultimately us feel good is having programs that actually work and help people who are in treatment to stay in recovery and help those who have not yet entered the world of addiction to not enter that world.”

Christie, citing the lack of time he has left in office, said the programs will begin as soon as possible.

“We have requests for proposals ready to be issued for these programs,” he said. “They are going to be issued in the next week. We will be awarding contracts before the end of the year. And these programs will start before I leave office … we’re not going to leave this for the next person.”

And, while Christie is leaving office, he hopes the program will have impact in New Jersey and, potentially, the rest of the country.

“We hope and trust that this will become the national model for states across the country,” he said. “We’re doing it not only for the people of the state of New Jersey, but we’re doing it in our role as chairman of the President’s Commission on Opioid Addiction to set an example for the president and his administration and Congress and for the rest of the country.”

Here’s a look at some of the initiatives, as released by the Christie administration:

Incentive-Based Opioid Recovery Pilot Program. The New Jersey Division of Mental Health and Addiction Services is being allotted $40 million to create an Incentive-Based Opioid Recovery Pilot Program, improving care for low-income adults, on Medicaid or uninsured, who need inpatient treatment. An RFP will be issued immediately and operational funding awards will be issued in October for three pilot sites to establish a program of holistic care for individuals in this population who have severe opioid-use disorders. Performance-based incentive payments will be made available to providers for hitting retention, relapse prevention, housing and employment benchmarks.

Recovery Coach Program. The Division of Mental Health and Addiction Services is being allocated $21 million for the expansion of New Jersey’s life-saving Recovery Coach Program for adults with substance-use disorders. This expansion will be done in three ways: establishing post-treatment recovery coaching; serving all overdose admissions to partner hospital emergency departments, beyond the current offering for those who have received Naloxone; and linking Recovery Coaches to people in treatment programs at Mid-State and Edna Mahon Correctional Facilities to sustain recoveries and break the costly cycle of recidivism. In 2016, there were 1,243 reversals seen in the Emergency Departments by the Recovery Coaches.

Residential treatment for pregnant women and new mothers. The Department of Health will use $5 million to create residential treatment for pregnant women and new mothers with substance-use disorders via a new program in each of the northern, central and southern regions of the state. Since 2011, around 6 percent of all infants born in New Jersey experienced neonatal abstinence syndrome, just one of the reasons for DOH to expand treatment and recovery options, including sober housing opportunities, for this critical population of adults. Grant awards are to be made by the end of October.

Supportive Housing. The Division of Mental Health and Addiction Services will be using $36 million to expand Supportive Housing for adults with substance use disorders. This program provides housing, as well as services that are individually tailored, including job coaching and interviewing skills, to help people sustain their recoveries by leading stable and productive lives.

Keeping Families Together program. The Department of Children and Families will expand the successful Keeping Families Together program with $20 million in additional funding in the regions of Salem, Cape May, Passaic, Essex, Middlesex, Camden and Atlantic/Cumberland/Gloucester counties. The DCF also will issue RFPs and make awards in December for programs to be created in the regions of Bergen, Burlington, Hunterdon/Mercer/Somerset/Warren, Monmouth/Ocean, Morris/Sussex and Union counties. This program provides supportive housing and services for high-needs families involved with the Division of Child Protection and Permanency, preventing or reversing homelessness and housing instability, reunifying those whose children are at risk of or in out-of-home placement and serving those who are facing at least two additional risk factors or co-occurring challenges including substance use disorders, mental illness and domestic violence.

Narcan. The New Jersey Department of Corrections is allocating $1.2 million to train DOC custody staff on the administration of Narcan and provide each staff member with a dose to carry on their person in case of an inmate emergency. The funding also will provide one Narcan dose to each inmate being released, estimated to be about 10,000 each year. Since April 2014, there have been more than 32,000 deployments of Narcan by law enforcement and EMS agencies throughout New Jersey including more than 9,500 deployments for 2017 thus far.

Substance Use Navigators. The New Jersey Department of Children and Families is increasing funding for Substance Use Navigators that serve youth with substance-use disorders, their families and community partners working with DCF’s Children’s System of Care by $1.5 million, doubling the amount of funding that was already available through a pending RFP. The RFP now provides $200,000 for each of 15 service areas for navigators, who will link families and youth with existing resources and coordinate work among the Care Management Organizations, the courts, local law enforcement, Division of Child Protection and Permanency, treatment providers, schools, pediatricians and community organizations such as the Human Services Advisory Council and the County Substance Use Coordinator. In addition, DCF is using $60,000 of state funding to work with partners to develop a certificate program for Division of Child Protection and Permanency staff to train them and build capacity within the DCP&P workforce to serve children and families affected by substance use and co-occurring mental health disorders.

On-campus recovery programs. The New Jersey Division of Mental Health and Addiction Services is increasing spending by $8 million for colleges and universities to provide on-campus recovery programs, giving each New Jersey public college and university the ability to apply for grants of up to $1 million in order to invest in substance-free housing and supportive services for students in recovery. Seven of New Jersey’s 13 public colleges and universities are subject to a 2015 Campus Recovery Housing law that requires dedicated substance-free housing for students by 2019.

Certified Alcohol and Drug Counselors. The New Jersey Department of Labor and Workforce Development is allotting $1.32 million to expand a pilot program to prepare individuals to be Certified Alcohol and Drug Counselors currently operated through the Health Care Talent Development Center managed by Rutgers University. The additional funds will expand the pilot by selecting a New Jersey college or university to lead a multicollege partnership to deliver CADC training statewide. The colleges will deliver this training to individuals who are current employees of nonprofit organizations serving at-risk populations as well as individuals who are unemployed and committed to pursuing a career in this field. LWD will contribute $6,000 per individual to be trained. It is expected that 220 individuals will receive training through this investment.

Decreasing the incidence of substance-exposed infants. The New Jersey Division of Mental Health and Addiction Services is spending $1 million to decrease the incidence of substance-exposed infants. DMHAS will identify the counties that have the highest incidence of women who are pregnant and have an opioid addiction and then provide funding to support the hiring of certified alcohol and drug counselors to work at prenatal clinics or other health clinics.  The counselors will work with the clinicians to identify women using substances during pregnancy and provide referral, linkage and case management services to facilitate access to treatment services, including medication-assisted therapy, with the goal of improving outcomes for pregnant women who are dependent on opioids. Data from the NJ Division of Medical Assistance and Health Services indicated there were 528 Neonatal Abstinence Syndrome births to 41,829 Medicaid mothers in 2014.

Opioid education campaign for obstetricians. The New Jersey Department of Health is working to reduce the number of babies born with neonatal abstinence syndrome by allocating $1 million for an opioid education campaign for obstetricians. DOH will address the barriers obstetricians face when addressing substance use with their patients as well as provide doctors with materials on prevention, recognition, response and reporting. Obstetricians also will receive opioid education during regional roundtables, as well as during Grand Rounds.

Prescription Monitoring Program. Roughly $1.8 million will be invested to increase the performance of New Jersey’s nation-leading Prescription Monitoring Program, which saves lives by preventing doctor shopping and the overprescribing of opioids. In October, the Division of Law and Public Safety, in partnership with the Office of Information Technology, will invest up to $1 million to create an Integrated Drug Awareness Dashboard that will facilitate and increase access to vital information sharing between state agencies. The Attorney General’s Office will invest $800,000 to implement software that will leverage PMP data and other sources, including mortality data from the Medical Examiner’s Office, to analyze and identify problem areas related to the opioid epidemic and indiscriminate prescribing of controlled dangerous substances.

New Jersey’s PMP is successfully collaborating with 12 other states. NJPMP data shows that prescribers in New Jersey are making use of the ability to view cross-border prescription data. In 2016, the interstate hub enabled 1,015,897 prescriber data requests between New Jersey and our interstate partners, a 512 percent increase from 2015. During the first five months of 2017, the interstate hub enabled a total of 824,138 prescriber data requests between New Jersey and our interstate partners, a 274 percent increase from the same period in 2016.

Medical Examiner’s Office. The state Medical Examiner’s Office will use $1.75 million to improve efficiency by bolstering laboratories, technology and staff resources, ensuring that toxicology testing covers all known substances, including analogs, and all state and county medical examiners can access an upgraded central database to input the most-in depth findings and indicators for tracking death statistics.

Training of Department of Corrections staff. As much as $2 million will be spent for ongoing training of Department of Corrections staff members through a partnership with Rutgers University. Mid-State and Edna Mahon Correctional Facility custody and civilian employees are partaking in a customized 20-hour workshop related to treatment, drug diversion, confidentiality and other important topics.

Youth recovering from substance-use disorder. The New Jersey Department of Education is facilitating the funding of $2.7 million aimed at helping youth recovering from substance use disorder. Most of the funds — $2.4 million — will pay for tuition and transportation for up to 30 students attending Knowledge, Empowerment, Youth and Sobriety Academy in Matawan, which will open on Oct. 1 to create an academically innovative and supportive environment to eliminate the achievement gap for those aged 14-21 diagnosed with substance use or dependency disorder who are seeking a sober lifestyle. The money also will expand learning opportunities for 30 students attending Raymond Lesniak Recovery High School in Union County. DOE is also providing $200,000 to hire two re-entry/recovery professionals to work with students, families and school staff to provide support for students transitioning back to their home schools, following their attendance at a Recovery High School. DOE also will offer $100,000 in grants to begin the process of planning a Recovery High School in South Jersey.

Peer Recovery Support Services. The New Jersey Department of Children and Families is allocating $5 million to develop Peer Recovery Support Services for parents with substance-use disorders involved with the Division of Child Protection and Permanency. The goal is to reduce the risk of harm associated with parental substance use disorders and improve child welfare outcomes, including safety, stability and reduced repeat maltreatment by increasing the rates of treatment engagement, treatment completion and recovery stability among parents. DCF will deploy two peer recovery specialists, trained in both recovery coaching and child welfare case practice, in all 21 counties.  The specialists will work with parents to develop a self-directed recovery plan that incorporates child welfare goals, and will provide services to facilitate treatment admission, support during the treatment process and post-treatment recovery stability and relapse prevention planning. The specialists also will be available to outreach parents who are reluctant to engage in formal treatment services to provide motivational interventions and support a path to recovery.

Drug and Alcohol Counselors. The New Jersey Juvenile Justice Commission is hiring five additional Drug and Alcohol Counselors at a cost of about $500,000 to ensure parolees continue substance abuse treatment once they reenter the community. One position will be placed at Warren to increase appropriate individual attention; one position will split time between Northern Regional Transitional home and Green Residential; and three counselors will rotate between JJC’s parole units in Camden, Newark and Trenton/New Brunswick.

Consumer Helpline. The Department of Human Services Division of Mental Health and Addiction Services is increasing funding by $1 million to expand the capacity of a Consumer Helpline that assists individuals and families attempting to access treatment but are faced with real or perceived barriers of their insurance.

Gap analysis. The New Jersey Department of Health is hiring a data/software vendor to do what is called a “gap analysis.” The amount to be spent will be determined by the contract, and this vendor will work with various state agencies to determine where the state’s data collection systems are lacking, where coordination could be improved and where there could be additional technology for data collection, analytics and/or dissemination of actionable information to those involved in battling substance abuse, including mining social media platforms for illicit drug transactions and emerging trends and providing information about the opioid crisis to local law enforcement and health departments.

Medication-Assisted Treatment. The New Jersey Department of Corrections is receiving $5.2 million for increased availability of what is known as Medication-Assisted Treatment for prisons and county correctional facilitiesDOC will provide $1.2 million for MAT for approximately 200 inmates with Opioid Use Disorders. MAT will be provided for six months to the inmates so that clinical staff can monitor the clinical stability to verify treatment effectiveness, engage the offender with their navigator prior to release and to prepare the inmate with transition to a community provider for continued treatment. DOC will make a total of $4 million in grant funds available to County Correctional Facilities to increase their MAT offerings to individuals with opioid use disorder.

Syringe Access Program. The New Jersey Department of Health will receive $2.1 million to increase the number of Access to Reproductive Care and HIV Services nurses at the each of the five existing Syringe Access Programs and at two new sites to be operational by the end of the calendar year.  The expansion will increase prevention, recognition and referral services for injection drug users. In the past year, four Syringe Access Program nurses successfully counseled and referred 154 people into treatment. In addition, Syringe Access Program nurses have integrated naloxone training and distribution into program services, educating 147 clients, which resulted in reversals. The additional funds will double the number of nurses, who work with the most at-risk population, current injection drug users.

Screening, Brief Intervention, and Referral to Treatment Program. DMHAS will receive $2 million to continue what is called the Screening, Brief Intervention, and Referral to Treatment program. This evidenced-based practice is used by primary-care practitioners to identify and prevent substance use. The program provides a brief intervention to individuals screened as being at risk of a substance-use disorder and refers individuals to appropriate treatment who screen as needing services. Resources will cover training and the dissemination of this program model along with funds to cover the costs for screening and brief intervention for individuals who do not have insurance. To date, more than 47,000 adults have been served and, since November 2013, any substance use among participants decreased by 13.9 percent from intake to follow-up.

New Jersey’s Housing First program. The Department of Community Affairs will receive $1.2 million to expand New Jersey’s Housing First programThis expansion will serve an additional 100 people who are long-term homeless and who have an opioid addiction. Vouchers will be targeted to the six counties with the highest number of substance use admissions for use of heroin or other opioids: Ocean, Camden, Essex, Monmouth, Atlantic and Middlesex.  Qualified nonprofit agencies will assist participants identified for these vouchers in locating apartments and will be required to provide case management to assist participants in accessing behavioral health and other services to address their addictions, improve their income and live independently in safe, stable permanent supportive housing.

Navigator services to inmates. The Department of Corrections will receive $800,000 for navigators for high-risk DOC releasesDOC will begin a pilot program with its current medical contractor, University Correctional Health Care, Rutgers University, to offer navigator services to inmates as they are being released from prison.  The caseload would be the approximately 200 inmates that are released from prison on medication-assisted treatment in a year.