A1742

An Act establishing a "Collaborative Mental Health Care Pilot Program" and making an appropriation.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. The Legislature finds and declares that:

a. Despite the important role primary care physicians have in identifying and treating mental and behavior disorders in children and adolescents, and their families, most primary care physicians report that they have little preparation to do so;

b. There is a shortage of child psychiatrists in New Jersey, based on established standards;

c. Between 65 and 75 percent of psychotropic medications prescribed to children and adolescents are ordered by primary care physicians, yet very few of these physicians have established a professional relationship that provides timely access for advice and consultation with a child psychiatrist or another child mental health specialist in the communities in which they practice;

d. Children and adolescents, and their families, who discuss a mental or behavioral health problem with a primary care physician, rather than a psychiatrist, may feel less stigma and be more comfortable exploring their concerns in the more familiar primary care setting; and

e. A formal program that would allow primary care physicians to gain timely access to child psychiatrists and other child mental health specialists and allow for consultation services with these specialists, by telephone or other electronic means, would result in primary care physicians being more willing to screen, assess, diagnose, and treat children and adolescents, and their families, with a mental or behavior disorder.

2. The Department of Health shall establish a two-year "Collaborative Mental Health Care Pilot Program" for children and adolescents, and their families, as provided in this act. The program shall integrate collaborative care between primary care physicians and child mental health specialists in order to provide for the timely screening, assessment, diagnosis, and treatment of mental and behavior disorders of children and adolescents, and their families, in the pilot program.

3. The pilot program shall be established in Bergen County, and shall provide for:

a. a child mental health treatment team which, at a minimum, shall include:

(1) child psychiatrists, who shall provide consultation support to a primary care physician to enable the primary care physician to: provide an appropriate level of screening, assessment, diagnosis, and treatment of children and adolescents, and their families; coordinate the care of children and adolescents, and their families, who otherwise might require psychiatric services directly from a child psychiatrist; and prescribe medications as needed and indicated.

(2) primary care physicians and other health care professionals who provide mental health services under the supervision of the primary care physicians, and who provide these services to children and adolescents, and their families, in a pediatric medical home which provides pediatric primary care that promotes prevention, wellness, and chronic care management to help children and adolescents be as healthy as possible, and is accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally competent.

(3) licensed social workers who shall: provide case management services; seek referrals for mental health services in the community; and provide supportive services to parents and other family members; and

(4) administrative personnel to support the clinical members of the child mental health team and coordinate communications among the members of the team;

b. consultation by telephone between a primary care physician and a child psychiatrist on the child mental health treatment team;

c. a one-time direct consultation child psychiatric service provided by a child psychiatrist when a child, adolescent, family member, or primary care physician requests or requires such services;

d. an education program, developed by the New Jersey Primary Care Child Psychiatry Collaborative, for primary care physicians that shall include training in best practices relating to the screening, assessment, diagnosis, and treatment of mental and behavior disorders in children and adolescents, and their families;

e. distribution of a mental health care guide, developed by the New Jersey Primary Care Child Psychiatry Collaborative, for use by primary care physicians and their staff that, at a minimum, includes information about referral, screening, assessment, diagnosis, and treatment of children and adolescents, and their families; and

f. distribution of a mental health resource guide, developed by the New Jersey Primary Care Child Psychiatry Collaborative, which shall be available to children and adolescents, and their families, in the waiting and examination rooms of primary care physicians, and shall include, but not be limited to:

(1) early warning signs, behaviors, and symptoms of mental and behavior disorders;

(2) coping skills, including, but not limited to, interventions and strategies to address challenging behaviors;

(3) information about what to expect upon diagnosis of a mental or behavior disorder, how a disorder may affect other family members, and strategies for helping meet the needs of those family members; and

(4) information about services and supports available in the community.

4. a. No later than six months before the expiration of this act, the Commissioner of Health shall report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), on the effectiveness of the pilot program.

b. The report shall include:

(1) an evaluation, before and after implementation of the pilot program, of: the knowledge level of primary care physicians about mental and behavior disorders in children and adolescents, and their families; the comfort level of children and adolescents, and their families, in discussing mental or behavioral health problems with primary care physicians; and the number of mental health screenings conducted of children and adolescents, and their families;

(2) recommendations for establishing a system of payment for services delivered by the pilot program or any successor program; and

(3) recommendations for continuing and, if appropriate, expanding the pilot program in the State.

5. The Commissioner of Health shall adopt rules and regulations as necessary to effectuate the purpose of this act, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).

6. There is appropriated $750,000 from the General Fund to the Department of Health to establish the "Collaborative Mental Health Care Pilot Program."

7. This act shall take effect on the first day of the seventh month next following the date of enactment, but the Commissioner of Health may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act. The act shall expire two years after the effective date.

STATEMENT

This bill establishes a two-year pilot program, the "Collaborative Mental Health Care Pilot Program" in the Department of Health (DOH), and appropriates $750,000 for the program.

The pilot program would be established in Bergen County and consist of a child mental health treatment team, which would consist of child psychiatrists, primary care physicians and other health care professionals under their supervision, licensed social workers, and administrative personnel. The program would provide for consultation by telephone between a primary care physician and a member of the mental health treatment team.

The child psychiatrists on the team would provide consultation support to a primary care physician to enable the primary care physician to: screen, assess, diagnose, and treat children and adolescents, and their families; coordinate the care of children and adolescents, and their families, who need psychiatric services directly from a child psychiatrist; and prescribe any medications.

The primary care physicians and other health care professionals would provide services in pediatric medical homes which provide pediatric primary care that promotes prevention, wellness, and chronic care management to help children and adolescents be as healthy as possible, and is accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally competent.

The licensed social workers on the team would provide case management, handle referrals, and provide support in person or by telephone to parents and other family members, and the administrative personnel would provide support services to members of the mental health treatment team.

The pilot program would also provide for a one-time direct consultation child psychiatric service provided by a child psychiatrist when a child, adolescent, family member, or primary care physician requests or requires such services.

The bill provides for the New Jersey Primary Care Child Psychiatry Collaborative to develop: an education program for primary care providers; a mental health care guide that, at a minimum, would include information about referrals, screenings, diagnoses, assessments, and treatments; and a mental health resource guide for children and adolescents, and their families.

The bill requires DOH to report to the Governor and the Legislature on the effectiveness of the program. The report is to include evaluations, before and after implementation of the pilot program, of: the knowledge level of primary care physicians about mental and behavior disorders in children and adolescents, and their families; the comfort level of children and adolescents, and their families, in discussing mental or behavioral health problems with primary care physicians; and the number of mental health screenings conducted of children and adolescents, and their families. Also included in the report would be recommendations for establishing a system of payment for services delivered by the pilot or a successor program, and continuing and expanding the pilot program in the State.