Senate Approves Codey Package To Improve Critical Emergency Mental Health Care

TRENTON – The full Senate today voted with overwhelming support to approve a trio of bills sponsored by Senate President Richard J. Codey (D-Essex) that would provide substantial relief for patients seeking critical emergency mental health services.

“When a person seeks treatment in an emergency room for a mental health issue, it is usually because the situation has reached a critical point,” said Sen. Codey. “To then make these patients go days without any significant relief, is agonizing and counter to all that we have done over the last several years to try and improve access to mental health services in New Jersey. What these bills will do more than anything is standardize and streamline care so that patients get the crucial help they need, when they need it, not days later.”

Presently, there is no standardized admission protocol and medical clearance criteria for transfer or admission of a hospital emergency department patient to a state or county psychiatric hospital or a short-term care facility. In light of this, the New Jersey Hospital Association (NJHA) conducted two surveys of patients in hospital emergency departments awaiting transfer to a behavioral health setting and concluded that roughly 95 percent of patients reported waits of at least 48 hours, while 60 percent reported waits of 48 to 120 hours.

Sen. Codey noted that the glaring results of the NJHA’s survey helped prompt the legislation that was passed today. The first bill A3582 (S2444), approved by a vote of 38 to 0, would require the New Jersey Department of Human Services (DHS) to develop protocol to help streamline the transfer of mentally ill patients from general hospital emergency rooms to an appropriate behavioral health setting if they have remained in an ER for 24 hours or longer. Specifically, DHS would be tasked with developing procedures to designate staff within the department who would be notified by a hospital when such a situation arises.

DHS would also be required to provide clinical facilitators to help ensure that a patient awaiting placement is transferred to a behavioral health setting that best meets the patient’s clinical needs. Furthermore, the bill requires DHS to provide for a mechanism that would enable the department to conduct ongoing assessments of patient flow and access to care and set forth objective criteria for identifying resources that are needed to ensure timely implementation of these required procedures.

The second bill in the package, A3583 (S2445), would require DHS to develop appropriate safeguards to ensure that mental health patients in emergency departments are being thoroughly screened and recommended for the appropriate care. The bill, which was approved by a vote of 38 to 0, would require the DHS commissioner, in consultation with the Commissioner of the Department of Health and Senior Services and other medical experts, to develop standardized admission protocols and medical clearance criteria for transfer or admission of an ER patient to a state or county psychiatric hospital or a short-term care facility.

The protocol would cover routine laboratory and diagnostic tests; a medical clearance checklist for transfers or admissions to a psychiatric hospital; guidelines for emergency medical services personnel, procedures for requesting a patient transfer; procedures for contacting the physician at a designated state or county psychiatric hospital or short-term care facility who is responsible for coordinating medical clearance of a patient; and a mechanism for training all of the appropriate medical personnel and screening staff on these new standardized admissions protocols. The bill would also require the Commissioner of the Department of Children and Families (DCF) to develop standardized admission protocols for children seeking emergency mental health services.

The last bill in the package, A3584 (S2446), would require the Commissioners of DHS and DCF to prepare an inventory of available behavioral health services; develop a methodology to quantify the usage of and need for inpatient, outpatient and residential behavioral health services; and annually assess the availability of mental health services, identify funding for existing mental health programs and report recommendations. The bill was approved by a vote of 38 to 0.

The General Assembly, which initially approved the bills in June, must now concur with the technical amendments approved by the Senate before the bills can be sent to the Governor for his signature.

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