Carrier Clinic and Hackensack Meridian Health to merge, expand addiction treatment

The Carrier Clinic, a century-old psychiatric and addiction treatment provider in rural Somerset County, is merging with Hackensack Meridian Health — a combination that will be the first in New Jersey to offer a complete range of mental-health services integrated into a statewide hospital network.

With Carrier as part of its hospital network, Hackensack Meridian will become the largest provider of inpatient psychiatric care in the state. Leaders of both organizations announced the agreement Wednesday.

The merger aims to expand treatment options for people fighting addiction, as deaths from opiate overdoses claimed six lives a day in the state last year and show no sign of abating, said Robert C. Garrett, co-CEO of Hackensack Meridian.

Patients often are frustrated by the lack of access to care, even after they get to a hospital, and emergency department waits for placement can sometimes take up to 10 days, the New Jersey Hospital Association reported. Success for the merged company will be measured by meeting that demand for care and satisfying patients, said Donald Parker, the Carrier Clinic’s president and CEO.

The newly integrated system also aims to round out the services for patients hospitalized for medical issues, half of whom also have mental-health diagnoses, and to improve the care of psychiatric and substance-abuse patients, the majority of whom also suffer from health problems such as high blood pressure, hepatitis and diabetes.

Patients with chronic medical conditions, for example, often suffer from depression. And elderly patients admitted for urinary tract infections can develop paranoia. All could benefit from the attention of mental-health professionals, Parker said.

“We know from research and practice, if you treat the whole person, then the outcomes are better and you can reduce cost,” said Mark Covall, president and CEO of the National Association for Behavioral Healthcare in Washington, D.C. He said the merger announcement was part of “a very positive trend.”

“We see behavioral health care now as being fragmented, if not broken,” Garrett said. It “is something that needs to be much more integrated into our system.” Hackensack Meridian has 12 acute-care hospitals, two rehabilitation hospitals and two children’s hospitals, along with more than 450 doctor’s offices and patient-care sites in eight counties, from Bergen to Ocean.

Gov. Phil Murphy has made the improvement of mental health care in New Jersey a priority of his administration. His health commissioner, Dr. Shereef Elnahal, has said that is best accomplished when patients receive both mental health and primary health care in one setting.

One of the first goals for the partnership is to open a new addiction treatment center next year, at a location that is expected to be announced in the next few months. The partners’ previous plan to convert the Carmel Retreat in Mahwah into a residential treatment center for 81 patients fell through earlier this year.

“Time is of the essence,” Garrett said, noting that New Jersey is on track to see more than 3,000 people die in 2018 from opiate overdoses. “Too many New Jersey residents are leaving our state” to receive addiction treatment, he said, and “we want to establish world-class addiction treatment right here.”

In addition, Hackensack Meridian is adding 37 new inpatient beds to its 150 existing beds as the result of former Gov. Chris Christie’s initiative to expand resources for the care of substance-abuse and psychiatric patients. It has yet to be decided if they will be added at the Carrier Clinic or dispersed throughout the hospital system, Garrett said.

For Carrier, the merger allows it to piggyback on Hackensack’s network of ambulatory care centers to treat new patients and follow up on those recently discharged from its psychiatric hospital in Belle Mead, which has 281 beds.

These “urgent-care centers for behavioral health” would be staffed by nurse practitioners linked to Carrier’s psychiatrists via telemedicine, a video conferencing connection that will use the latest in facial-recognition technology to enhance accurate diagnoses, Parker said.

By moving care for less urgent mental-health issues outside the hospital, the new approach is expected to relieve some overcrowding in emergency departments. Half the increase in emergency room visits in 2016 was due to behavioral health concerns, Hackensack officials said.

The newly opened Hackensack Meridian Medical School at Seton Hall University also offers “an enormous opportunity to engage in the training — and, ultimately, the retention — of new psychiatrists,” who are in short supply in New Jersey and across the nation, Parker said.

Behavioral health and addiction medicine are part of the “core curriculum” of the medical school, Garrett said.

The combination of medical education and research, a health care system with a broad hospital network, and a psychiatric hospital makes the merged system similar to other major programs. In Massachusetts, for example, Harvard Medical School, Massachusetts General Hospital and McLean Hospital work together, and in New York, New York-Presbyterian Health Care System and its Westchester Division psychiatric hospital are aligned with Columbia University Vagelos College of Physicians and Surgeons and Weill Cornell Medicine.

“This is extremely important, and comes at a good time,” said Debra L. Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies. A larger entity has economies of scale, and also can fight to preserve recent gains in coverage for mental-health patients, she said.”I think it will be a good marriage.”

As a full-asset merger, the agreement must be approved by the state Commissioners of Health and Education and reviewed by the Attorney General’s office. In addition to its psychiatric hospital, detoxification center, and adolescent treatment residences, Carrier has an accredited school for seventh through 12th graders.


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