New Jersey Adopts Landmark Regulatory Change to Promote Health Care Integration and Improve Patient Care

TRENTON - The New Jersey Department of Health (NJDOH) today announced the adoption of rules creating a single, integrated license for outpatient health care facilities. This landmark reform - achieved in conjunction with the New Jersey Department of Human Services (NJDHS) - cuts historical red tape and enables providers to deliver integrated primary care, mental health, and addiction treatment services. This comprehensive, whole-person approach is proven to deliver improved health outcomes and better patient experiences.

"Health care works best when patients are treated as a whole person, not a collection of separate problems," said Acting Health Commissioner Jeff Brown. "These rules put people first, by letting them walk through one door and receive all the care they need. That means less red tape for providers to meet their patients' needs. And it means a simpler path to better outcomes for New Jerseyans."

"Outdated rules have made it harder for clinicians to deliver coordinated primary and behavioral health care to their patients," said Human Services Commissioner Sarah Adelman. "Integrated licensing puts the patient first and removes barriers for providers, so they can focus on delivering the care their patient needs. This enables better access and, ultimately, better patient experiences and outcomes."

The adopted rules-N.J.A.C. 8:47K; 8:43A; 8:43E; 8:121; and 10:161B under NJDOH plus program standards through N.J.A.C. 10:36 under NJDHS-address longstanding obstacles and a complex regulatory regime that have impeded health care providers' ability to offer coordinated physical and behavioral health services. The COVID-19 pandemic demonstrated the interconnectedness of physical and mental health, making this reform particularly urgent.

Under the previous fragmented regulatory system, facilities offering primary care, mental health, and addiction treatment services in a single location were required to secure three separate licenses, each with different regulatory requirements. These rules historically required providers to make patients receiving different categories of care use different entranceways. The old rules also required providers to keep separate medical records when a patient received physical and behavioral health services.

The integrated license will benefit several types of outpatient facilities, including Federally Qualified Health Centers (FQHCs), outpatient mental health and substance use disorder providers, and licensed primary care clinics.

Key improvements include:

• Allowing facilities to maintain unified medical records for patients
• Eliminating requirements for separate physical spaces and entrances
• Enabling shared treatment spaces and infrastructure
• Expanding access to withdrawal management services and medications for addiction treatment like buprenorphine
• Enabling qualified physicians to deliver reproductive health services without unnecessary barriers and eliminating the requirement of a staff OB/GYN to provide essential care
• Allowing integration of counseling and therapy into primary care without full behavioral health licensure

Importantly, the rule also makes permanent a Department of Health waiver that increased the accessibility of Medications for Opioid Use Disorder (MOUD) treatment.

This builds on other State efforts to address the opioid crisis and that have resulted in a reduction in overdose deaths for the first time in a decade, including decriminalizing harm reduction supplies, expanding harm reduction centers, anonymously dispensing naloxone for free at 675 pharmacies statewide, and making New Jersey the first state in the nation to allow paramedics to treat opioid addiction in the field with buprenorphine.

The rules have been filed with the Office of Administrative Law and will take effect upon publication in the New Jersey Register, which is anticipated in February.