[INSPRATIONAL MUSIC STING] - Hey, everyone, Steve Adubato, we kick off the program with a longtime friend and colleague, Deborah Visconi, President and Chief Executive Officer at Bergen New Bridge Medical Center.

Deb, good to see you.

- Good to see you too, Steve.

Thanks for having me on.

- Now tell everyone as we put up the website what Bergen New Bridge Medical Center is.

- So Bergen New Bridge Medical Center is the largest hospital in the state of New Jersey.

It is a full service, acute care hospital with a specialty in behavioral health, mental health, addiction services, chronic disease conditions, as well as long-term care.

We are 1,070 beds located in Paramus, New Jersey, which is in Bergen County, New Jersey.

- You know, people hear Bergen County and people think, "Wow, it must be one of the wealthiest counties in the state and the nation."

But you and your team conducted what's called "The Bergen County Community Health Needs Assessment."

What came back from that that makes it clear that Bergen County, a county with 70, 7-0 communities is a very diverse county and there are very complex and challenging health needs?

- Yeah, thanks, Steve.

So yes, Bergen County is close to one million people strong.

And the Community Health Needs Assessment was a comprehensive evaluation that identifies the most significant health needs, disparities, and priorities within a community that helps to guide hospitals, community partners in improving population health and directing resources where they're needed most to help address those health needs.

- Deb, sorry for interrupting.

Go back.

You mentioned population health.

We hear that term a lot.

Explain that for those who are not familiar with it.

- So population health is around all of the things that encompass an individual's life.

So it includes healthcare, it includes education, it includes transportation, it includes food, it includes housing, all the things that you need to live your life.

And it's all interconnected and under the umbrella of population health.

And really assuring the health and wellbeing of the communities that we serve.

- Great, and the Health Needs Assessment told us, what are the top three, four medical health needs of the citizens of Bergen County?

- Yeah, so not surprisingly to us certainly, but mental health continues to be one of the largest challenges, one of the largest health issues that we're facing.

A second to mental health and behavioral health is chronic diseases.

So things like obesity, diabetes, hypertension.

That would be the second category of issues that our communities are facing.

And then I mentioned population health, but it's the social determinants of health that drive a healthy community.

So things like housing insecurity or food insecurity or lack of transportation all play into an individual's being able to live their healthiest lifestyle.

- Deb, let's go back to the mental health piece.

I mean, all of us either for ourselves or our family members or both, I hear people saying all the time, and I know in our family it was like, "How do we find a mental health professional?"

Why is there such a disparity between the needs that we have in terms of mental behavioral health and the supply of professionals in the field?

I don't want to complicate the question, but it can't be a new thing.

- No, so we are seeing an unprecedented demand for behavioral health and mental health services in our area.

And not just here in Bergen County, but I would say throughout the region, certainly.

What we're seeing is that more than half of our emergency behavioral health visits that we evaluated involve some sort of mental health crisis.

And we're seeing increasing rates of anxiety, depression, substance use disorders, social isolation, emotional distress, particularly, Steve, amongst adolescents and young adults.

And I think that's where we're seeing this almost crisis come to the tipping point.

And the way we look at it, and this is the truth, right, mental health is no longer a healthcare issue alone.

It affects families, schools, workplaces, and entire communities.

And so one of the clearest messages that we got from the Community Health Needs Assessment is that people need timely access to care when they are the most vulnerable.

And that's for us, you know, one of the reasons why we're transforming our emergency department and expanding our emergency department, because people need access to healthcare services, in particular, behavioral health.

- Let's talk economics.

And let me disclose that Bergen New Bridge is an underwriter of our healthcare programming.

Economics.

Most of your money comes from where?

Is it government money?

Is it private money?

Talk about that.

- Most of our money comes from patient revenue, patient visits.

And though, you know, from the Medicaid program in particular is a very big payer for us.

So 65% of our of the individuals that we care for have Medicaid or some sort of Medicaid.

And another 10 to 15% of the individuals that we serve don't have any insurance at all.

And so they fall into what we call the charity care bucket.

And so that's, you know, 1 out of 10 people that use our services don't have insurance to pay for the services.

And us, we are a safety net provider, the true beacon of health, hope, and healing for our communities.

And so we take care of the individuals regardless of the type of insurance they have or if they have insurance at all.

And then, you know, we do get some state funding through the charity care program and through the state-directed payments that support our Medicaid patients.

- So as Deb's talking about charity care, just to be clear, and if I'm mistaken, you correct me, charity care means if someone comes into your emergency room, regardless of their ability to pay, regardless of their insurance situation, your hospital takes care of them.

It's called charity care, and that is paid for with public dollars.

- Yes, through the state.

- Through the state.

Now, thorny question, but important.

Federal money, changes in federal policy as it relates to Medicaid/Medicare has had what impact on the patients you serve?

- Oh, it's going to be devastating for a huge amount of the patients that we serve because we believe that the federal changes coming soon will affect people's ability to enroll in Medicaid, and people will fall off the Medicaid books, and then they'll end up in charity care, which means, again, very, very devastating for safety net hospitals.

And hospitals across the country will really experience significant struggles in being able to take care of these individuals.

- Hey, listen, all the federal government's doing is saying you have to prove that you're trying to get a job, you have to prove that you're going to school.

You just have to prove it, and then you get Medicaid.

And if not, you can't.

Is it that simple?

- Well, I mean, that's what the rule says, right?

You have to show that you work or volunteer for 80 hours or you have to, you know, be able to.

But I think the complexity in that is the administrative bureaucracy for individuals to re-certify twice a year with Medicaid now and people- - Twice?

- Twice a year.

Now it's once a year.

It'll be twice a year starting next year.

And that will absolutely affect people that may not have access to a computer or ability to log on and resubmit their applications.

And we're going to see a big shift in people coming off Medicaid but still needing care.

And, again, what's going to end up happening is that people are not going to get the care that they need.

They're not going to go for their routine maintenance checks that they need on a regular basis.

So you're going to see an increase in individuals with more chronic diseases, more cancer, more heart disease that hasn't been cared for because they don't have insurance or they don't have ability to access services.

- Complex, important healthcare matters.

Deb Visconi is President and Chief Executive Officer at Bergen New Bridge Medical Center.

Deb, as always, thank you for joining us.

We appreciate it.

- Thank you, Steve.

Always great to be with you.

- Absolutely.

Stay with us.

We'll be right back.

- [Narrator] State of Affairs with Steve Adubato is a production of the Caucus Educational Corporation.

Funding has been provided by NJM Insurance Group.

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