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S4414 2R FISCAL ESTIMATE
LEGISLATIVE FISCAL ESTIMATE
[Second Reprint]
SENATE, No. 4414
STATE OF NEW JERSEY
222nd LEGISLATURE
DATED: JULY 6, 2026
SUMMARY
Synopsis:
Requires DCF to strengthen Statewide pediatric psychiatry
and behavioral health care services for children and families.
Type of Impact:
Annual State expenditure and revenue increase.
Agencies Affected:
Department of Children and Families, Department of Health,
Department of Banking and Insurance, Department of Human Services, and
Department of Law and Public Safety.
Office of
Legislative Services Estimate
Fiscal Impact
Year 1
Year 2 and Beyond
State Expenditure Increase
At least $380,000
At least $235,000
State Revenue Increase
Indeterminate
Indeterminate
�
The Office of Legislative Services (OLS) concludes that the State
will incur an indeterminate annual cost increase as a result of overseeing and
implementing the policies and procedures required under the bill.�
These State costs may be offset to some extent by the
collection of penalties from various types of healthcare providers for
noncompliance with a reporting requirement established under the bill.�
�
At a minimum, the OLS estimates that one-time expenditures for
the Department of Children and Families will increase by approximately
$145,000, while annual costs for the Department of Children and Families and
the Department of Health will increase by approximately $235,000.� These
estimates reflect salary and benefit expenses associated with the staffing
needs of implementing the bill�s provisions.� Additional annual costs may
include materials and supplies.�
�
The OLS notes that the department may incur additional expenses
under the bill associated with supporting the potential expansion of the
services provided under the Child Collaborative Mental Health Care Program;
however, it is assumed that any costs will be minimal as the collaborative
largely fulfills the requirements of the bill under its current service
offerings.
�
To the extent that these efforts include collaboration with the
Department of Banking and Insurance, the Division of Consumer Affairs in the Department
of Law and Public Safety, and the Department of Human Services, those
departments may also experience increases in expenditures under the bill.�
BILL DESCRIPTION
����� This bill requires that the Department of Children and
Families be responsible for overseeing and implementing policies and procedures
to strengthen Statewide pediatric psychiatry and behavioral health care
services for children and their families.�
����� Specifically, in implementing the policies and
procedures prescribed in the bill, the department is to: (1) complete an
evaluation, and potential expansion, of the current services provided by the
contracted entity for the Child Collaborative Mental Health Care Program; (2)
analyze and recommend, in consultation with the Department of Banking and
Insurance, the Department of Health, and the Department of Human Services,
adjustments to payment structures and reimbursement rates for pediatric primary
care physicians providing pediatric psychiatry and behavioral care health
services; and (3) increase transparency and accountability within contracted
system administrators.�
����� Additionally the Department of Health, in consultation
with the Department of Children and Families, the Division of Consumer Affairs
in the Department of Law and Public Safety, and the Department of Human
Services, is to:� (1) require health care facilities, pediatric primary care
physicians, and hospital emergency departments, and pediatric behavioral health
care programs
that use electronic health records to
report to the department standardized data on hospitalization visits and
admissions, discharge, and placement information concerning children seeking
pediatric psychiatry or behavioral health care services; and (2) collect,
compile, analyze, and publicly report the standardized data reported by
providers under the bill to guide service delivery planning, identify service
gaps, prioritize capacity development, and support policy and funding
decisions. The bill establishes a penalty of at least $100 but not more than
$500 for each day a provider is in violation of this reporting requirement.
�
����� The Department of Children and Families is to submit
to the Governor and the Legislature a report on the standardized data collected
pursuant to the provisions of the bill and to make the materials and the data
available to the public on the department�s Internet website.
FISCAL ANALYSIS
EXECUTIVE BRANCH
����� None received.
OFFICE OF LEGISLATIVE SERVICES
����� The OLS concludes that the State will incur an
indeterminate cost increase as a result of overseeing and implementing the
policies and procedures required under the bill.� At a minimum, the OLS
estimates that one-time expenditures incurred by the Department of Children and
Families will increase by approximately $145,000, while annual costs for the
Department of Children and Families and the Department of Health will increase
by approximately $235,000.� These estimates reflect salary and benefit expenses
associated with the staffing needs of implementing the bill�s provisions.�
Additional annual costs may include materials and supplies.� To the extent that
these efforts include collaboration with the Department of Banking and
Insurance, the Division of Consumer Affairs in the Department of Law and Public
Safety, and the Department of Human Services, those departments may also
experience increases in expenditures under the bill.�
����� These State costs may be
offset to some extent by the collection of penalties from various types of
healthcare providers for noncompliance with a reporting requirement established
under the bill.� The nature and number of infractions that may be committed,
however, is unpredictable.� As such, the OLS cannot quantify the amount of
revenue generated from penalties under the bill.
����� The one-time salary and benefits cost increases
estimated under this analysis assume two new temporary six month positions,
each reflecting a $72,500 increase in Department of Children and Families
expenditures: one full-time equivalent employee in a program specialist
position who will lead the provisions of the bill regarding adjustments to
payment structures and reimbursement rates for pediatric primary care
physicians; and one full-time equivalent employee in a program specialist
position who will evaluate the current services provided under the Child
Collaborative Mental Health Care Program.��
����� The annual salary and benefit cost increases estimated
under this analysis assume two new permanent positions: one 0.5 full-time
equivalent Department of Children and Families employee in a contract
administrator position, costing approximately $89,000 per year, who will
implement the required changes to, and oversight of, the contract with the
contracted system administrators; and one full-time equivalent Department of
Health employee in a program specialist position, costing approximately
$146,000 per year, who will collect, compile, and analyze the standardized data
required to be submitted by various provider types under the bill.
����� The OLS notes that the Department of Children and
Families may incur additional expenses under the bill associated with
supporting the potential expansion of the services provided under the Child
Collaborative Mental Health Care Program; however, it is assumed that any costs
will be minimal as the collaborative largely fulfills the requirements of the
bill under its current service offerings.� For reference, the Child
Collaborative Mental Health Care Program is a Statewide, Department of Children
and Families grant-funded program available for children, adolescents, and
young adults up to the age of 21 who are under the care of their pediatric
primary care provider. This program is available free of cost and allows
participating pediatric primary care providers to consult with mental health
professionals.�
����� Specifically, the bill requires the Child
Collaborative Mental Health Care Program to: increase access to telepsychiatry
services; develop structured consultation, follow-up support, clinical
guidance, and intake and referral services; and provide medical education via
case-based learning collaboratives.� Currently, the collaborative administers a
telehealth project under which
its
members have access to telepsychiatry services facilitated by a regional hub,
as well as to telehealth equipment, in order to allow patients and families to
access consultations from child psychiatrists at a
primary care provider
�s office.
� Additionally,
participation in the collaborative includes such benefits as: timely access to
psychiatry consultation for the patient, consultative support to assist the
primary care provider with diagnostic clarification, medication management, and
care coordination; and referrals for patients and families to appropriate
community mental health treatment services.� Finally,
the
collaborative offers a variety of continued education opportunities, such as
monthly learning opportunities featuring didactic and case-based presentations.�
Section:
Human Services
Analyst:
Sarah Schmidt
Principal Research Analyst
Approved:
Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the
Office of Legislative Services due to the failure of the Executive Branch to
respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980,
c.67 (C.52:13B-6 et seq.).