80 Conover Rd.
Marlboro, NJ 07746

New Hope Foundation Featured in NJAMHAA News

Agency Offers New Hope through Expanded Programs and Research Initiatives

Since its inception in 1970 as a small program for men with alcohol dependence, New Hope Foundation has greatly expanded to provide a full array of services for substance use and co-occurring mental health disorders to include compulsive gambling. In addition to offering inpatient, residential halfway house and outpatient services, New Hope is also involved in research initiatives that aim to enhance the overall effectiveness of treatment.

Tony Comerford, Ph.D., New Hope’s CEO and a licensed Psychologist also licensed as a Professional and Alcohol and Drug Counselor stated that “co-occurring disorders are really the norm at New Hope with roughly 70-80% of those entering our main inpatient setting being treated concurrently for a substance use and other mental health disorders. There are no barriers to admission at New Hope as long as the person is suffering from a substance use disorder and meets ASAM* admission criteria. Our inpatient services include 24-hour nursing and physician and psychiatric care and we work closely with emergency rooms and county ICMS and PACT* teams in central New Jersey. We are contracted with major insurance and managed care companies, the NJ Division of Mental Health and Addiction Services, The Department of Children and Families and 17 of New Jersey’s 21 County Governments.” Dr. Comerford indicated that New Hope is also monitoring the State’s move to ASO* and ultimately the MBHO* management of indigent funds to include Medicaid and anticipating an increased demand for inpatient acute care and outpatient services that will need to be served. “I don’t believe that inpatient facilities are at risk. They will be at risk only if they don’t provide intensive services for sicker patients,” he said.

(* ASAM: American Society of Addiction Medicine; ICMS: Integrated Case Management Services; PACT: Programs for Assertive Community Treatment; ASO: Administrative Services Organization; MBHO: Managed Behavioral Health Organization)

Providing a Combination of Housing and Services

“Housing is a major problem in New Jersey and driving some of the demand for inpatient and residential services that could be delivered in an outpatient setting if housing accommodations were available; in other words some are being driven into more intensive settings than would be necessary if more basic needs were met. In part, licensing is also driving care in an artificial level-of-care model as opposed to providing the services that are actually needed; many miss the fact that ASAM* criteria is really primarily focused on matching people with service needs and not the boxes they are placed in; there is a great deal of research indicating that you get better outcomes when service needs are met, worse when they are not.”

New Hope provides Halfway House services for both men and women and has some low income housing available under its Epiphany House programs. Ron Hari, a now retired former Chairman of New Hope’s Board indicated that New Hope saved the Epiphany House programs from total collapse when they began managing them and eventually took them over several years ago. Housing residents include Epiphany House Halfway House graduates that may continue to be engaged in outpatient services and others qualified for low income housing; applications from others recovering from substance use and other mental health disorders and in need of and qualified for low income housing are encouraged.

Treating All Addictions, Including Gambling

New Hope has the State’s only inpatient care for compulsive gambling and has five certified gambling counselors on staff providing care in inpatient, outpatient and halfway house settings. According to Dr. Comerford, 7 percent of individuals admitted into inpatient services screen positive for gambling disorders, and most have other substance use problems.

“The pleasure center in the brain is affected the same way from gambling as it is with drugs,” Dr. Comerford said. He noted that the Diagnostic and Statistical Manual V will likely include gambling under addiction, not as a separate impulsive disorder.

Developing Tools for Better Engagement and Prediction of Relapse

While overseeing programs that serve an increasing number of clients and preparing the agency for massive changes in the healthcare system, Dr. Comerford is also involved in the development of tools that would help maximize clients’ participation in treatment and improve treatment outcomes.

Dr. Comerford expressed confidence in receiving a grant from the National Institutes of Health on one of these initiatives: the development of Polaris EECD (Engagement Enhancement for Chemical Dependency) system. The project is in collaboration with Polaris Health Directions, a Pennsylvania-based company that Dr. Comerford has worked with for over ten years. “Researchers have documented the potential of several evidence-based practices for improving engagement, but their adoption in routine clinical practice has been hindered by the lack of efficient methods for introducing the practices. Information technology can play an important role in overcoming the barriers to implementation,” as explained in the abstract submitted as part of the grant application.

“EECD will incorporate an existing outcomes management system, Polaris CD, which assesses most known predictors of engagement,” Dr. Comerford explained. “In Phase I, we will develop and field test three enhancements to Polaris CD: a multivariate model for prediction of risk for non-engagement; a motivational, personalized feedback report for clients; and a guide for using EECD to implement two evidence-based practices, Patient-Services Matching and Motivational Enhancement Therapy, as part of routine treatment.”

Dr. Comerford and Polaris Health Directions are also working with Rajita Sinha, a researcher at Yale University, on a new application that would predict “post treatment relapse by combining biomarkers of stress with psychosocial predictors that have been established,” he said. “The project holds the promise of helping inpatient, intensive outpatient and hospital based treatment programs to more accurately target both behavioral and pharmacological interventions that will more effectively and efficiently reduce relapse events, readmissions and other adverse events.”