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Behavioral Health Workforce Assessment

Behavioral Health Workforce Assessment. Health Workforce Council November 17, 2017 Project Team Presenters Nova Gattman, Sue Skillman. Washington’s Behavioral Health Workforce Assessment.

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Behavioral Health Workforce Assessment

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  1. Behavioral Health Workforce Assessment Health Workforce Council November 17, 2017 Project Team Presenters Nova Gattman, Sue Skillman

  2. Washington’s Behavioral Health Workforce Assessment • Funded by Governor Inslee’s federal Workforce Innovation and Opportunity Act (WIOA) discretionary funds. • Conducted by: • Workforce Training and Education Coordinating Board • Nova Gattman, Legislative Director • University of Washington Center for Health Workforce Studies • Susan Skillman, Deputy Director • Rachelle McCarty, Research Scientist • With support from: • Agnes Balassa Solutions, LLC • Washington’s Health Workforce Council

  3. Washington’s Behavioral Health Workforce Assessment - Project Goals • Goal 1: Assess workforce-related barriers to accessing behavioral health services in Washington. • Goal 2: Create a recommended action plan to address behavioral health workforce needs.

  4. Behavioral Health Workforce Assessment – Required Deliverables • Phase I report completed November, 2016. • Focused on synthesizing data to create actionable recommendations to address behavioral health (BH) workforce needs for the 2017 legislative session. • Reports at: http://www.wtb.wa.gov/behavioralhealthgroup.asp https://depts.washington.edu/fammed/chws/studies/wabh/ • Phase II report due December 15, 2017.

  5. Phase I Recommendations (slide 1/2) • Adjust reimbursement rates to better support competitive recruitment and retention of a skilled behavioral health workforce. • Promote team-based and integrated (behavioral and physical health) care. • Increase access to clinical training for students entering behavioral health occupations. • Expand the workforce available to deliver medically-assisted behavioral health treatments. • Increase diversity in the behavioral health workforce.

  6. Phase I Recommendations (cont.) • Increase the number of dually-certified BH providers. • Address barriers to licensing and credentialing. • Increase the efficiency of the BH workforce by streamlining paperwork and reporting requirements.

  7. Which Recommendations Received Attention This Legislative Session? #1 Reimbursement: • Increased BHO Medicaid rates – 2.5 percent increase effective 10/1/17. • Requires DSHS to work with the actuaries responsible for certifying BH capitation rates to adjust average salary assumptions in order to implement this increase. • SSB 5779 – Directs HCA to review behavioral health payment codes and rules, and make adjustments to payment rules if needed to support integration (signed into law).

  8. Which Recommendations Received Attention This Legislative Session? Reimbursement, cont. • Governor’s Budget: Requested raise for inpatient psychiatric payment rate for hospitals, and inquiry for specific occupations or rates with maximum impact in outpatient settings. • House Budget: $50M for a rate increase for BHO and psychiatric inpatient provider Medicaid rates. • Proposed HB 1637/SB 5471 – requiring primary care providers’ reimbursement rates in Medicaid to be equal with Medicare rates (did NOT pass).

  9. Which Recommendations Received Attention This Legislative Session? #2 Promote team based and integrated (behavioral and physical health) care: • Governor’s budget directed HCA to develop a plan for innovative, team-based practice changes (did not pass).

  10. Which Recommendations Received Attention This Legislative Session? #4-a, 4-b Technology: • SB 5436: Expands the definition of origination site to any site of the patient’s choosing (signed into law). • Proposed SB 5457 requests telemedicine payment parity beginning January 1, 2018 (Did NOT pass). • ESHB 1713 includes a provision requiring BHOs to reimburse providers for the use of telemedicine to deliver medically necessary services to Medicaid clients (signed into law).

  11. Which Recommendations Received Attention This Legislative Session? #8 Streamlining Paperwork: • HB 1819 – paperwork reduction. Would require DSHS to review documentation policies by April 1, 2018 (signed into law). • Funded for $103,000 in the state budget.

  12. Phase IIResearch Efforts and Stakeholder Input

  13. Research Efforts Phase II report will include a UW CHWS component with details on: • Who comprises the behavioral health workforce. • Available data on: • supply, distribution and demand statistics, • demographic characteristics, • education/training output (completions statistics), • education and training requirements, and • practice characteristics. • Other key topics to inform discussions.

  14. Research Efforts (example) DRAFT

  15. Research Efforts (example) DRAFT

  16. Research Efforts (excerpt from occupation snapshot/profile)

  17. Stakeholder Input • Health Workforce Council key stakeholders advisory committee • Three policy focus groups – October 24, 2017 • Integrated care delivery and medically assisted BH treatment. • Reimbursement. • Clinical training and increasing workforce supply, distribution and diversity. • CEO Roundtable – November 6, 2017

  18. Selected Draft Recommendations (1/3) • Reimbursement • Provide a salary schedule based on factors related to the cost of living and taking into consideration regional differences in costs. • Integrated care expansion • Recommend continuing the Practice Transformation Hub (funding ends in 2019).

  19. Selected Draft Recommendations (2/3) Clinical training for BH students; supervision requirements. • DOH-led workgroup to review supervision barriers and recommend a pathway for a BH supervisor to provide supervision hours for all BH occupations. • Develop incentives for facilities with clinical supervisors to address time and productivity loss. Expand the workforce available to deliver medically-assisted behavioral health treatments. • Consider reimbursement for patient navigation/management. • Reimbursement for consultation services.

  20. Selected Draft Recommendations (3/3) Supply, Distribution and Diversity of the BH Workforce • Provide financial support and other incentives to students pursuing careers in BH. • Broad category – includes support for loan repayment and work study. • Loan repayment – increase eligibility for the program to include population groups based on specific BH diagnoses. • Explore use of apprenticeship as a model to expand BH pipeline, especially for non-credentialed or entry level occupations. • Convene education programs with providers to identify mismatches between the skills of graduates/completers and expectations of employers.

  21. Next Steps • Revise recommendations based on HWC and stakeholder feedback. • Report to Governor Inslee and Legislature due December 15, 2017.

  22. Thank you! Contact: Sue Skillman Nova Gattman skillman@uw.edunova.gattman@wtb.wa.gov

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