Bill Overview
Title: Expand the Behavioral Health Workforce Now Act
Description: This bill requires the Centers for Medicare & Medicaid Services to issue guidance for states on ways to increase education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and the Children's Health Insurance Program (CHIP), particularly in rural and underserved areas.
Sponsors: Sen. Stabenow, Debbie [D-MI]
Target Audience
Population: People who require mental health and substance use disorder services
Estimated Size: 50000000
- The bill focuses on improving the availability of mental health and substance use disorder services.
- Education, training, recruitment, and retention efforts aim to increase the workforce offering these services.
- Rural and underserved areas are specifically mentioned, indicating a focus on populations with limited current access to mental health services.
- Global statistics indicate that mental health disorders affect hundreds of millions worldwide annually, making many individuals potentially benefit from enhanced workforce capabilities.
Reasoning
- The policy focuses on improving mental health and substance use disorder services in underserved areas, which will likely have varying levels of impact on different populations.
- Not everyone in the country will be directly impacted due to budget limitations and the policy's targeted nature.
- Mental health and substance use disorder services cater to those with psychiatric or substance abuse challenges, potentially improving their life satisfaction and overall wellbeing.
- The current workforce shortages exacerbate problems in rural areas, so individuals in these regions may experience the most significant improvements.
- The social stigma around mental health can impact willingness to seek help, which may affect the initial uptake of expanded services.
- The budget restrictions over the next ten years suggest gradual improvements rather than immediate resolution of workforce shortages.
Simulated Interviews
High school teacher (Rural Kentucky)
Age: 34 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 3/20
Statement of Opinion:
- Right now, it's hard to find someone local who can help with my anxiety.
- Traveling an hour for each therapy appointment is not sustainable for my family.
- If more professionals were available nearby, I'd definitely use those services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 9 | 4 |
Software engineer (Urban California)
Age: 29 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 4/20
Statement of Opinion:
- Finding a suitable therapist is already feasible in the city, so this policy won't affect me much.
- Still, improving access for others in less accessible areas is a necessary step.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Nurse (Suburban Texas)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- We desperately need more trained professionals—they're critical in handling the mental health cases we're seeing more often.
- This policy could ease our waitlists and provide quicker care for our patients.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired logger (Remote Idaho)
Age: 63 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 15.0 years
Commonness: 2/20
Statement of Opinion:
- Accessing help is tough due to where I live, and it's very expensive.
- If this policy brings providers nearby, it could be life-changing for me and others like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 7 | 3 |
Psychologist (Urban New York)
Age: 52 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 4/20
Statement of Opinion:
- There is sufficient workforce here for now, but nationwide improvements are necessary.
- It's good to see mental health getting the attention it deserves.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
College student (Detroit, Michigan)
Age: 22 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- Finding the right therapist has been a challenge, especially on a student budget.
- More available resources would definitely help improve my mental health journey.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 8 | 5 |
Farmer (Rural Montana)
Age: 38 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 12.0 years
Commonness: 2/20
Statement of Opinion:
- I've had to choose between paying bills and seeing a therapist.
- Bringing more providers here would greatly benefit our community.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Retail worker (Urban Florida)
Age: 19 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I think more available counselors would make managing my anxiety easier.
- The current wait times are too long.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 8 | 4 |
Fishing industry worker (Rural Maine)
Age: 47 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 15.0 years
Commonness: 2/20
Statement of Opinion:
- Localized counseling would be more effective than traveling long distances.
- The policy offers hope for quicker assistance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 7 | 3 |
Unemployed (Rural Alabama)
Age: 26 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- I feel isolated without access to mental health services.
- The policy could make a significant difference in my wellbeing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Cost Estimates
Year 1: $300000000 (Low: $250000000, High: $350000000)
Year 2: $310000000 (Low: $260000000, High: $360000000)
Year 3: $320000000 (Low: $270000000, High: $370000000)
Year 5: $340000000 (Low: $290000000, High: $390000000)
Year 10: $380000000 (Low: $330000000, High: $430000000)
Year 100: $-1 (Low: $-1, High: $-1)
Key Considerations
- The need for a sustained investment in the behavioral health workforce over the decade to counteract professional shortages.
- Potential need for continuous monitoring and adjustments in recruitment and retention strategies to ensure rural areas benefit.
- The exact amount of savings from reduced emergency care is uncertain as it requires behavioral health outcomes to improve.