Background
Much remains unknown about the characteristics of and challenges facing the behavioral health workforce employed by Certified Community Behavioral Health Clinics (CCBHCs). While CCBHCs are required to provide, or contract with organizations to offer, nine types of service categories, the SAMHSA CCBHC certification criteria do not specify the types of services CCBHCs must offer and staff CCBHCs must employ or partner with to provide these services. Consequently, HHS devolves most staffing related decisions to states and CCBHCs; states can impose additional staffing requirements on CCBHCs within their state, and CCBHCs can hire the providers they believe are most appropriate for offering the nine mandated service categories.
This project examines the characteristics of (i.) the behavioral workforce employed by CCBHCs, (ii.) the challenges facing CCBHCs in hiring and retaining staff, (iii.) solutions employed to address hiring and retention concerns, and (iv.) the financial viability of the CCBHC staffing model. Early research on CCBHC staff suggests that CCBHCs generally increased the number of staff following CCBHC certification and participation in CCBHC federal programs (ASPE 2019; ASPE 2020). However, the increase concentrates in certain provider types, such as family support staff, community health workers, interpreters or linguistic counselors, and occupational therapists (ASPE 2020). These reports also discuss challenges hiring and retaining staff, including rural and frontier site locations, salary expectations, state and regional workforce shortages, competition with other health facilities, and the demand of the CCBHC model. To address these concerns, some CCBHCs have offered enhanced salaries, expanded telehealth, and used recruiters and credentialing boards to fill vacancies (ASPE 2019; ASPE 2020).
Our project builds upon this research. First, we examine the effect of federal program participation on the CCBHC workforce. There are two federal programs available to CCBHCs, yet most research on CCBHCs only examine those that participate in the Section 223 Demonstration Program, ignoring the far majority of CCBHCs that do not participate in this Program but have received a SAMHSA Expansion Award. Indeed, reports from advocacy organizations suggest that federal program participation likely impacts the CCBHC workforce. Second, to our knowledge, we are the first research examining perspectives on the short- and long-term financial viability of the CCBHC staffing model.
Findings
Examining the design and utility of CCBHC–FQHC arrangement best practices will aid policymakers in understanding the dynamics of behavioral health and primary care integration at the community level. Future research can examine the implications of a shared patient population for FQHCs and CCBHCs, particularly the potential workforce implications. Other research should examine the facilitators and barriers to electronic health record integration between CCBHCs and FQHCs. This project in particular may be well suited for the CCBHC Expansion Grant Implementation Science Pilot.
Um das Thema Potenz ranken sich so viele Mythen, dass es ein ganzes Buch und nicht nur einen Artikel bräuchte, um sie auszuräumen. Dennoch möchte ich einige von ihnen Besucherseite erwähnen, um ein für alle Mal mit ihnen aufzuräumen.
