Behavioral health providers lament the problem all the time: There just aren’t enough workers to keep up with the growing demand for services. Low reimbursement rates and slim operating margins are a big part of the problem because they hinder providers’ ability to pay competitive wages.
The consensus among providers is that higher reimbursement rates would help, but that kind of institutional change is typically incremental and slow-going — plus, it takes cooperation from commercial and government payers. So until that happens, providers will have to lobby for change and get creative to bolster their workforces.
The key is to focus on controllable factors — such as job descriptions and recruitment tactics — rather than uncontrollable ones — such as reimbursement rates and the COVID-19 pandemic — according to Alyssa Harley, Director of People and Culture at DATIS, a provider of unified HR and payroll software solutions for health and human services organizations.
“Anything that we can do to provide a better employment experience for our teammates will help with that recruitment and retention,” Harley said during a recent National Council for Behavioral Health webinar, which was moderated by Behavioral Health Business. “And a lot of things that we can do will actually have very little or minimal financial impact, especially when you consider the cost of turnover.”
When it comes to the recruitment process, providers can implement a number of low-cost changes to expand their applicant pools, from where they advertise positions to how they approach job descriptions.
“Subconsciously, I think we might use gendered tones [in job descriptions], whether directly saying ‘she’ or ‘he’ or using words that will appeal to more men than women,” Harley said during the webinar.
Examples include terms such as “chairman” instead of “chair” or “salesman” instead of “salesperson.”
By identifying and removing biased language, providers can prompt more candidates to apply for open positions. A similar rule of thumb goes for the requirements and duties detailed in job postings.
Long lists of very specific requirements can intimidate job seekers and discourage qualified candidates from applying. Instead, providers should stick to the essentials and consider whether all the specifications they’ve included in the posting are necessary.
National Council CEO Chuck Ingoglia used educational requirements as an example. While certain behavioral health jobs require special degrees, many lower-level positions have no such regulatory requirement — yet organizations still frequently ask applicants to have certain degrees.
“Sometimes we impose those [degree requirements],” Ingoglia said during the webinar. “We have assumptions about who can do what kind of jobs, and I know that’s one of the issues that we’re looking at, even internally at the National Council.”
Another important factor providers should consider when looking to expand and improve their workforce is from where they’re recruiting.
“It’s not enough to put up a job post and hope that the right people apply,” Harley said.
Instead, she recommends providers reach out to sources and recruiting channels that can help them draw in diverse talent. A common criticism of the behavioral health industry is that workforces often lack diversity, with Black, brown and Asian clinicians in short supply.
In addition to rewriting job descriptions to eliminate bias, Harley recommends providers work with historically black colleges and universities (HCBUs) to help with that.
“We’ve found success by partnering with our regional HBCUs, forming relationships with them and being able to recruit directly from there,” Harley said.
That’s possible even for providers that don’t have any HBCUs in their area.
Take Care Plus New Jersey, for example. The nonprofit behavioral health provider offers comprehensive, recovery-focused integrated primary care, mental health care and substance use disorder (SUD) treatment services across northern New Jersey. It provides outpatient, inpatient, residential and community-based care.
While there aren’t any HBCUs in New Jersey, Care Plus has found success in working with those in nearby states, according to Brigitte Johnson, the organization’s executive senior VP of corporate affairs, compliance and in-house counsel.
“We started … reaching out to the HBCUs that may not be in our area, but probably have students that are from New Jersey,” Johnson said during the webinar. “We’re [also] talking about actually saying to some of our local colleges, ‘We need minorities, and this is the reason why.’ Then, we’re really trying to solicit and advertise for minorities to come to Care Plus.”
On top of that, Care Plus is looking at offering more supervision as a lure to draw in workers with provisional licenses.
While recruitment is undoubtedly important, it’s only half the battle. Retention can be equally difficult.
When it comes to retention, Carolyn Petrak — associate executive director of the Ability Network of Delaware — said some of her members have found success in creating an inclusive, supportive culture and outlining potential career growth pathways and opportunities.
The Ability Network of Delaware is an association that represents disability service providers across the state.
“You would have to create a career pathway if you’re going to recruit [and retain] for the immense need in this field,” Petrak said.
Harley agreed. She encouraged providers to explore development programs and ask workers about their professional goals early on.
Meanwhile, Johnson said Care Plus NJ recently formed a diversity and inclusion committee to review policies and procedures for implicit bias. So far, it’s already identified a few areas that need improvement to make the workplace more welcoming.
“We started talking about certain policies that we have in place that are not seeming inclusive,” Johnson said. “One thing, for example, was our dress code, so we started looking at our dress code: How could we change that? How can we make it more inclusive?”
Finally, Ingoglia said the pandemic is a good reminder that providers have to be understanding of employees’ personal needs, which can help keep employees happy in the long-run. As such, the National Council has implemented options like flex scheduling to give people the flexibility they need.