What the Biden Administration Is Doing Help the Behavioral Health Workforce Crisis

The Biden-Harris administration has bolstered programs meant to overcome the educational costs of getting into the behavioral health workforce in an effort to lessen the staffing pains felt sector-wide.

Late in November, the White House hyped $1.5 billion in executive branch spending — $1 billion of which came from the American Rescue Plan Act, passed in March — going into loan repayment and scholarship programs that are heavily utilized by the behavioral health industry.

Even before the pandemic, many in the health care sector warned of present shortages in the workforce and sometimes gloomy projections of looming stagnation in specific segments of health care. This is notably true for the behavioral health industry.

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However, there are only a few places where this money is specifically dedicated to the behavioral health space, despite the heavy impact on the industry. That’s simply because it’s up to professionals and students to go after the money provided by these loan repayment and scholarship programs overseen by the federal agency Health Resources and Services Administration (HRSA), a part of the U.S. Health and Human Services Department (HHS).

And the biggest and most obvious help for the behavioral health industry was not discussed in the announcements by the White House or HHS. The American Rescue Plan Act appropriates $100 million for the Behavioral Health Workforce Education and Training (BHWET) Program for Professionals.

BHWET supports organizations that establish or expand education and training programs at several levels of training and in a broad array of fields. These range from internships to post-doctoral residency programs and counseling to psychiatry. It also supports social work education.

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Newly created programs get a boost

The White House and the HHS’ communications highlight that the Substance Use Disorder Treatment and Recovery Loan Repayment (STAR-LRP) program, a newly created program with HRSA, will receive $28 million.

Its mission is to recruit and retain medical, nursing, clinicians and paraprofessionals to the behavioral health workforce. To qualify for loan repayment, participants must work in counties that have overdose death rates higher than the national average or in an area with a recognized shortage of mental health providers.

The bulk of the $1.5 billion will go to the National Health Service Corps and the Nurse Corps. These programs offer loan forgiveness and scholarships in exchange for professionals working in specific medical fields in areas with provider shortages and are administered by HRSA.

The National Health Service Corps has its own loan repayment program for substance use disorder professionals and for behavioral health providers who can work in rural communities. And the Nurse Corps has set aside funding specifically for psychiatric nurse practitioners through its loan repayment programs.

Representatives of HRSA provided a specific breakdown for where the $1.5 billion will be spent. The National Health Service Corps has $1.23 billion, $800 million of which comes from the American Rescue Plan and has no annual spending deadline. The Nursing Corp has $284 million in appropriations, $200 of which comes from the American Rescue Plan like with the National Health Service Corps.

Behavioral health workforce has history with HRSA programs

By the end of the federal fiscal year (September 30), the National Health Service Corps and the Nursing Corp had spent about $400 million.

National Health Service Corps loan repayment and scholarships are primary care, dental, or mental and behavioral health in places with health professional shortages.

Data from HRSA show that the National Health Services Corps supported about 9,300 mental health professionals as of the end of the federal fiscal year 2021. Mental health providers made up about 47% of the 20,000 professionals in the program. The program also supported about 8,400 (42%) primary care providers and about 2,200 (11%) dental providers.

Cumulatively, HRSA currently has about 22,700 serving in areas where more professionals are needed. Just under 10,000, or 44%, of the professional participation in the National Health Service Corps, Nurse Corps, and Substance Use Disorder Treatment and Recovery loan repayment programs are in the behavioral health space, HRSA representatives said in an email.

Health care professionals are required to serve for as little as two years or as long as seven years in an area that needs additional health care professionals, depending on the program and the size of the financial assistance.

The additional funding from the American Rescue Plan Act allowed for HRSA’s programs to allocate 27% more funds in loan repayment and scholarships in federal fiscal year 2021.

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