Health workforce professional shortages have been a longstanding concern across the United States and worsened because of the pandemic. In the behavioral health field, these shortages are compounded for professions ranging from paraprofessionals to psychiatrists. States have grappled with strategies to identify effective approaches to measure unmet need and to meet demand. During this learning network session, we heard from three health care workforce professionals about strategies they are pursuing in California, Indiana, and Utah to assess need and establish new roles and career trajectories in the workforce. On February 13, 2024 we met to discuss:

  • How states can use health workforce licensure data to assess supply and demand;
  • California’s methodology for assessing their workforce needs and workforce strategies they are pursuing such as wellness coaches to support youth; and
  • New behavioral health extender licenses intended to bridge gaps in training and experience while promoting increased safety measures.

Watch the full session and read the key takeaways below.

Identify efficient strategies for collecting and analyzing standardized information about the health care workforce

    • Pursue the federal process to be designated as a Health Workforce Shortage Area (HPSA/mHPSA)
    • Ensure that workforce data is high-quality and robust
      • Maxey stressed that states must know more than the number of people who hold licenses; they must know who is actually practicing, the communities where they practice, the type of services they provide, and the populations they serve.
      • Additionally, Maxey underscored the necessity of clear definitions when collecting data to ensure accuracy of information.

Address issues related to licensure, liability, protection, and scope of practice policies

  • Assess licensure questions, considering what questions may need to be added, and which questions should be limited or eliminated
  • Position clinicians to work at the top of their license and optimize their scope of practice
    • Shumway is an ardent proponent for finding ways to better utilize professionals such as case managers, crisis managers, peer support specialists, community health workers, etc.
  • Investigate and evaluate workforce incentives
    • Are they aligned and appropriate for workforce development?
    • Are the allocated resources being maximized?
    • Are there better options?
  • Support health care workers by addressing the challenges of the profession and allowing them to access support without fear or consequence
    • The “State Strategies to Support the Future of the Primary Care Physician and Nursing Workforce” cites promoting provider wellness and wellbeing, guarding against burnout and ensuring safe working environments and conditions as areas to address
    • To mitigate turnover and burnout, Maxey asserted that residents and workers (especially those who work in community-based settings) should receive behavioral health care from the first day their work commences. Shumway built on this point, noting that, given the difficulty and emotional toll of behavioral health occupations, quality and consistent supervision “is about more than safety and gaining skills, it’s really a workforce retention tool.”
  • Establish trauma-responsive workplaces and institute trauma-responsive culture within organizations

Pursue new training and career pathways for behavioral health professionals, and provide support throughout their career lifespans

  • Explore and establish new categories and designations that can scaffold pipelines, respond to emerging and projected trends, and broaden access to the profession
  • Pursue cross-sector and inter-sector insights and examples that can defray training and education costs for potential providers (ex. paid internships, apprenticeships, letting part-time workers access or retain benefits, etc.)
    • Make sure that graduates aren’t paying for their own supervision
    • Consult bodies such as The National AHEC (Area Health Education Centers) Organization and The National Conference of State Legislatures Scope of Practice Landscape
    • Abbott shared that California is tapping into the expertise of its labor and workforce development agency to collaborate and look at creating paid and supported transitions into the field.
    • “States can have a role in looking at workforce and training investments, but employers also need to be a very big part of the solution; they should see their contributions and resource allocations as part of a larger workforce development strategy,” Maxey said
  • Consider new pathways that can circumvent potential barriers and biases
    • In its 2023 Periodic Review, Utah puts forth a path that would allow potential providers who have attempted the licensing exam to do additional clinical hours in lieu of retesting. “Research shows a strong correlation between doing supervised clinical hours and building skills related to patient outcomes and patient safety. We couldn’t find any studies that showed changes in skills, behaviors, and patient outcomes related to the national exam, it shows almost no connection, which I think is largely because the exam is duplicating what the master’s does in terms of abstract knowledge,” Shumway said
  • Establish trauma-responsive workplaces and institute trauma-responsive culture within organizations

*One month after this Learning Network Session, Utah passed S.B. 26, the Behavioral Health Licensing Amendments bill, which introduces new certifications for entry-level workers, allows entry-level workers with related degrees to pursue a BH Coach license, and creates an alternate pathway for mental health therapists to become fully licensed with additional clinical supervision and recommendations in lieu of passing a national exam.

Meet the Speakers

Libby Abbott, Deputy Director, California Department of Health Care Access and Information

Libby Abbott joined California’s Department of Health Care Access and Information (HCAI) in October 2023 to lead the Office of Health Workforce Development. Prior to joining HCAI, Libby was the Director of the Health Workforce Program at the Clinton Health Access Initiative, where she led a portfolio of technical assistance to the governments of 12 countries on health workforce planning, programs, and policy. In this capacity she worked closely with the governments of several countries – Ethiopia, Liberia, Malawi, and Rwanda – to design and launch national health workforce strategies, including supply and demand modeling to set workforce targets, pre-service scale up plans, and introducing new health professions training programs. Libby also has a background in research, monitoring, and evaluation and holds a Masters in Public Health and a Masters in International Affairs from Columbia University.

Hannah Maxey, PhD Associate Professor of Family Medicine and Director of the Bowen Center for Health Workforce Research and Policy at the Indiana University School of Medicine

Dr. Hannah Maxey is an Associate Professor at Indiana University, where she also serves as Founding Director of the Bowen Center for Health Workforce Research and Policy located in Indianapolis, IN. She is a nationally recognized expert and thought leader on state health workforce policy issues. Her expertise includes strategy development and consensus building for state centric solutions to complex health workforce issues. Dr. Maxey’s consulting experience includes both government and private sector clients interested in advancing health care workforce initiatives and she established Veritas Health Solutions, LLC (VHS) in 2019 as a mechanism to provide a broad range of integrity-based services to help clients generate and implement customized solutions. She received her PhD from the Department of Health Policy and Management at Indiana University Richard M. Fairbanks School of Public Health in 2014, and holds a Master of Public Health as well. She has held an Indiana State Dental Hygiene license since 2000. Prior to pursuing graduate training, Dr. Maxey spent nine years practicing dental hygiene in federally qualified health centers.

Jeff Shumway, Director, Office of Professional Licensure Review for the State of Utah

Jeff Shumway helped launch the Office of Professional Licensure Review in July 2022. Prior to accepting that role, Jeff worked with The Bridgespan Group and Social Finance where he advised major nonprofits, philanthropies, and government agencies. As director of the Office of Professional Licensure Review, Jeff leads a team of employees who take a critical look at all state licensure requirements to inform the state legislature on necessary changes and updates to those requirements. Jeff holds a degree in public policy from the Harvard Kennedy School of Government and a degree in Economics from Brigham Young University.

Event Info

  • Location: Virtual
  • Date: February 13
  • Time: 4:00 PM - 5:00 PM ET
  • Phone: