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Building for the Future: An Update on the Work of the CA Future Health Workforce Commission

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An overview of key strategies prioritized for the California Future Workforce Commission

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Building for the Future: An Update on the Work of the CA Future Health Workforce Commission

  1. 1. Building for the Future An Update on the Work of the California Future Health Workforce Commission (CFHWC) Anne Bakar, CFHWC Commissioner President and CEO, Telecare Corporation
  2. 2. California Future Health Workforce Commission: Foundation Funders and Charge • Funders: Blue Shield of California Foundation, California Health Care Foundation, The California Endowment, The California Wellness Foundation, and the Gordon and Betty Moore Foundation. • Chaired by: Lloyd Dean, CEO of Dignity Health and Janet Napolitano, President of UC • Charge: By December 2018, develop a strategic plan for building the future health workforce (practical short-, medium- and long-term solutions to address current and future workforce gaps) Build on and leverage relevant public/private efforts Engage public and private stakeholders to support success Recommendations to the legislature, governor, and media campaign Funding for recommendations to be determined
  3. 3. CA Future Health Workforce Commission Structure
  4. 4. Behavioral Health Focused Commissioners and Technical Advisory Members Broad public/private representation, including: • Anne Bakar, CEO, Telecare Corporation (Commissioner) • Jane Garcia, La Clinica de la Raza (Commissioner) • Liz Gibboney, MA, CEO Partnership Health Plan (Commissioner, Subcommittee Co-Chair) • Kimberly Mayer, California Institute for Behavioral Health Solutions (Technical Advisory Committee, Lead Consultant) • Maggie Merritt, Steinberg Institute (Technical Advisory Committee), • Stuart Buttlaire, PhD Kaiser Permanente (Subcommittee Member) • Sergio Aguilar-Gaxiola, MD, PhD, Director UC Davis Center for Reducing Health Disparities (Technical Advisory Committee, Subcommittee Co-Chair)
  5. 5. Behavioral Health Subcommittee Context Assumptions: HHS predicts moderate to severe workforce shortages in practically every behavioral health profession nationally in 2023. Increased demand is being fueled by the Affordable Care Act and Medicaid expansion, parity policy, criminal justice reform, the mental health needs of veterans returning from war, the national substance use/opioid epidemic, and the increased rate of teenage suicide among other factors. Behavioral health workforce needs are across the spectrum from psychiatrists and nurses to substance use counselors and peer providers.
  6. 6. Behavioral Health Subcommittee Context Future workforce needs will be different than in the past:  Training on integrated “whole person care” and co-occurring conditions  Capable of using current and emerging technology  Able to promote health for people across the spectrum (hospital, home and community)  Collaborative, team-based and outcome oriented  More racially and ethnically diverse with corresponding language capabilities  More able to provide services in rural, suburban and underserved areas  Comfortable addressing the social determinants of health  Capable of community/patient empowerment
  7. 7. Key Strategies Prioritized for Discussion at January 2018 Subcommittee Meeting (preliminary & not all-inclusive) Enhance Behavioral Health Professions Education Support Educational /Career Pipeline for Unlicensed Staff Remove Workforce Licensing and Technology Barriers Advance Models of Integrated Care
  8. 8. Enhance Behavioral Health Professions Education Increase sustainable funding sources and incentives to address the high cost of professional education, such as MHSA WET. • Promote cross-training in primary care and mental health education, including co-occurring substance use, physical health, intellectual disabilities, and the impact of justice involvement (JIMH). • Strengthen integration of linguistic and cultural responsiveness into all education and training programs. • Integrate education on the social determinants of health as part of training curriculum for all primary care and behavioral health education programs.
  9. 9. Support Educational/Career Pipeline for Unlicensed Staff Increase education, training and skill of unlicensed staff: Peer Support Specialist Certification State-Sanctioned Substance Use Counselor Certified Psychosocial Rehabilitation Counselor
  10. 10. Remove Workforce Licensing and Technology Barriers • Remove practice and licensing barriers for Psychiatric Nurse Practitioners to ensure full scope of practice through fiscal/regulatory strategies including models from other states. • Expand use of telepsychiatry/telemedicine to its full capacity by eliminating regulatory, reimbursement, and cultural barriers. • Document success in other states and risks of escalating psychiatric shortages. • Assure accurate and efficient credentialing processes or remove credentialing barriers.
  11. 11. Advance Models of Integrated Care Highlight models of care that effectively treat the whole person and reduce disparities in access to care as “models” and training sites: The Integrated Behavioral Health Project: launched by the CA Endowment MHSA funding has led to numerous organized integration efforts for populations with co-occurring needs Santa Clara County/Telecare Pay for Success program addresses the need for Whole Person Care AND payment reform UC Davis/UC Irvine TNT Primary Care Psychiatry
  12. 12. What Might the Future Look Like? The Commission Northstar Vision: “All primary care providers will have the training they need to identify early signs of brain illness (mild/moderate), and do a warm hand-off to a BH specialist.” “Everyone has access to the right care at the right time without extra financial burden on the consumer.” “Sufficient supply of BH workers to meet the demand and who understand integrated care and the social determinants of health.” A Provider Perspective: Current State vs Future State: Prescribers and Telepsychiatry Current State vs. Future State: Peer Providers (SB 906) Other goals/priorities/strategies?

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