The Texas Statewide Health Coordinating Council www.dshs.state.tx.us/chs/schcc (SHCC) ensures that healthcare services and facilities are available to all Texans through health planning activities. Based on these planning activities, the SHCC makes recommendations to the Governor and the legislature through the Texas State Health Plan by providing data, analysis, and policy recommendations on how to deal with mental health workforce shortages in the state.
On August 21, 2014, SHCC submitted their plan and policy recommendations to the Texas Department of State Health Services https://www.dshs.state.tx.us (DSHS) with the recommendations organized around five key approaches aimed at mitigating the mental health workforce shortage.
The recommendations are to:
- Increase the size of the mental health workforce by identifying and expanding incentives to practice psychiatry.
- Have the state provide loans to psychiatrists and primary care physicians serving in state-supported living centers and state hospitals and to those psychiatrists and primary care physicians involved in patients care after transition to community-based care from these facilities
- Extensively incorporate advanced practice nurse and physician assistants into the mental- health workforce. The legislature should allow qualified advanced practice nurses and physician assistants to conduct initial and follow-up psychiatric evaluations
- Remove barriers to the adoption and practice of telemedicine and telehealth such as the requirement that current telemedicine and telehealth rules requiring a new patient to present at an established medical or health site. The use of an established medical/health site may be unnecessary for certain mental health provider-patient interactions
- Allocate funds and direct the Texas HHSC to implement rules to allow for adequate Medicaid reimbursement covering the costs of patient site presenters when utilized by the provider and facility use
- Require relevant licensing boards to collect information on the linguistic competencies of health professionals to promote a culturally competent workforce. Specifically, the legislature should amend the Health and Safety Code to direct the Health Professions Council www.hpc.state.tx.us and the Texas Department of Information Resources www.dir.state.tx.us/Pages/Home.aspx to collect linguistic proficiency data for analysis by DSHS
- Incorporate interprofessional collaborative training as part of the preparation for new health professionals since training is needed to establish collaborative healthcare teams and patient-centered medical homes
- Develop analytical and statistical models for workforce supply, demand, and patient utilization to inform others on the mental healthcare needs within the State
- Provide HHSC and DSHS access to data related to mental health services needs and direct these agencies to develop statistical models to measure and predict workforce shortages
- Direct HHSC and DSHS to evaluate the potential long and short term impacts of projects funded by the Delivery System Reform Incentive Payment Program for over $11,000,000,000 covering almost 1,200 projects across the state.
Dr. Mike Ragain, Chair of the SHCC reports that while the recommendations are specific to the mental health workforce shortage, the SHCC will be addressing payment and delivery aspects of the shortage in its update to the Texas State Health Plan due to the governor’s office November 1, 2014.