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Stephanie Pellitt

, National Council for Behavioral Health

Congressional Briefing Urges Congress to Empower Addiction Workforce

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Addiction workforce advocates presented on the Hill this week as part of a congressional staff briefing exploring opportunities for Congress to better equip front-line providers to prevent and treat opioid and other addictions. The hearing featured testimony from Mary-Catherine Bohan, representing a Certified Community Behavioral Health Clinic (CCBHC) from New Jersey, who shared how the CCBHC model is transforming her clinic’s ability to hire addiction treatment professionals and serve more patients.

The National Council – members of both the Coalition to Stop Opioid Overdose (CSOO) and the Mental Health Liaison Group (MHLG) – helped lead this staff briefing, attended by dozens of staff and advocates. With workforce shortages driving a lack of treatment access nationwide, a panel of addiction experts offered strategies for bringing more qualified professionals into the field.

UNTAPPED WORKFORCE OPPORTUNITIES

Congresswoman Annie Kuster (D-NH), founder and co-chair of the Bipartisan Heroin and Opioids Task Force, opened the briefing by outlining some of Congress’ recent work to address the opioid epidemic, including the SUPPORT Act (H.R. 6), but acknowledged that much more had to be done, especially in the area of bolstering the addiction workforce.

“We are experiencing a dire shortage of front-line providers,” Kuster explained while adding that Congress must appropriate funds for programs that support these desperately-needed professionals. Specifically, Kuster urged legislators and advocates to ensure the currently unfunded Mental Health and Substance Use Disorder Workforce Training Program, authorized by the 21st Century Cures Act, receives $10 million in funding for FY 2020. This program would grow the addiction workforce pipeline by giving academic institutions grants to support students interested in pursuing careers in addiction medicine.

Congressman Hal Rogers (R-KY) also joined the briefing to highlight legislation he sponsored alongside Representative Katherine Clark (D-MA) called the Substance Use Disorder Workforce Loan Repayment Act. Enacted as part of the SUPPORT Act, the law authorizes the Health Resources and Services Administration (HRSA) to create a student loan forgiveness program specifically dedicated to professionals working in addiction treatment and recovery support in underserved areas. Rogers noted that the bill provides addiction services professionals “substantial financial incentives to work in the programs where they can have the biggest impact.” The legislation was first introduced as a result of education and advocacy by the National Council for Mental Wellbeing and the Association for Behavioral Healthcare in Massachusetts. Congressman Rogers urged Congressional appropriators to ensure this new program is fully funded at $25 million for Fiscal Year 2020.

CCBHCs: A SUSTAINABLE WORKFORCE SOLUTION

Mary-Catherine Bohan, Vice President of Outpatient Services with Rutgers University Behavioral Health Care, spoke on the panel to share how her clinic was able to address its addiction workforce challenges and dramatically expand access to addiction care. Bohan credited Rutgers’ participation in a two-year, eight-state Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration as the reason for its success.

As a CCBHC, Rutgers is required to provide a comprehensive array of mental health and addiction services integrated with physical health services. The CCBHC model also places an emphasis on evidence-based practices, improved access to care and cost efficiency. Bohan explained that since becoming a CCBHC, Rutgers has increased access for patients with addictions by hiring new addiction-focused staff including psychiatrists who are waivered to prescribed buprenorphine, nurses, counselors and peer support specialists. Rutgers also expanded key services such as case management, which under the CCBHC model, allows clinicians to reach at-risk individuals outside the four walls of the clinic in community settings. With an enhanced workforce, Rutgers has increased its patient caseload by 65 percent in the first year alone.

Unfortunately, all current CCBHCs participating in the Medicaid demonstration could see their progress in expanding access to addiction and mental health care stripped away as the program is set to end in mid-2019. Congressional action is needed to authorize an extension and expansion of the demonstration. The National Council is working with Members of Congress to reintroduce the bipartisan Excellence in Mental Health and Addiction Treatment Expansion Act as early as next week. This bill would extend CCBHC funding for the current eight demonstration states by two years and add eleven new states to the program.

OTHER SOLUTIONS

Other panelists illustrated the need for well-funded addiction workforce programs, such as those created by the SUPPORT Act and 21st Century Cures Act, by sharing the challenges they face in the field. Dr. Yngvild Olsen with the Institutes for Behavioral Resources Inc/REACH Health Services testified that addiction is a chronic brain disease requiring long-term treatment and support. As such, Dr. Olsen recommended investing in treatment professionals across the whole continuum of care for addiction, but especially for specialty mental health and addiction treatment clinics that help individuals sustain their recovery in the long-term.

Daniel Raymond with the Harm Reduction Coalition explained how more community health and outreach workers are needed to engage individuals who are not connected with the traditional health care system in treatment. Shannon Gresham of the Council on Alcoholism and Drug Abuse of Northwest Louisiana, who oversees a 16-bed adolescent treatment center, highlighted the need for more professionals who are trained in prevention, early intervention and adverse childhood experiences, so these conditions can be treated earlier. Further, Dr. Eric Ketcham, an Emergency Medicine Physician and Addiction Specialist, noted that emergency departments need more addiction-focused staff who can initiate medication-assisted treatment (MAT) and help bridge the gap between the ER and ongoing addiction treatment.