Improving behavioral health workforce supply and needs estimates using active surveillance data.

INTRODUCTION: Previous studies show that supply of behavioral health professionals in rural areas is inadequate to meet the need. Measuring shortage using licensure data on psychiatrists is a common approach. Although inexpensive, the licensure data have many limitations. An alternative is to implement an active surveillance system, which uses licensure data in addition to active data collection to obtain timely and detailed information. METHODS: Nebraska Health Professions Tracking Service (HPTS) data were used to examine differences in workforce supply estimates between the passive (licensure data only) and active (HPTS data) surveillance systems. The impact of these differences on the designation of psychiatric professional shortage areas has been described. Information regarding the number of psychiatrists, advanced practice registered nurses and physician assistants specializing in psychiatry was not available from the licensure database, unlike HPTS. RESULTS: Using licensure data versus HPTS data to estimate workforce, the counts of professionals actively practicing in psychiatry and behavioral health were overestimated by 24.1-57.1%. Ignoring work status, the workforce was overestimated by 10.0-17.4%. Providers spent 54-78% of time seeing patients. Based on primary practice location, 87% of counties did not have a psychiatrist and 9.6% were at or above the Health Professional Shortage Area designation ratio of psychiatrists to population. CONCLUSION: Enumeration methods such as ongoing surveillance, in addition to licensure data, curtails the issues and improves identification of shortage areas and future behavioral workforce related planning and implementation strategies.

An Academic and Practice Partnership to Assess the Behavioral Health Needs of Nebraska.

Schools of Public Health have a commitment to engage in practice-based research and be involved in collaborative partnerships. In 2016 the faculty, staff, and students from the University of Nebraska Medical Center College of Public Health and the Nebraska Department of Health and Human Services, Division of Behavioral Health collaborated to develop and administer a comprehensive assessment of the mental health and substance use disorder services provided by the Division of Behavioral Health. The purpose of this paper is to describe the process used to develop the trusting and mutually beneficial partnership and the data tools that were created and used to assess and determine the behavioral health needs. It is unrealistic to think that practitioners could undertake a project of this magnitude on their own. It is essential to have identified processes and systems in place for others to follow.

Needs Assessment for Behavioral Health Workforce: a State-Level Analysis.

This study describes trends in the supply and the need for behavioral health professionals in Nebraska. A state-level health workforce database was used to estimate the behavioral health workforce supply and need. Compared with national estimates, Nebraska has a lower proportion of all categories of behavioral health professionals. The majority of Nebraska counties have unusually high needs for mental health professionals, with rural areas experiencing a decline in the supply of psychiatrists over the last decade. Availability of robust state-level health workforce data can assist in crafting effective policy for successful systems change, particularly for behavioral health.

Estimating the State-Level Supply of Cancer Care Providers: Preparing to Meet Workforce Needs in the Wake of Health Care Reform.

PURPOSE: This study describes the supply of cancer care providers-physicians, nurse practitioners (NPs), and physician assistants (PAs)-in Nebraska and analyzes changes in the supply over a 5-year period. METHOD: We used workforce survey data for the years 2008 to 2012 from the Health Professions Tracking Service to analyze the cancer care workforce supply in the state of Nebraska. The supply of cancer care providers was analyzed over the 5-year period on the basis of age, sex, specialty, and practice location; distribution of work hours for cancer care physicians was analyzed for 2012. RESULTS: From 2008 to 2012, there was a 3.3% increase in the number of cancer care physicians. Majority of the cancer care physicians (82.5%), NPs (81.1%), and PAs (80%) reported working in urban counties, whereas approximately half of the state's population resides in rural counties (47%). Compared with the national distribution, Nebraska has a lower proportion of medical oncologists, radiation oncologists, and pediatric hematologists/oncologists. The gap between the number of cancer care physicians age ≥ 64 years and the number younger than 40 years is slowly closing in Nebraska, with an increase in those age ≥ 64 years. CONCLUSION: Increasing cancer incidence and improved access to cancer care through the Affordable Care Act could increase demand for cancer care workers. Policymakers and legislators should consider a range of policies based on the best available data on the supply of cancer care providers and the demand for cancer care.