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On September 8th the Appropriations Committee hosted a public hearing on LR238, which is an interim study that examines sources of funding for behavioral & mental health internship programs in rural Nebraska.
Much of the behavioral & mental health workforce is experiencing a shortage of professionals. This shortage strains the existing resources available for those who need behavioral or mental health services. This could be people who struggle with addiction, individuals with developmental disabilities, head trauma patients, and many others. And that shortage is particularly pronounced in the rural areas of Nebraska.
According to a report prepared by the University of Nebraska Medical Center – College of Public Health, 79 counties were designated as shortage areas for psychiatrists and mental health practitioners in 2014. Virtually all of those counties are in rural areas.
There were a number of professionals from Western Nebraska who travelled to the Capitol to testify on some of the issues they have experienced with their workforce and acquiring the funding to operate internship programs. I’d like to thank Dr. Anne Talbot and Dr. Mark Hald from Options in Psychology in Scottsbluff, Dr. Katie Carrizales from Educational Service Unit (ESU) #13 in the Panhandle, Brent Anderson from Cirrus House in Scottsbluff, and Jeff Tracy from Community Action Partnership of Western Nebraska. Each testifier did an excellent job illustrating the issues unique to our area of the state.
Some of the issues outlined by our providers in the Panhandle included regulatory interpretation of Medicaid reimbursements for behavioral & mental health internships, the authorization process for PhD candidates seeking an internship, lower reimbursement rates for behavioral health when compared to other healthcare services, and the use of leftover Medicaid funds for referral programs to behavioral & mental health services.
Other indirect ways of funding internships is simply to decrease the costs for providers. I had highlighted some of the regulations by the Department of Health and Human Services that could be simplified to make it easier for providers to initiate internships. One such regulation is concerned with the authorization of professionals in Nebraska to practice their trade: called credentialing. The process can sometimes take over months, delaying payment to interns and disincentivizing their participation in training programs.
But not all funding sources identified were through Nebraska Medicaid, however. There are many private sources that offer funding for internships. One such program is the newly formed High Plains Psychology Internship Consortium, which operates in Northeastern Colorado and Western Nebraska. Private programs such as this one are a viable source for internships, and are especially designed to keep professionals in rural areas.
The best way to keep our professionals in rural areas is exemplified by School Psychologist Dr. Katie Carrizales of ESU #13. Originally from the Panhandle, Dr. Carrizales decided to come back home after getting her degree. Part of what made this possible was the internship program she participated in and later training. Rural professionals need to be a “jack-of-all-trades” so to speak, and providing internship programs in rural areas provides training that is different from the more specialized training received in urban areas.
I learned a lot about funding issues and more broadly the behavioral & mental health workforce issues experienced in rural Nebraska. I’m grateful to all those who testified in Lincoln and look forward to working on these issues.
As always, I remain open to your feedback on how I may address the issues that mean most to you. Please do not hesitate to contact my office with any questions you may have. Thank you to those who have taken the time to express their views on various issues. My contact information is located on the right hand side of this webpage.