David A. Sharar: Rebuilding the State Health Workforce | Columnists

When a person with serious mental illness living in supportive housing has a troubled night, a third shift housing worker consoles and supports them. When that same person is going through severe depression and past trauma, a trained mastery therapist helps them through their depressive episode. When a client with an alcohol use disorder is frightened, ill, and admitted for residential addiction treatment, a nurse and an addictions counselor care for and stay with them.

These essential workers have always been difficult to find and keep. Now it’s harder than ever. Illinois’ private nonprofit community behavioral health sector is experiencing the worst workforce crisis in its more than 50-year history.

There are approximately 8,000 to 10,000 vacancies at community behavioral health agencies in Illinois, as demand for services is at an all-time high. Agencies are losing staff en masse because we can’t pay essential workers enough to stay. Some leave the field completely or take early retirement. For-profit behavioral health companies, digital behavioral health start-ups, large health systems and private group practices are hiring other workers offering more money, less documentation, increased flexibility and “easier” and less complex customers.

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Meanwhile, community behavioral health programs are reporting increased wait lists, reduced access, and even the closure of some critical programs — all too often in communities of color and rural areas. These agencies primarily serve people with low incomes, living at or near the poverty line, and without access to behavioral health care. The lion’s share of funding for community behavioral health comes from Medicaid — public insurance funded by state and federal governments — and grants from the Illinois Department of Social Services.

Community behavioral health agencies need to attract and retain workers with the right skills and focus on our core mission. It starts with tackling unsustainable wages. Failure to invest modestly in improving access now will inevitably result in significantly higher downstream costs to society in the form of more arrests, days in jail, ER visits, in schools and admissions to public hospitals, nursing homes and foster homes.

How to stabilize the workforce? The plan must include passing legislation to preserve and expand access to Medicaid-covered behavioral health care in Illinois.

I am grateful to the champions of the Illinois General Assembly — Majority Leader Greg Harris and Senator Elgie Sims — for pursuing legislation to increase state Medicaid rates. The Rebuild Illinois Mental Health Workforce Act would inject $130 million into mental health services and an additional $41 million into addictions services. I am also encouraged that Governor JB Pritzker drew attention to the workforce crisis in his recent budget speech and called for increased funding to support community behavioral health agencies.

Many years ago, as a graduate student at the University of Illinois, I attended a lecture by former Illinois Governor Jim Edgar, who said, “The purpose of government is to help those who cannot help themselves. This quote stuck with me. I am thrilled to see our General Assembly, the Governor’s office, the Department of Human Services under Secretary Grace Hou and the Department of Health and Family Services under Director Theresa Eagleson implement Governor Edgar’s memorable quote and take action. in unison to ensure the preservation of community behavioral health services in Illinois, a priority for fiscal year 2023.

David A. Sharar is CEO of Chestnut Health Systems.

Michael A. Bynum