An overview of key strategies prioritized for the California Future Workforce Commission

1. Building for the Future
An Update on the Work of the California Future Health Workforce Commission (CFHWC)
Anne Bakar, CFHWC Commissioner
President and CEO, Telecare Corporation

2. California Future Health Workforce Commission:
Foundation Funders and Charge
• Funders: Blue Shield of California Foundation, California Health Care
Foundation, The California Endowment, The California Wellness Foundation,
and the Gordon and Betty Moore Foundation.
• Chaired by: Lloyd Dean, CEO of Dignity Health and Janet Napolitano,
President of UC
• Charge: By December 2018, develop a strategic plan for building the future
health workforce (practical short-, medium- and long-term solutions to
address current and future workforce gaps)
Build on and leverage relevant public/private efforts
Engage public and private stakeholders to support success
Recommendations to the legislature, governor, and media campaign
Funding for recommendations to be determined

3. CA Future Health Workforce Commission Structure

5. Behavioral Health Focused Commissioners
and Technical Advisory Members
Broad public/private representation, including:
• Anne Bakar, CEO, Telecare Corporation (Commissioner)
• Jane Garcia, La Clinica de la Raza (Commissioner)
• Liz Gibboney, MA, CEO Partnership Health Plan (Commissioner, Subcommittee Co-Chair)
• Kimberly Mayer, California Institute for Behavioral Health Solutions (Technical Advisory
Committee, Lead Consultant)
• Maggie Merritt, Steinberg Institute (Technical Advisory Committee),
• Stuart Buttlaire, PhD Kaiser Permanente (Subcommittee Member)
• Sergio Aguilar-Gaxiola, MD, PhD, Director UC Davis Center for Reducing Health Disparities
(Technical Advisory Committee, Subcommittee Co-Chair)

6. Behavioral Health Subcommittee Context
Assumptions:
HHS predicts moderate to severe workforce shortages in practically every
behavioral health profession nationally in 2023.
Increased demand is being fueled by the Affordable Care Act and Medicaid
expansion, parity policy, criminal justice reform, the mental health needs of
veterans returning from war, the national substance use/opioid epidemic, and the
increased rate of teenage suicide among other factors.
Behavioral health workforce needs are across the
spectrum from psychiatrists and nurses to substance
use counselors and peer providers.

7. Behavioral Health Subcommittee Context
Future workforce needs will be different than in the past:
 Training on integrated “whole person care” and co-occurring conditions
 Capable of using current and emerging technology
 Able to promote health for people across the spectrum (hospital, home and community)
 Collaborative, team-based and outcome oriented
 More racially and ethnically diverse
with corresponding language capabilities
 More able to provide services in rural,
suburban and underserved areas
 Comfortable addressing the social determinants
of health
 Capable of community/patient empowerment

8. Key Strategies Prioritized for Discussion at January 2018
Subcommittee Meeting (preliminary & not all-inclusive)
Enhance
Behavioral
Health
Professions
Education
Support
Educational
/Career
Pipeline for
Unlicensed
Staff
Remove
Workforce
Licensing
and
Technology
Barriers
Advance
Models of
Integrated
Care

9. Enhance Behavioral Health Professions Education
Increase sustainable funding sources and incentives to address the high cost of
professional education, such as MHSA WET.
• Promote cross-training in primary care and mental health education,
including co-occurring substance use, physical health, intellectual
disabilities, and the impact of justice involvement (JIMH).
• Strengthen integration of linguistic and cultural
responsiveness into all education and training programs.
• Integrate education on the social determinants of
health as part of training curriculum for all primary
care and behavioral health education programs.

10. Support Educational/Career Pipeline for Unlicensed Staff
Increase education, training and skill of unlicensed staff:
Peer Support Specialist Certification
State-Sanctioned Substance Use Counselor
Certified Psychosocial Rehabilitation Counselor

11. Remove Workforce Licensing and Technology Barriers
• Remove practice and licensing barriers for Psychiatric Nurse Practitioners to
ensure full scope of practice through fiscal/regulatory strategies including
models from other states.
• Expand use of telepsychiatry/telemedicine to its full capacity by eliminating
regulatory, reimbursement, and cultural barriers.
• Document success in other states and risks of escalating
psychiatric shortages.
• Assure accurate and efficient credentialing processes
or remove credentialing barriers.

12. Advance Models of Integrated Care
Highlight models of care that effectively treat the whole person and reduce
disparities in access to care as “models” and training sites:
The Integrated Behavioral Health Project: launched by the CA Endowment
MHSA funding has led to numerous organized integration efforts for populations
with co-occurring needs
Santa Clara County/Telecare Pay for Success program addresses the need for
Whole Person Care AND payment reform
UC Davis/UC Irvine TNT Primary Care Psychiatry

13. What Might the Future Look Like?
The Commission Northstar Vision:
“All primary care providers will have the training they need to identify early signs of
brain illness (mild/moderate), and do a warm hand-off to a BH specialist.”
“Everyone has access to the right care at the right time without extra financial
burden on the consumer.”
“Sufficient supply of BH workers to meet the demand and who understand
integrated care and the social determinants of health.”
A Provider Perspective:
Current State vs Future State: Prescribers
and Telepsychiatry
Current State vs. Future State: Peer Providers (SB 906)
Other goals/priorities/strategies?