As our lawmakers navigate the final phases of the pandemic, they will make hundreds of financial decisions aiming to maximize our collective recovery. If leaders aim to amplify the mental, physical and economic health of our communities, it is imperative that they invest in community behavioral health.
Across Washington, nonprofit community behavioral health agencies are responsible for the health and wellness of our most vulnerable community members, enabling them to lead fulfilling, productive lives. We serve as engines for local economies by supporting employment among those we serve, by creating jobs and by driving efficiencies and savings across the public safety net.
However, years of chronic underfunding are undermining our ability to deliver at a crucial time — and it’s up to state lawmakers to take more dynamic action to change that.
As leaders of three of the largest community behavioral health providers in our state, we know firsthand the impact of providing mental health services and substance use treatment to low-income and homeless adults and families who qualify for Medicaid benefits.
Our work helps adults find and keep housing and remain in their jobs. We cultivate healthy home environments for families. We embed therapists in public schools, working to support students’ mental wellness, prevent suicide and advance educational opportunities.
Larger providers are also significant employers in the areas we serve. Across Central Washington, Comprehensive Healthcare’s team numbers more than 700 — with 550-plus employees in the Yakima area alone.
Importantly, we alleviate strain on the limited resources of medical providers, law enforcement and others. Comprehensive Healthcare partners with hospitals including Yakima Valley Memorial, law enforcement agencies from Ellensburg to Walla Walla, and many more organizations to help individuals achieve mental and physical health and avoid the emergency department or jail. Care delivered by our trained mental health professionals in purposeful settings leads to better outcomes and much more cost-effective use of our safety net resources overall.
Unfortunately, for years, community behavioral health providers have also been chronically underfunded. Unsustainably low Medicaid reimbursement rates simply don’t track with the realities of what it costs to keep our communities healthy. They are also a paltry reflection of the value and economic multipliers we provide to our communities.
As a result, we don’t have enough mental health professionals to carry out our critical work.
Underfunding has led to a systemic shortage of mental health professionals who can afford to work in community behavioral health. Although around 80 cents of every revenue dollar goes to salary and benefits, community behavioral health agencies are unable to provide competitive wages compared to private practices, large hospital systems and even other state-funded health care providers.
Statewide, staff vacancy rates persist at 13 percent and it takes an average of five months to fill open positions, according to a survey by the Washington Council for Behavioral Health. At some agencies, vacancy rates stand at 26 percent.
This dynamic has been building for years and is creating existential issues as the pandemic increases the need for our services. For example, Comprehensive Healthcare has been working to fill positions for three school-based therapists in Mt. Adams, Toppenish, Union Gap and Wapato School Districts for nearly a year. A similar role in Sunnyside School District has been open for four months.
Providing sustainable funding to community behavioral health agencies would allow us to realize our full potential as health care providers and economic engines in our local communities.
Recently, state legislators took a step forward by including a modest Medicaid rate increase in their budget. We applaud this stopgap funding to help prevent further erosion of our system capacity, but the increase will not functionally assist us with more competitive pay.
These entrenched challenges require greater action.
In the short term, potentially in a proposed supplemental session later this year, we call on state leaders to allocate federal COVID-relief funding to community behavioral health agencies at a rate that recognizes the value we provide to local communities and economies. In the future, we hope to build on this foundation with more innovative funding models, expanded educational opportunities and economic incentives for individuals working in community behavioral health.
We look forward to working with lawmakers to ensure community behavioral health can compete fairly for mental health professionals and maximize our state’s recovery and resilience. It’s a smart investment for the behavioral and economic health of our communities.