After nearly six years as a licensed therapist in Colorado, Jenna Eisenhart decided to move to a place where her services were needed more. She surveyed rural states facing shortages of behavioral health providers and in January 2018, she accepted a job as a chief clinical primary her therapist at Shodair Children’s Hospital in Helena, Montana. rice field.
However, she was unable to start a new job immediately because state officials denied her application for a license to practice in Montana. This was because her master’s program required her only 48 credits instead of 60.
Eisenhart spent nearly $7,000 to acquire an additional 12 credits to meet the requirement.
“I’m here as a licensed therapist to provide a service Montana desperately needs. You’re saying you’re not educated enough when you really aren’t.” “It made me feel unwanted.”
The Eisenhart problem is just one example of the problems medical professionals may face in obtaining a license to practice in Montana. State lawmakers are considering proposals to make it easier for out-of-state licensed professionals to work in Montana. The need to attract more workers is particularly acute within the nation. mental health crisis And labor shortages, both exacerbated by the covid-19 pandemic. But legislators, behavioral health advocates and providers say the need is so great that lowering the barriers to out-of-state practitioners is not enough.
one measure, House Bill 101, sponsored by Republican Congressman Jane Gillette and drafted by the Interim Committee on Children, Families, Health and Welfare, specializes in social workers, professional counselors, addiction counselors, marriage and family therapists, and behavioral health peer support. Intended for homes. The Department of Labor and Industry allows Montana providers to automatically obtain a license if they meet certain requirements. For example, she has a valid license in another state for at least one year and has the appropriate educational qualifications.
Eisenhart says he wouldn’t have had to overcome so many obstacles to work in Montana if the bill had taken effect in 2018.
another, House Bill 152 Sponsored by Republican Congressman Bill Mercer and requested by the State Department of Labor and Industry as part of Gov. Greg Gianforte “Bureaucratic Relief” Initiativeaims to streamline the licensing process for all professions regulated by the department, from nurses to real estate appraisers.
HB 152 is designed to simplify the licensing process for more than 50 professions and 150 types of licenses under the Department of Labor’s jurisdiction, said Eric Strauss, manager of the Department’s Employment Standards Division. said at a January 18 committee hearing on the bill. .
Last year, the department received more than 21,300 professional licensing applications, half of which were from out-of-state professionals. Healthcare-related licenses have an even higher percentage of out-of-state applicants, 60 percent, he said.
HB 152 said it would improve license mobility by creating criteria that the department uses across professions to determine whether out-of-state license holders are eligible to work in Montana. , a department official said. Also, after receiving the completed application, he sets a 30-day timeline for the agency to issue the license.
“This allows engineers who have been working as engineers, psychologists, social workers or cosmetologists for 20 years to get their licenses without additional education or exams,” said the department. spokesperson Jessica Nelson said.
Although the two bills have the same purpose, Labor Department officials criticized Gillette’s bill on licensing behavioral health workers for not doing enough to remove barriers to out-of-state workers.
HB 101 “places additional burdens on licensing, such as requiring residency and taking certain licensing exams,” Nelson wrote in an email. “These are the issues that HB 152 seeks to reform.”
Gillette said she doesn’t think her bill or Gianforte’s bill alone will solve the workforce problem in healthcare. You need a higher redemption rate.
“It will work, but it won’t be a one-shot,” Gillette said, referring to streamlining the licensing process.
Ah Research commissioned by Congress in 2021 found that Medicaid provider rates in Montana are too low to cover the costs of many of the elderly, people with disabilities, and those working with children and adults with mental illness.
State Medicaid programs are now paying, according to research. On average, 85% of actual care costs For example, for adult behavioral health services. Gianforte’s proposed budget raises next year’s funding to 94% of his cost on average, before lowering it again to 91%. The budget bill is before legislators, asking providers to raise rates higher than the governor proposes in order to adequately fund the service.
Mary Windecker, executive director of the Montana Behavioral Health Alliance, which strives to make community-based services more accessible to patients, said her organization came up with what the interim committee became HB 101. but HB 152 said they did more than they could.
Windecker said any institution Her organization represents a staffing shortage of 25% to 30%. Alliance Up to 90% of her members’ income comes from Medicaid reimbursements, which isn’t enough, she said. She said it would speed up the licensing process and raise fees for Medicaid providers. the study Promoted by the Montana Department of Public Health and Human Services, it is a key strategy needed to meet the demand for behavioral health services.
“We have to get the people working here,” Windecker said. “We are severely understaffed and have a really hard time hiring people because Medicaid reimbursements are so low.”
According to the Behavioral Health Commission, as of last April, Montana had 5,126 active behavioral health providers. The Montana Chapter of the National Psychiatric Alliance reported: 163,000 adults I have a mental illness in Montana.
Keely Larson is a KHN Fellow of the UM Legislative News Service, a partnership of the University of Montana School of Journalism, the Montana Newspaper Association, and Kaiser Health News. Larson is a graduate student in environmental and natural resource journalism at the University of Montana.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. KHN is one of his three major operational programs in the United States, along with policy analysis and polling KFFMore (Kaiser Family Foundation). KFF is a donated non-profit organization that provides information on health issues to the public.
