It’s no secret that the COVID-19 pandemic and its ripple effects caused an unprecedented workforce shortage. For community behavioral health, this shortage has reached crisis levels. 

In Washington, the vacancy rate for behavioral health professionals with advanced degrees was an astounding 29% in 2022, with a turnover rate of 32%—trending up from 2021, according to a survey by the Washington Council for Behavioral Health.

While community behavioral health providers are some of the largest employers in the areas we serve, decades of underfunding have made it nearly impossible to recruit and retain professionals. 

Community behavioral health providers are on the front lines, caring for the most vulnerable populations—low income and homeless adults and youth who qualify for Medicaid benefits. We intervene in—or better yet, prevent—mental health crises, helping individuals stay out of the hospital or jail. We also partner with schools to ensure kids from low-income families can get the services they need. Despite the vital roles we play, in 2022, a staggering 74% of community behavioral health agencies in  the state limited or closed programs due to low staffing levels.

Because community behavioral health agencies serve primarily Medicaid enrollees, they lack the diverse mix of insurance contracts and private pay that enables other types of providers to maintain workable compensation and margins. In Washington, community-based providers spend around 80 cents of every revenue dollar on compensation and still fall short. The council’s report showed that 84% of respondents cited low salaries and uncompetitive benefits as top reasons employees leave community behavioral health.

Our agencies are employing creative solutions to address the workforce crisis and keep our doors open. In Spokane, Frontier Behavioral Health recently launched our CARE Model, which creates new roles for professionals with bachelor’s degrees to complement the care provided by those with advanced education. Since launching the model in 2021, unfilled positions have dropped to 30% from 50% in our outpatient program.

In Central Washington, Comprehensive Healthcare has shown what a difference competitive compensation makes. Through stewardship of resources, we used one-time stabilization funding to increase salaries for key roles in 2021, and résumé submissions for behavioral health associates and case managers shot up 24%.

Unfortunately, creative solutions and planning aren’t enough to address the enormity of the workforce shortage in 2023. Without support from state lawmakers, the situation is untenable.

We’re calling on the Washington state Senate and Gov. Inslee to join the House in approving a 15% increase in the Medicaid and non-Medicaid rates that fund community behavioral health. 

Beyond increased resources, it’s also essential to make substantive systemic changes to improve community behavioral health in Washington. We’re working with state leaders to develop a new, evidence-based behavioral health care model called Certified Community Behavioral Health Care Centers. The CCBHC model has been adopted by over a dozen other states and has shown promising results.

It’s tragic that community behavioral health systems are hobbled by lack of resources in a time of unprecedented need. But it doesn’t have to be this way. It’s time to show up for the workers who care for the most vulnerable among us.

Jeff Thomas is CEO at Frontier Behavioral Health, and Jodi Daly is CEO at Comprehensive Healthcare.