University of Nebraska Medical Center

The BHECN-ARPA Project -- A landmark opportunity

From left: Rob Taillon (ARPA supported Intern), Jesica Vickers, LIMHP, LPC, NCC (Owner & Therapist), and Denise Bredthauer (Office Manager) at Live Well Counseling in Kearney. Live Well received ARPA funding to support the supervision of counseling interns and provisionally licensed therapists. Taillon is supervised by Vickers. The center also received ARPA support to help provide more telebehavioral health, which is essential to meeting needs, particularly in rural parts of the state.

Supervision for training behavioral health students and partially or provisionally licensed behavioral health providers — or more accurately, a lack of supervisors — is a major factor in Nebraska’s behavioral health workforce shortage.

As part of their career paths – many behavioral health students and provisionally licensed trainees — must spend time working with fully licensed providers to complete their course work and licensure requirements.

The struggle comes in finding enough licensed providers to supervise the students and provisionally licensed providers. A major reason this is so because fully licensed providers receive little to no compensation for their time supervising students and provisionally licensed providers.

“The lack of compensation has caused many licensed providers in Nebraska to forgo being supervisors because they need to take time away from their practices to provide that service,” said Jessie Buche, MPH, MA, Director of the ARPA Awards Program. “This has made it difficult to help students find needed internships and led many provisionally licensed providers to never achieve full licensure.”

A pressing issue

The issue of supervision is so pervasive that addressing it was a key focus of two categories in BHECN’s dissemination of more than $25.5 million in American Recovery Plan Act (ARPA) dollars to Nebraska behavioral health providers.

Much of the $11.7 million that BHECN disseminated in the Behavioral Health Training and Opportunities Category – the largest award category in the BHECN ARPA Program – went to providers around the state to support supervision of behavioral health student internships. Another entire category of awards was dedicated to supervision of provisionally licensed providers.

“Lack of supervision is not a problem that is unique to Nebraska but the approach we’re taking with the ARPA dollars is different than what you see in most other places around the country,” Buche said. Some other states offer supervisors tax benefits for doing such work but the ARPA funds are allowing some to provide direct reimbursement for supervision and this could be a game changer, she said.

ARPA funds helping address several key behavioral health challenges

Novel and innovative solutions to other major behavioral health workforce challenges also are being implemented thanks to the ARPA funds, Buche said, noting that along with funding to increase training and supervision, BHECN disseminated:

  • About $7 million for Telebehavioral Health in Rural Areas
  • About $2.2 million for projects that address behavioral health workforce projects related to the pandemic

To distribute the dollars, BHECN put together and executed a comprehensive review and dissemination process that allowed the organization to have selected recipients for all funds by July of 2023. The dollars will be distributed through 2025. In total, 105 projects throughout the state were awarded BHECN-ARPA funds.

“The shortage of behavioral health care workers is rooted in many factors and resolving it will require approaching it from multiple angles,” Buche said. “The BHECN ARPA Program presents an unprecedented opportunity to make significant headway on addressing the shortage.”

Project benefits could extend beyond Nebraska

And the project stands to have benefits that reverberate well beyond Nebraska, said Erin O. Schneider, EdD, BHECN Associate Director for External Affairs, noting that BHECN has built an evaluation component into the ARPA program that will allow researchers to study the various projects to see how effective they are, how they can be improved and how they could be implemented elsewhere.

“Thanks to BHECN, Nebraska has long been a leader in behavioral health workforce research,” Dr. Schneider said. “Now, we are in a position to have findings and innovations gleaned from this remarkable program published and used in such a way that could improve behavioral health care and improved lives not just here in Nebraska but also across the nation.”