RD412 - Behavioral Health Loan Repayment Program Plan – November 1, 2016

Executive Summary:
*This report was replaced in its entirety by the Department of Health on December 6, 2016.

Virginia has a significant need for behavioral health providers. Seventy-three recently completed community health needs assessments reported behavioral health services as the most commonly reported critical service gap. It was also among the top three most frequently reported strategies for implementation within Virginia’s communities.

In an attempt to address gaps in behavioral health workforce availability and accessibility, the General Assembly directed the Virginia Department of Health (VDH) in collaboration with other stakeholders to develop a plan to increase the number of Virginia behavioral health practitioners through the use of a student loan repayment program.

The purpose of the Virginia Behavioral Health Loan Repayment Plan (BHLRP) is to provide support for services and create access to behavioral health care by arranging for assets within communities that are chronically without mental health providers.

In 2014, Virginia ranked 47th in the nation for both adults and children that have acute mental illness with unmet behavioral health needs. (Mental Health America, 2014) According to a newly updated report by Mental Health America in 2016, the ranking for adults that have acute mental illness with behavioral health needs has improved to 39th in the nation. (Mental Health America, 2016) Among Virginia’s primary obstacles to meeting unmet needs are workforce availability, in which the state ranks 39th in the nation, and access to mental health, for which the state ranks 32nd in the nation. These findings corroborate well with current data on Virginia’s Mental Health Professional Shortage Areas (mental HPSAs). Mental HPSAs identify communities and populations with the highest need for mental health professionals. Virginia’s total population is 8,382,993 (U.S. Census Bureau, 2015). In Virginia, 77% of counties/cities contain at least one mental HPSA (partial area, whole area, or facility) and as of 2016, 3,347,880 Virginians, or approximately 40% of all Virginians, live in areas designated as mental HPSAs.

The goal of the program is to ultimately increase the number of Virginia behavioral health practitioners by way of an educational loan repayment incentive that “complements and coordinates with existing efforts to recruit and retain Virginia behavioral health practitioners.” The stakeholder group reviewed a multitude of available state and national data pertaining to behavioral health workforce, identified gaps in those data and reviewed a thorough inventory of state sponsored programs that aim to incentivize the recruitment and retention of behavioral health providers. This plan is a product of a shared vision and many months of extensive stakeholder engagements.

The plan allows for a variety of behavioral health practitioners to receive a student loan repayment award from the Commonwealth in exchange for providing service to Virginia communities that are otherwise underserved. This plan is distinctive, strong and promotes health equity for Virginians while providing the opportunity for practitioners to receive loan repayment for up to 25% of student loan debt for each year of health care service provided to the Commonwealth. Maximum loan repayment amounts per year are dependent upon the type of behavioral health professional applying and shall not exceed the total student loan debt. Participating practitioners will have an initial two-year minimum participation obligation and may renew for a third and fourth year. This provides the practitioner with the opportunity to fully pay off their student loan debt while providing four years of service to the Commonwealth.

The maximum anticipated fiscal impact is $1,600,000 to fully fund and administer for a two-year period a program that provides at least 30 providers and 108,000 hours of additional behavioral health services to Virginia’s underserved communities.