We’re pleased to see Christian Theological Seminary (CTS) sharing their involvement in the Playbook for Enhancing Indiana’s Mental and Behavioral Health Workforce.
CTS’s unique model of integrating education, clinical experience, and community outreach was recognized as an institutional best practice in the Playbook.
Bowen Assistant Director of Data and Research Sierra Vaughn
Bowen’s Assistant Director of Data and Research Sierra Vaughn gave a presentation on rural health care in Indiana to the Indiana Rural Health Association on August 1.
Mirroring national trends, rural health care in Indiana faces significant challenges. The state has seen hospital closures, with 52 rural hospitals remaining as of 2024, and 25% of open hospitals experiencing service reductions. Workforce shortages are acute, particularly in mental health, where rural areas have two-thirds fewer behavioral health professionals than urban areas. Additionally, 35 Indiana counties lack a birthing hospital, impacting maternal care access. These issues are compounded by broader rural health disparities, including slower life expectancy increases and higher mortality rates for conditions like heart disease and cancer compared to urban areas.
Read more about the challenges faced by rural hospitals in Indiana and nationwide as well as potential solutions in Vaughn’s presentation here:
Bowen Center Director Dr. Hannah Maxey presented August 1 the Playbook for Enhancing Indiana’s Mental and Behavioral Health Workforce to the Indiana Commission to Combat Substance Use Disorder. Indiana faces an enormous challenge of recruiting and retaining a sufficient number of mental and behavioral health workers, with every county in the state meeting the criteria for a federally designated workforce shortage in these areas.
The results are staggering, with real-life implications for hundreds of thousands of Hoosiers:
We are excited to announce that 4C Health, a leading Community Mental Health Center in North Central Indiana, has made a significant commitment to support the Bowen Center for Health Workforce Research & Policy’s “Playbook for Enhancing Indiana’s Mental & Behavioral Health Workforce.” This commitment, announced on July 12, 2024, represents a crucial step towards addressing the pressing workforce challenges in Indiana’s mental health sector.
Dr. Carrie Cadwell, CEO and President of 4C Health, emphasized the importance of this commitment:
“The need in our rural communities is so great, and the critical factor in our ability to meet that need is workforce. We hope our transparent and public commitment to these Playbook strategies spurs others to do the same. Together we can be industry transforming!”
4C Health has outlined an impressive array of initiatives aligned with the Playbook’s strategies, including:
Increasing the number of behavioral health students trained annually to 50
Expanding their Peer Workforce from 12 to 30 peers
Implementing a Doctoral Psychology Practicum program
Developing an APA-approved psychology internship and post-doctoral program
Collaborating with local educational institutions to create new pathways into behavioral health careers
Continuing and expanding their Tuition Assistance and Loan Repayment Programs
Implementing a 4-day work week model for all staff
These commitments demonstrate 4C Health’s dedication to not only enhancing their own workforce but also contributing to the broader goal of strengthening Indiana’s mental health services.
Indiana’s mental health care system faces significant challenges, with real-life impacts on millions of Hoosiers and long-term implications for our state’s economic outlook. The Bowen Center’s Playbook offers concrete solutions to increase the number of mental health care workers in Indiana. To learn more about the Playbook and its strategies, visit The Playbook home page.
Together, we’re building a stronger, more resilient mental health workforce for Indiana. We encourage other organizations to consider how they can contribute to this crucial effort and make their own commitments to the Playbook’s strategies.
Top Health Workforce Themes in the 2024 Legislative Session
Let’s cut to the chase. What health workforce legislation has been introduced in the 2024 session? There were a few major themes that arose. We have conceptualized these themes and summarized the outcomes below.
Nursing Workforce
This session has seen many legislative initiatives related to the nursing workforce. One such bill (SB 45) would establishadditional training requirements in trauma-informed care for all licensed Registered Nurses (RN). One bill would modify certain licensure requirements for health facility administrators, allow NCLEX passage to satisfy English proficiency requirements for internationally-educated nurse applicants, and eliminate telehealth certification requirement for telehealth nurses and other telehealth providers (HB 132). The final nursing-focused bill making progress this session makes various changes to nurse licensing, education, and training regulations regarding requirements for clinical preceptors, and requirements for certain foreign nursing applicants (HB 1259).
Bills under this theme that were introduced but did not progress include: a bill removing the collaborative practice agreement with physicians and APRNS, and allows a APRN with prescriptive authority to prescribe a schedule II substance (HB 1059); a requirement for nurses to complete implicit bias training as part of their continuing education requirements (HB 1167); establishment of nurse staffing councils within hospitals in order to develop nurse staffing plans (HB 1015); allowing Certified Registered Nurse Anesthetists to administer anesthesia under the immediate presence of a podiatrist or dentist, which is currently only allowed under the presence of a physician (HB 1371).
EMS
There have been several bills introduced regarding Hoosier emergency medical services professionals (EMS) this session. HB 1142 would establish a program of recognition for first responders killed or injured in the line of duty. A new grant pilot program was introduced in SB 10 for the purpose of assisting in the costs of mobile integrated health care programs and mobile crisis teams across Indiana. Finally, SB 142 would require healthcare coverage for mobile integrated healthcare and emergency medical services for all state employees on the state employee health plan (and other insurers).
Bills under this theme that were introduced but did not progress include: HB 1118 would establish a program to support the mental health of first responders through the Indiana first responders mental health wellness fund and program.
Regulatory Changes
House Bill 1214 would add Indiana to the Dental and Dental Hygienist Licensure Compact.
Bills under this theme that were introduced but did not progress include: A bill proposing the expansion of eligible clinical experience supervision to include physicians, and psychologists for the Clinical Social Work Licensure and expansion of supervision through telehealth (SB 261); bills that would establish new licenses – Professional Music Therapists (HB 1103) and Naturopathic Physicians (SB 262); and a bill (SB 110) that would add Indiana as a member of the Social Work Compact.
Behavioral Health Workforce
A bill proposed in the House would allow a Social Worker licensee applicant to take the social worker examination during their last term of a program that meets educational requirements, and provides a letter of good standing from the director of the academic department (HB 1138). This bill would allow a student to sit for their professional exam early if all requirements in the bill are met. House Bill 1238 would add certain physician assistants and advanced practice nurses as potentially qualifying professionals to serve as competency evaluators in criminal proceedings (previously only psychiatrists and psychologists).
Bills under this theme that were introduced but did not progress include: SB 166 which would have allowed community mental health center staff to provide social work services without a license and remove examination requirement for BHHS temporary permits; SB 261 which would have expanded the qualifications for clinical experience supervisors for clinical social workers and expanded tele-supervision.
Other health workforce themes from legislators that didn’t make it to the second chamber:
Health Workforce Incentives
There were a few bills related to health workforce specific incentives, including a bill that would establish a medical school loan forgiveness pilot program (HB 1175). Another bill would establishanIndiana rural hospital and critical health care services fund, new health workforce student loan repayment program, and associated health workforce advisory board (advisory board (HB 1196).
There’s More on the B4!
One way we monitor health workforce trends is by tracking Indiana health workforce legislation through implementation of the Bowen Bi-Weekly Bill Brief or “B4.” There are many other health and workforce/education-related bills that have been introduced this session. Check out the full B4 to learn more about those bills and keep track of the active bills as they progress through the second half of session!
