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County Workforce, Reimbursement, and Organizational Factors Associated with Behavioral Health Capacity in Health Centers

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Abstract

This study describes on-site behavioral health treatment capacity in health centers in 2007 and examines whether capacity was associated with health center characteristics, county-level behavioral health workforce, and same-day billing restrictions. Cross-sectional data from the 2007 Area Resource File and Uniform Data System were linked with data on Medicaid same-day billing restrictions. Mental health treatment capacity was common; almost four in five health centers provided on-site mental health services. Additional services such as crisis counseling (20 %), treatment from a psychiatrist (29 %), and substance abuse treatment were offered by fewer health centers (51 % provide on-site services and only 20 % employ substance abuse specialists). In multivariate analysis, larger health centers, health centers located in counties with a larger behavioral health workforce per capita, and those located in the West and Northeast were more likely to have behavioral health capacity. Same-day billing restrictions were associated with lower odds of substance use treatment capacity and providing 24 hr crisis counseling services.

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Notes

  1. At the suggestion of QRS, the contractor that maintains the Area Resource File for HRSA, a crosswalk was purchased for $99.99 (http://www.zipinfo.com/). The crosswalk contains information from January 2011 and is offered by CD Light, Incorporated.

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Acknowledgments

The authors are grateful to Alex Ross of the Health Resources and Services Administration for his comments on the manuscript draft. The views expressed in this publication are solely the opinions of the authors and do not necessarily reflect the official policies of the Department of Health and Human Services, the Office of the National Coordinator for Health Information Technology, or The Substance Abuse and Mental Health Services Administration, nor does mention of the department or agency names imply endorsement by the US government.

Conflict of Interest

No authors have a conflict of interest to report, financial or otherwise.

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Authors and Affiliations

  1. Office of Economic Analysis, Evaluation, and Modeling in the Office of the National Coordinator for Health Information Technology, United States Department of Health and Human Services, Washington, DC, USA

    Emily Jones PhD, MPP

  2. Department of Health Policy, School of Public Health and Health Services, George Washington University, Washington, DC, USA

    Leighton Ku PhD, MPH

  3. Formerly of SAMHSA, Center for Mental Health Services, The Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services, Washington, DC, USA

    Shelagh Smith MPH, CHES

  4. Health Information Technology and Strategic Development, The National Council for Community Behavioral Healthcare, Washington, DC, USA

    Michael Lardiere LCSW

Authors
  1. Emily Jones PhD, MPP
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  2. Leighton Ku PhD, MPH
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  3. Shelagh Smith MPH, CHES
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  4. Michael Lardiere LCSW
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Correspondence to Emily Jones PhD, MPP.

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Jones, E., Ku, L., Smith, S. et al. County Workforce, Reimbursement, and Organizational Factors Associated with Behavioral Health Capacity in Health Centers. J Behav Health Serv Res 41, 125–139 (2014). https://doi.org/10.1007/s11414-013-9364-9

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  • DOI: https://doi.org/10.1007/s11414-013-9364-9

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