Regular Session 2019-2020 House Resolution 0193 P.N. 1814

PRIOR PRINTER'S NO. 1189

PRINTER'S NO. 1814

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE RESOLUTION

No.

193

Session of

2019

INTRODUCED BY McNEILL, READSHAW, HILL-EVANS, SCHLOSSBERG,

FREEMAN, KINSEY, D. MILLER, LONGIETTI, DAVIDSON, MURT,

NEILSON, DeLUCA, MIZGORSKI, CIRESI, SIMMONS, SIMS, TOOHIL,

THOMAS, MARKOSEK, T. DAVIS, HOWARD, KORTZ AND STURLA,

APRIL 5, 2019

AS REPORTED FROM COMMITTEE ON HUMAN SERVICES, HOUSE OF

REPRESENTATIVES, AS AMENDED, MAY 14, 2019

A RESOLUTION

Directing the Joint State Government Commission to conduct a

study on the mental health CARE provider shortage in this

Commonwealth and to issue a report.

WHEREAS, The National Survey on Drug Use and Health estimates

that approximately 18.76% of adults in Pennsylvania, or

1,861,000 individuals, have a mental illness; and

WHEREAS, The National Survey on Drug Use and Health also

estimates that approximately 4.2% of adults in Pennsylvania, or

416,000 individuals, have a serious mental illness; and

WHEREAS, Mental health CARE providers, including

psychiatrists, psychologists, MARRIAGE AND FAMILY THERAPISTS,

clinical social workers and professional counselors, render

crucial services to residents across this Commonwealth; and

WHEREAS, Adequate access to mental health care is essential

to maintaining the mental health of Pennsylvanians; and

WHEREAS, Despite the growing demand for mental health

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treatment across the United States, a mental health CARE

workforce crisis has been developing, largely due to a shortage

of mental health CARE providers; and

WHEREAS, Pennsylvania ranks 35 out of all 50 states and

Washington, DC, for mental health CARE workforce availability,

with a patient to mental health care worker ratio of 600 to 1;

and

WHEREAS, Pennsylvania has a Statewide average of 179 mental

health CARE providers per 100,000 people, which is below the

national average of 214 providers per 100,000 people; and

WHEREAS, The lack of readily available mental health CARE

providers in Pennsylvania has negatively impacted access to

mental health care for a countless number of residents; and

WHEREAS, An estimated 53.2% of the adult population with a

mental illness in Pennsylvania did not receive treatment for

their mental illness in 2017; and

WHEREAS, Other factors contributing toward the mental health

CARE workforce crisis include higher demand for mental health

CARE providers, high turnover rates, an aging workforce and low

compensation for workers in the field; and

WHEREAS, The mental health CARE provider shortage has led to

an over-burdening of current mental health CARE providers to

make up for insufficient staffing, lower quality of care for

consumers and a lack of stability for patients due to frequent

staff turnover; and

WHEREAS, The shortage of mental health CARE providers also

has direct and indirect costs on the economy, including a loss

of efficiency and productivity for employees and employers; and

WHEREAS, It is estimated that over the next five years, the

shortage of psychiatrists MENTAL HEALTH CARE PROVIDERS in the

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United States will result in more than 4.2 million lost or less

productive workdays each month, which is a major cost to

employers; and

WHEREAS, The psychiatrist MENTAL HEALTH CARE PROVIDER

shortage in Pennsylvania alone is estimated to result in over

163,000 lost or less productive workdays each month over the

next five years; and

WHEREAS, Untreated mental illness in the United States costs

the nation more than $70 billion annually, solely due to lost

productivity; and

WHEREAS, When accounting for the diverted resources of

individuals in law enforcement, education and health care who

are often the first responders to individuals experiencing

mental health emergencies, the cost of untreated mental illness

in the United States increases to more than $193 billion per

year; and

WHEREAS, The prevalence of mental illness in an individual

can impact their overall health, as individuals with serious

mental illness face an increased risk of having chronic medical

conditions; and

WHEREAS, Adults in the United States living with a serious

mental illness die on average 25 years earlier than those

without, largely due to treatable medical conditions; and

WHEREAS, Research has identified a definite connection

between mental health and the use of addictive substances, as

many patients with disruptive or uncomfortable mental health

symptoms tend to self-medicate by using alcohol, drugs or

tobacco; and

WHEREAS, Unfortunately, the use of drugs and alcohol does not

address the underlying mental health symptoms and often causes

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additional health and wellness problems for the patient, while

also increasing the severity of the original mental health

symptoms; and

WHEREAS, The mental health CARE provider shortage is

considerably more prevalent in rural counties and a significant

discrepancy exists between access to mental health care in rural

counties compared to urban and suburban counties; and

WHEREAS, Pennsylvania counties that are considered

predominantly rural have some of the fewest mental health CARE

providers per 100,000 people, with some counties only having a

small number of working providers; and

WHEREAS, While the mental health CARE provider shortage is

pervasive, it impacts certain populations to a larger extent;

and

WHEREAS, In 2015, among adults with any mental illness, 48%

of Caucasians received mental health CARE services, compared

with 31% of African Americans and Hispanics and 22% of Asians;

and

WHEREAS, One in four older adults experience a mental health

issue such as depression, anxiety, schizophrenia or dementia,

which is expected to double to 15 million older adults by 2030;

and

WHEREAS, Adults 85 years of age and older have the highest

suicide rate of any age group, especially among older Caucasian

men who have a suicide rate almost six times that of the general

population; and

WHEREAS, Two-thirds of older adults with mental health

problems do not receive the treatment they need and have limited

access to current preventative services; and

WHEREAS, It is believed that telemedicine, which involves the

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use of electronic communications and software to provide

clinical services to patients without an in-person visit, will

expand the mental health CARE workforce by offering flexibility

to work from home and will enable collaboration between

psychiatrists MENTAL HEALTH CARE PROVIDERS and primary care

providers; and

WHEREAS, Increased access to more varied client populations

through telemedicine can decrease provider burnout and improve

mental health CARE workforce retention; and

WHEREAS, The National Council for Behavioral Health

identifies six broad areas that require change to address the

shortage of psychiatrists MENTAL HEALTH CARE PROVIDERS, which

include:

(1) Expanding the workforce providing psychiatric MENTAL

HEALTH CARE PROVIDER services.

(2) Increasing efficiency of delivery of psychiatric

MENTAL HEALTH CARE PROVIDER services.

(3) Implementing innovative models of integrated

delivery of primary care and psychiatric MENTAL HEALTH care

in more settings that have the potential to impact the total

cost of care for high-risk patient populations with co-

occurring medical and behavioral health conditions.

(4) Training psychiatric MENTAL HEALTH CARE residents

and the existing workforce in delivering new models of care.

(5) Adopting effective payment structures that

adequately reimburse psychiatric MENTAL HEALTH CARE providers

for improved outcomes of care.

(6) Reducing the portion of psychiatric MENTAL HEALTH

CARE providers who engage in exclusive, private, cash-only

practices;

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and

WHEREAS, Encouraging the growth and retention of the mental

health CARE workforce in Pennsylvania will ensure that more

individuals have access to timely and adequate mental health

screening and treatment for mental illnesses; therefore be it

RESOLVED, That the House of Representatives direct the Joint

State Government Commission to conduct a study on the mental

health CARE provider shortage in this Commonwealth; and be it

further

RESOLVED, That the Joint State Government Commission prepare

a report of its findings that shall, at a minimum:

(1) Identify the factors behind the mental health CARE

provider shortage in this Commonwealth.

(2) Make projections on the number of mental health CARE

providers in Pennsylvania in 5 and 10 years.

(3) Determine how telemedicine can be used to extend the

mental health CARE workforce in rural counties.

(4) Determine how Pennsylvania government entities can

encourage more individuals to enter and remain in the mental

health CARE workforce.

(5) Make recommendations regarding:

(i) How to solve the disparity in the number of

mental health CARE providers in rural counties compared

to urban and suburban counties.

(ii) Any other solutions to stop and reverse the

mental health CARE provider shortage in Pennsylvania;

and be it further

RESOLVED, That the Joint State Government Commission report

its findings and recommendations to the House of Representatives

no later than one year after the adoption of this resolution.

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