Publications

The County Behavioral Health Directors Association of California (CBHDA) is developing a 10-year strategic plan for strengthening the county behavioral health safety net workforce to meet the needs of a rapidly evolving safety net delivery system and the people it serves. This workforce encompasses people who work for county behavioral health agencies and the community-based organizations (CBOs) with which they contract. To develop the strategic plan, CBHDA commissioned this needs assessment, which encompasses:

• Analysis of existing sources of data about the supply, distribution, and demographic characteristics of California’s behavioral health workforce and graduates of behavioral health professions education programs
• A survey of county behavioral health agencies and contracted CBOs
• Key informant interviews with experts on the workforce challenges the county behavioral health safety net faces.

The authors offer a number of conclusions, including:

• To meet clients’ needs, California’s county behavioral health safety net must recruit and retain significantly more behavioral health professionals who reflect their clients’ racial/ethnic diversity, linguistic diversity, sexual orientations, and gender identities, particularly among SUD providers. The county behavioral health safety net’s ability to meet its workforce needs is constrained by characteristics of California’s overall behavioral health workforce and trends in new graduates from behavioral health professions education programs.
• The workforce does not reflect the racial/ethnic and linguistic diversity of the state’s population.
• Additional factors that hinder the county behavioral health safety net’s ability to compete with private employers and other public sector employers (e.g., schools) for experienced behavioral health professionals include inability to offer competitive salaries, lengthy hiring processes, and extensive Medi-Cal documentation requirements.
• High staff turnover is compelling counties to invest more resources in training and supervision of less experienced staff.
• Existing sources of data are inadequate to fully assess the workforce needs of California’s county behavioral health safety net.