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California’s Nurse Practitioner Workforce: Understanding Demographics, Education, and Scope of Practice
09-27-24
Nurse practitioners — often referred to as NPs — are the largest group of nonphysician primary care providers and play a growing role in filling gaps in health care provision in both primary care and behavioral health across California. NPs are registered nurses who have completed additional...
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Perspectives on APRN Prescribing of Medications for Opioid Use Disorder: Key Barriers Remain
11-16-23
Deaths from drug overdoses are rising dramatically in the United States. Treatment for opioid use disorders may include behavioral treatments as well as medications for opioid use disorders (MOUD). Buprenorphine can be prescribed by physicians, nurse practitioners (NPs), other advanced practice...
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Influences on Advance Practice Nursing Education to Prescribe Medications for Opioid Use Disorder
03-30-23
Opioid misuse is a major public health concern in the United States. Opioid agonist medications are evidence-based treatments for opioid use disorders (OUD) that can be prescribed by advance practice registered nurses (APRNs) with prescriptive authority and appropriate training. This article...
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Paraprofessionals in California’s Behavioral Health Workforce
02-13-23
One in five adults in California had a mental illness in 2018-2019. Some 23.5% of these adults had unmet need for mental health services as did an estimated 64.5% adolescents with major depression.
The shortage of licensed behavioral health professionals, which affects communities throughout...
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Building the Future Behavioral Health Workforce: Needs Assessment
02-13-23
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...
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Eliminate the Buprenorphine DEA X Waiver: Justification Using a Policy Analysis Approach
01-09-23
Drug overdoses have reached a historic milestone of over 100,000 deaths in a single year, 75,673 related to opioids. The acceleration in opioid-related deaths coupled with stark health inequities demands a close examination of opioid use disorder (OUD) treatment barriers and swift consideration of...
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Rural-Urban Prescribing Patterns by Primary Care and Behavioral Health Providers in Older Adults with Serious Mental Illness
11-30-22
Older adults with serious mental illness (SMI) often have multiple comorbidities and complex medication schedules. Shortages of behavioral health specialists (BHSs), especially in rural areas, frequently make primary care providers (PCPs) the only clinician managing this complex population. The aim...
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Analysis of US County Characteristics and Clinicians With Waivers to Prescribe Buprenorphine After Changes in Federal Education Requirements
10-21-22
Buprenorphine is associated with decreased mortality from opioid use disorder, but prescribing is limited in office-based settings to clinicians with federal waivers. To expand this workforce, on April 28, 2021, the US federal government eliminated educational requirements for waivers to prescribe...
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Buprenorphine Treatment: Advanced Practice Nurses Add Capacity
09-01-22
During the COVID-19 pandemic, there was slower growth in the number of new waivers authorizing clinicians to provide buprenorphine treatment for opioid use disorder. However, treatment capacity grew at a stable rate as a result of already authorized clinicians obtaining waivers for larger patient...
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The Future of Behavioral Health - Harnessing the Potential of Psychiatric Mental Health Nurse Practitioners
07-29-22
The toll of mental illness in the US is substantial: 1 in 5 adults live with a mental illness. As the population ages, greater numbers of individuals will need care for the comorbidities associated with older age and their mental health needs. There is a lack of mental health services nationwide,...
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Beyond State Scope of Practice Laws for Advanced Practitioners: Additional Supervision Requirements for Buprenorphine Prescribing
07-01-22
Buprenorphine is a life-saving medication for people with opioid use disorder (OUD). U.S. federal law allows advanced practice clinicians (APCs), such as nurse practitioners (NPs) and physician assistants (PAs), to obtain a federal waiver to prescribe buprenorphine in office-based practices....
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Changes in U.S. Clinician Waivers to Prescribe Buprenorphine Management for Opioid Use Disorder During the COVID-19 Pandemic and After Relaxation of Training Requirements
05-12-22
The COVID-19 pandemic worsened the opioid overdose crisis. Buprenorphine management for opioid use disorder (OUD) reduces overdose risk and can be offered in office-based settings or via telehealth. Federal regulations require that clinicians complete training and obtain a waiver from the Drug...
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Prescribing Patterns in Nursing Home Residents Living with Dementia by Specialty and Provider Type
04-04-22
Objective/Issue
Little is known about the contributions of different provider specialties in prescribing medications for nursing home residents living with dementia. In this study, we examine prescribing patterns for common psychiatric medications and for opioid and non-opioid analgesics in long-...
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Measuring the Financial Contribution of Peer Providers
03-01-22
Background
Peer support providers (peers) are increasingly delivering behavioral health treatment, but evaluation of their impact on client outcomes remains limited. Prior studies to determine the effectiveness of peers identify inconsistent training requirements and role definition as barriers to...
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CIN Connections, Winter 2022 — Centering Equity in Health Care Improvement
01-11-22
The California Improvement Network (CIN) is a community of health care professionals committed to identifying and spreading ideas for better primary care delivery. This issue of CIN Connections offers ways to implement quality improvement efforts that intentionally advance health equity in primary...
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Recommendations to Deliver Person-Centered Long-Term Care for Persons Living With Dementia
07-02-21
Person-centered care (PCC) is the standard for the delivery of long-term services and supports (LTSS). In this article, we summarize the state of the science on meaningful outcomes and workforce development and discuss what is needed to ensure that person-centered LTSS becomes a universal reality....
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Barriers and Facilitators of Advanced Practice Registered Nurse Participation in Medication Treatment for Opioid Use Disorder
07-01-21
The misuse of opioids is a health crisis in the United States. Medication treatment for opioid use disorder reduces negative health outcomes, but there are widespread shortages of appropriately trained and credentialed providers. Advanced practice registered nurses (APRNs) have recently become...
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A Systematic Review of the Roles and Contributions of Peer Providers in the Behavioral Health Workforce
06-24-21
Approximately 1 in 5 U.S. adults experienced a mental illness in the past year, a number that is expected to rise amid a shortage of mental health and substance use disorder (SUD) providers. One way to address this growing need for behavioral health services is through the use of peer providers, or...
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Adolescents' Substance Use and Physical Activity Before and During the COVID-19 Pandemic
05-03-21
Stay-at-home policies related to the COVID-19 pandemic could disrupt adolescents’ substance use and physical activity. This study aimed to compare adolescents’ substance use and physical activity behaviors before and after stay-at-home restrictions. In this cohort, a reduction in e-cigarette use...
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The Association Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine After the 2016 Opioid Bill
04-01-21
This article examines the relationship between federal regulations, state scope-of-practice regulations on nurse practitioners (NPs), and buprenorphine prescribing patterns using pharmacy claims data from Optum’s deidentified Clinformatics Data Mart between January 2015 and September 2018. The...
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These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity
09-11-20
Suspected opioid overdose deaths are surging during the COVID-19 pandemic, increasing by more than 40% in May and continuing to rise. The short-term emergency authorizations for audio-only buprenorphine treatment during COVID-19 have helped us reach people previously unable to access treatment, and...
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Addressing the Opioid Epidemic Amidst the COVID-19 Pandemic
05-01-20
Three of every four pharmaceutical overdose deaths in 2010 involved opioids, according to the CDC. This sobering statistic focused attention on the rapid acceleration and devastating impact of the epidemic of opioid use disorder in the United States. Throughout the country, individuals and families...
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California’s Psychiatry Workforce Challenges
03-02-20
In his 2020 State of the State address, California Governor Gavin Newsom called for the state’s counties to spend Mental Health Services Act funds more quickly to assist the 1 in 6 California adults who suffer from mental illness and the 1 in 13 California children who suffer from a serious...
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CIN Connections, Fall 2018: Integrating Primary Care and Substance Use Disorder Treatment
10-18-18
Ensuring that Californians have timely access to substance use disorder (SUD) treatment that is appropriately linked to their physical health care represents a huge challenge and opportunity for health leaders, providers, and care teams throughout the state. This issue of CIN Connections features...
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Peer Providers Uniquely Positioned to Support Long-Term Recovery of People with Mental Health and Substance Use Disorders
05-17-18
According to the National Alliance on Mental Illness, one in five adults experience mental illness in a given year; yet our health care system does not have enough behavioral health workers to meet service demands. Psychiatrists, psychologists, advanced practice nurses, therapists and other...
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California Peer Providers in Transitions of Care
03-16-18
This study explored care models and policies that enhance the utilization of peer providers in California and to identify and describe best practices in peer support roles and practices for individuals with mental health or substance use disorders in California. This research focused on services...
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California’s Current and Future Behavioral Health Workforce
02-12-18
This report analyzes and projects future needs related to California’s behavioral health workforce. This workforce is critical to meeting California’s health care needs. One in six adults suffers from mental illness and one in fourteen children has a serious emotional disturbance. While access to...
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National Trends in School-based Health Centers With and Without Mental Health Providers
08-01-17
Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and are less likely to have access to mental health...
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Review of Recent Literature on Peer Support Providers
03-23-17
This report updates a literature review on peer support providers prepared in 2015. Peer support workers fulfill a broad range of tasks ad job titles, in a broad range of mental health and substance use disorders recovery settings, and in various service models, although there is a lack of...
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Characteristic Differences Between School-Based Health Centers With and Without Mental Health Providers: A Review of National Trends
02-14-17
Minority racial/ethnic pediatric populations and those living in poverty are at greater risk of exposure to trauma, development of mental health disorders and school failure, yet are less likely to have access to mental health services (MHS). School-based health centers (SBHCs) staffed with mental...