title: County workforce, reimbursement, and organizational factors associated with behavioral health capacity in health centers.
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.
authors.affiliation: 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, emilybjones@gmail.com.
authors.forename: Emily
authors.initials: E
authors.lastname: Jones
authors.forename: Leighton
authors.initials: L
authors.lastname: Ku
authors.forename: Shelagh
authors.initials: S
authors.lastname: Smith
authors.forename: Michael
authors.initials: M
authors.lastname: Lardiere
mesh_terms: D001524:Behavioral Medicine / Q000191:economics / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility; D006280:Health Workforce; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D012051:Reimbursement Mechanisms; D016320:Substance Abuse Treatment Centers / Q000191:economics / Q000458:organization & administration*; D014481:United States