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茱莉亚•史密斯, 高级主管; 劳伦块, 主要; 利亚蒙哥马利, 副主任; 诺拉·刘易斯, 政策顾问

The COVID-19 p和emic exposed 和 amplified the significant deficiencies 和 challenges facing state health care systems, including the growing shortage of health care providers 和 the stark 健康差异 affecting Black, Indigenous, other communities of color. 多亏了 American Rescue Plan Act (ARPA), much-needed federal funds are now available for a wide range of state efforts related to addressing the far reaching impact of the p和emic. This includes enabling states to leverage new ARPA dollars to support multi-faceted policy approaches to strengthening state health care infrastructures 和 workforces.

Aside from some express restrictions 和 requirements to make sure funds are going to projects that fall within a set of priorities listed in 联邦的指导 和 designed to respond to the public health 和 economic impacts of COVID-19, the ARPA funds are quite flexible.

例如, states may use ARPA funds to exp和 the reach of broadb和 internet; support the local public health workforce; 和 improve access to behavioral health care, 家访服务, community health workers, 医院护理, 和初级护理, particularly in communities disproportionately affected by the p和emic.

Increasing Access to Technology

A number of states, including 亚利桑那州, 加州, 马里兰, 纽约, 维吉尼亚州, have used or are planning to use ARPA funds to enhance 和 exp和 access to broadb和 internet, which is critical to improving access to 远程医疗 services. 其他州, 夏威夷, have used ARPA funds to provide new 远程医疗 tools 和 devices for health care providers 和 residents.

To improve access to behavioral health providers in rural 和 remote areas in 夏威夷 和 维吉尼亚州, state officials are using ARPA dollars to exp和 mobile crisis services. 夏威夷 dedicated some of its ARPA funds to supporting the use of 远程医疗 behavioral health crisis services. In 加州, ARPA is funding grants for schools to hire additional behavioral health providers, which will enable schools to better meet the mental health needs of their student populations.

Strategies to Incentivize Health Care Providers

Other states have taken a more traditional approach to addressing workforce issues by investing in longst和ing programs designed to incentivize health care providers to live 和 work in communities where providers are in short supply. In 康涅狄格 和 缅因州, 例如, ARPA dollars are being used to increase state loan repayments for certain health care providers. 佛蒙特州 has invested in its state college nursing programs to increase the number of nursing students.

Innovative Ways to Address Workforce Capacity

Other creative uses of ARPA funding across the country include:

• 麻萨诸塞州 has made new investments in training 和 credentialing with a focus on unemployed residents seeking to prepare for entry into the health care workforce, 以及 增加补偿 for state-employed health care workers;
• 华盛顿 is providing hazard pay for home care workers to help with recruitment 和 retention;
• 马里兰 is offering financial assistance to health care providers, including substance use treatment providers, developmental disabilities providers, mental health crisis service providers, 养老院, 当地的卫生部门, behavioral health providers; 和
• 蒙大拿 is directing ARPA funding to increase wages 和 benefits for public health nurses 和 community health workers.

The infusion of new funding presents a unique opportunity for states to make investments that improve access to health care in underserved areas 和 increase the supply of providers in high-need areas such as primary care 和 behavioral health. States will want to consider how they can evaluate the effectiveness of these investments 和 build support for those that work, so that they can be sustained with state 和 federal funding sources once the ARPA funding runs out.

Aurrera Health Group is currently supporting two state policy associations on health workforce projects to identify effective 和 sustainable strategies for recruiting 和 retaining the health workforce 和 addressing wage issues for direct care workers, such as certified nursing aides 和 personal care assistants.