ARPA Funds are Helping States Shore Up the Health Care Workforce

The COVID-19 pandemic exposed and amplified the significant deficiencies and challenges facing state health care systems, including the growing shortage of health care providers and the stark health disparities affecting Black, Indigenous, and other communities of color. Thanks to the 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 pandemic. This includes enabling states to leverage new ARPA dollars to support multi-faceted policy approaches to strengthening state health care infrastructures and workforces.Aside from some express restrictions and requirements to make sure funds are going to projects that fall within a set of priorities listed in federal guidance and designed to respond to the public health and economic impacts of COVID-19, the ARPA funds are quite flexible.For example, states may use ARPA funds to expand the reach of broadband internet; support the local public health workforce; and improve access to behavioral health care, home visiting services, community health workers, hospital care, and primary care, particularly in communities disproportionately affected by the pandemic.

Increasing Access to Technology

A number of states, including Arizona, California, Maryland, New York, and Virginia, have used or are planning to use ARPA funds to enhance and expand access to broadband internet, which is critical to improving access to telehealth services. Other states like, Hawaii, have used ARPA funds to provide new telehealth tools and devices for health care providers and residents.To improve access to behavioral health providers in rural and remote areas in Hawaii and Virginia, state officials are using ARPA dollars to expand mobile crisis services. Hawaii dedicated some of its ARPA funds to supporting the use of telehealth behavioral health crisis services. In California, 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 longstanding programs designed to incentivize health care providers to live and work in communities where providers are in short supply. In Connecticut and Maine, for example, ARPA dollars are being used to increase state loan repayments for certain health care providers. Vermont 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:

• Massachusetts has made new investments in training and credentialing with a focus on unemployed residents seeking to prepare for entry into the health care workforce, as well as increasing compensation for state-employed health care workers;

• Washington is providing hazard pay for home care workers to help with recruitment and retention;

• Maryland is offering financial assistance to health care providers, including substance use treatment providers, developmental disabilities providers, mental health crisis service providers, nursing homes, local health departments, and behavioral health providers; and

• Montana is directing ARPA funding to increase wages and benefits for public health nurses and 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 and increase the supply of providers in high-need areas such as primary care and behavioral health. States will want to consider how they can evaluate the effectiveness of these investments and build support for those that work, so that they can be sustained with state and 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 and sustainable strategies for recruiting and retaining the health workforce and addressing wage issues for direct care workers, such as certified nursing aides and personal care assistants.

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Author

Lauren Block [Vice President]