May 18, 2023
The Honorable Stephen Kinsey
Chairman, Human Services Committee
Pennsylvania House of Representatives
P.O. Box 202201
Harrisburg, PA 17120-2201
The Honorable Doyle Heffley
Minority Chairman, Human Services Committee
Pennsylvania House of Representatives
P.O. Box 202122
Harrisburg, PA 17120-2122
Dear Chairman Kinsey and Chairman Heffley:
On behalf of approximately 235 member hospitals—including 157 hospital emergency departments and nearly 85 inpatient behavioral health units, institutions for mental disease and standalone psychiatric hospitals—The Hospital and Healthsystem Association of Pennsylvania supports House Bill 849, sponsored by Representative Mike Schlossberg.
Last year the General Assembly appropriated $100 million in one-time, federal COVID-relief dollars to support vital behavioral health services across the commonwealth. HB 849 seeks to authorize these already appropriated funds pursuant to the recommendations made by last year’s Behavioral Health Commission for Adult Mental Health.
The hospital community draws particular attention to the bill’s investment of $34 million to help address the commonwealth’s urgent need to incentivize, invest in, retain, and grow the behavioral health care workforce via recruitment/retention activities, internship programs, and loan repayment. There is a nationwide health care workforce crisis with detrimental implications for patients, health care professionals, and provider organizations. While all practitioners need help in all settings, the shortage of behavioral health clinicians and support professionals is profound—53 of Pennsylvania’s 67 counties (nearly 80%) are designated as full or partial Mental Health Professional Shortage Areas.
We know that you are consistently hearing from all sectors that workforce shortages are dire. There are unique challenges in health care, however, because the entire interrelated continuum of care is being disrupted. In almost every community statewide, Pennsylvanians’ access to many vital health care services is threatened.
The decreasing availability of behavioral health services is overwhelming the commonwealth’s hospitals as increasing numbers of Pennsylvanians present with mental health conditions.
Hospital emergency departments (ED) are a main point of entry for patients who need critical behavioral health care. While EDs are continuing to improve their abilities to effectively assess and triage patients in need of such care, after stabilizing a person’s physical health, there are often long delays in being able to transition patients to the proper settings to get the additional treatment they need. Placement delays require patients to wait in EDs for extended periods—a situation that is stressful for the person in crisis, the health care professionals who want to provide the best care, and the hospital staff charged with finding and coordinating clinically appropriate treatment.
This not only impedes progress for patients with mental health concerns, it also negatively affects others who need care. You may have been hearing from your constituents, for example, that wait times have been steadily increasing for all patients in EDs. Similarly, patients who need to be admitted for other ailments cannot be treated in acute care beds or by clinical staff who are occupied by or treating patients awaiting transfer to meet their mental health needs.
The hospital community believes that a number of the bill’s other provisions have meaningful value as well. Expanding suicide prevention, walk-in, and mobile crisis services can—for some patients—offer viable alternatives prior to ED intervention. Developing well-trained peer supports can augment current providers and improve treatment success. Investing in the telehealth infrastructure can eliminate physical barriers between patients and mental health care. Finally, addressing social determinants of health can help assure that all Pennsylvanians have what they need to live healthfully in the first place.
Thank you for scheduling HB 849 for committee consideration. We respectfully ask you to vote yes, urge your caucuses to actively support, and work with your chamber’s leaders to assure swift passage through the House. HAP and its members stand ready to assist you in this critical work. Our patients and staff need your help.
If you have any questions or concerns, please reach out to me at HTyler@haponline.org or (717) 733-1997.
Vice President, State Legislative Advocacy
c: The Honorable Michael Schlossberg
Members of House Human Services Committee