First Lady Testifies on Bill to Cut Red Tape for Behavioral Health Workers

First Lady Aimee Kotek Wilson, chair of the Governor’s Behavioral Health Talent Council, joined members of the council and community providers to testify today before the House Committee on Behavioral Health in support of Governor Kotek’s House Bill 4083, legislation designed to cut red tape for behavioral health workers.

House Bill 4083 represents the first set of actions being recommended by the Behavioral Health Talent Council (council). The bill addresses Oregon's behavioral health workforce crisis by streamlining credentialing through a single, centralized process which will help to alleviate long wait times for providers ready to provide care, reducing unnecessary administrative work that contributes to burnout, and expanding access to clinical supervision by allowing qualified professionals to supervise across license types. Together, these changes are designed to retain workers in the field, ensure new talent can enter more seamlessly, and get Oregonians the care they need when they need it.

The First Lady, who earned her Master of Social Work in 2017, has professional experience in the field working with high acuity clients. She has recent, direct experience in navigating the education-to-credentialing-to-work continuum for behavioral health professionals.

“The Council’s recommendations have been carefully vetted, shaped by frontline voices and experts in the field,” First Lady Kotek Wilson said. “Providers told us they're drowning in paperwork and struggling to find clinical supervisors for associates. House Bill 4083 addresses what they need now: streamlined credentialing so qualified workers can start serving patients sooner, reduced administrative burden, and expanded access to supervision.”

"Oregon's behavioral health workforce is stretched beyond capacity, and we cannot afford to lose more skilled professionals to unnecessary red tape," Governor Kotek said. "The Behavioral Health Talent Council brought together the expertise we needed to identify real solutions grounded in what frontline workers actually experience.”

What House Bill 4083 Would Do:

Streamline Credentialing for Behavioral Health Workers
Currently, workers are required to be validated through the Oregon Health Authority (OHA) to bill Medicaid and then credentialed and reported on separately through different entities including each payer that their provider bills for their services. This causes unnecessary delays that keep qualified professionals from serving patients who are waiting for care and requires providers to pay workers who are not yet able to provide care.

House Bill 4083 will require OHA to adopt a centralized credentialing process for behavioral health workers, allowing qualified workers to begin providing care sooner and reducing administrative burden on providers.

Reduce Administrative Burden
Behavioral health workers report that increasing administrative requirements – including duplicative reporting – take time away from patient care and contribute to burnout.

House Bill 4083 directs OHA to minimize unnecessary administrative burden as part of their mission, and report to the Legislature and Governor every two years on steps they have taken to reduce administrative burdens on providers.

Expand Access to Clinical Supervision
Prospective master’s level licensees need supervised hours to attain their license, but a lack of qualified clinical supervisors has created a bottleneck. Current rules for some behavioral health licensees allow for supervision by “any qualified mental health professional,” while others are more restrictive.

House Bill 4083 directs the licensing boards to draft and implement rules allowing for any prospective master’s level qualified mental health licensee to receive supervision from any qualified mental health licensed professional, regardless of whether they and their supervisor possess the same type of license. This will reduce barriers for qualified workers obtaining their license.

"I've experienced a long, difficult journey to secure clinical supervision, which I need to become licensed and advance in my career," Rachel Knaff, Clinical Social Work Associate at Telecare Recovery Center at Woodburn said. "If House Bill 4083 had been in place when I entered the field, it would have expanded the pool of qualified supervisors available to me, and I may have been able to obtain my license by now. Instead, I and countless other associates are stuck in a frustrating cycle, missing out on higher pay and unable to advance in our careers and clinical skills - hurting us and the quality of patient care. This bill removes an unnecessary barrier that's keeping qualified workers like me from getting licensed faster."

"Mobile crisis responders provide immediate support and de-escalation for clients on what is often the worst day of their lives," Liz O'Connor, Triage Manager at Cascadia Health said. "After a full day of crisis response, we face hours of additional administrative work before we can go home. Imagine the impact on morale - even for people whose hearts are completely in this work. And imagine how many more people we could help with the time spent on extraneous reports and unnecessary documents. These are common-sense changes that will make the profession more sustainable for current workers and more attractive to those called to this work."

"When staff tell me about their burnout, it's rarely about clients or therapy - it's about the paperwork, reporting requirements, and documentation expectations," Shyra Merila-Simmons, Executive Director of Clatsop Behavioral Healthcare said. "This work is hard enough. We must minimize administrative stressors and support staff in doing meaningful, lifesaving work. Access to clinical supervision is also a serious bottleneck. While larger urban providers may have enough supervisors to match license types, that's much harder for smaller, rural providers. Licensure candidates benefit most from onsite supervisors who know their work, understand their programs, and have ties to their communities - not from simply matching credential to credential."

"A centralized credentialing system will make an incredible impact. Right now, qualified behavioral health workers sit on the sidelines for weeks or months - unable to serve patients who desperately need care - while navigating duplicative credentialing requirements across multiple payers," Eli Kinsley, Director of Operations at Bridgeway Community Health and Vice Chair of the Licensing and Credentialing subcommittee said. "This delay financially burdens providers who must pay workers who can't yet bill for services, keeps Oregonians waiting for critical care, and drives talented professionals out of the field."

Oregon faces a behavioral health workforce crisis. The Higher Education Coordinating Commission (HECC) surveyed 14 behavioral health profession types and found that 9 have alarmingly high turnover risk, with more than two-thirds of workers intending to quit. When professionals leave, Oregonians in crisis go without care.

Governor Kotek has made addressing Oregon's behavioral health workforce crisis a top priority. She commissioned the HECC to conduct theBehavioral Health Talent Assessment, consolidating years of important yet fragmented, siloed research into one comprehensive resource with over 60 recommendations. Last May, she then established the Behavioral Health Talent Council to transform those recommendations into actionable plans for implementation. Working with frontline providers, licensing authorities, educational leaders, agency staff, and experts across the state, the Council developed a comprehensive set of recommendations for improving training and education pathways into the workforce, streamlining licensing and credentialing, and strengthening recruitment and retention for providers. House Bill 4083 represents the first recommendations to come out of the Council’s work.

“Improving our behavioral health system is a sizable challenge,” First Lady Kotek Wilson said in her testimony. “House Bill 4083, “Cutting Red Tape for Behavioral Health Workers”, is an important start, and the first of what we hope will be many actions from the Council’s recommendations to help support and expand Oregon's behavioral health workforce.”

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