Topic Descriptions
Professions
Behavioral Health
Behavioral health care includes diagnosis, treatment and preventative services for mental health, substance use disorders and health behaviors. Behavioral health professionals work in a variety of settings from prevention programs to community-based and inpatient treatment programs. There are many types of occupations in the behavioral health workforce, including psychiatrists, psychologists, social workers, marriage and family therapists, licensed professional counselors, addiction counselors, peer support specialists and others.
For more information on state actions relating to the behavioral health workforce, visit NCSL’s report, State Strategies to Recruit and Retain the Behavioral Health Workforce.
Long-Term Care
Long-term services and supports, often referred to as long-term care, includes care provided to older adults and people with disabilities in the home, in community-based settings or in facilities such as nursing homes. The long-term care workforce includes direct care workers (certified nursing assistants, home health aides and personal care assistants), nurses (licensed practical nurses, registered nurses and APRNs), supervisory staff (assisted living managers, nursing home administrators and medical directors), as well as unpaid and informal caregivers.
For more information on the long-term care workforce, visit NCSL’s policy brief, Strengthening the Direct Care Workforce.
Maternal Health
Maternal health professionals play an important role in providing care to mothers and in reducing maternal mortality. The maternal health workforce includes physicians specializing in family medicine, internal medicine and obstetrics and gynecology, as well as midwives, registered nurses specializing in maternal health, doulas and maternity care coordinators.
For more information on maternal health workforce, visit NCSL’s report, Workforce Supports: Improving Maternal Health Outcomes and Maternal and Child Health Legislative Database.
Nursing
Nurses provide care to protect, promote and optimize health and functioning; prevent illness and injury; facilitate healing and alleviate suffering. Nursing professions include registered nurses, advanced practice registered nurses (including nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists) and licensed practical or vocational nurses.
For more information on the nursing workforce, visit NCSL’s policy brief on Addressing Nursing Shortages: Options for States.
Oral Health
Oral health refers to the health of the teeth, gums, mouth and entire oral-facial system. Oral health professionals may diagnose and treat oral disease, manage patients’ oral health, educate patients on good oral health behaviors and refer patients to their health care providers as needed. The oral health workforce includes dentists, dental hygienists, dental therapists and community dental health coordinators.
For more information on oral health workforce, visit NCSL’s policy snapshot, Workforce Strategies to Improve Access to Oral Health.
Primary Care
Primary care is a fundamental part of the nation’s health care workforce, providing care coordination, preventative care and treatment for chronic conditions. Primary care professionals include physicians (including medical doctors in primary care specialties, such as family medicine, general pediatric medicine, general internal medicine and geriatric care, and doctors of osteopathic medicine), as well as nurse practitioners (NPs) and physician assistants (PAs).
Emergency Medical Services
Emergency medical responders (EMRs), emergency medical technicians (EMTs), advanced EMTs and paramedics respond to the emergency health care needs of residents.
For legislative tracking on EMS workforce topics, visit NCSL’s Emergency Medical Services Legislation Database.
Other Professions
Other health care workforce occupations not captured in the specific topics above. This may include professions like community health workers, community paramedics, pharmacy professionals, occupational therapy professionals and physical therapy professionals.
For more information on the allied health workforce, visit NCSL’s policy series, Allied Health Professions: Considerations for State Legislatures.
Strategies
Education and Training
States are responsible for setting the education and training requirements for health professionals practicing within their borders. Education requirements may include a degree, classroom or didactic training and continuing education. Training requirements may include clinical training, residencies or fellowships (such as Graduate Medical Education), as well as specialty training requirements (for dementia, behavioral health, cultural competency or other topics).
Licensure and Certification
States set the licensure, certification and registration requirements for health professionals practicing within their borders. Licensure and certification requirements may include background check, examination, and third-party certification requirements, as well as licensure portability measures (including reciprocity, endorsement and interstate licensure compacts).
Scope of Practice
A practitioner's scope of practice refers to what a health professional can and cannot do to or for a patient and is defined by state professional regulatory boards—typically with the guidance or instruction of the state's legislature. States consider a broad range of issues related to scope of practice, including supervision requirements, prescriptive authority and other requirements for practice. This may include practice authority and prescriptive authority for advanced practice registered nurses, physician assistants, optometrists, pharmacists, psychologists, dental hygienists and licensed professional counselors, among other professions.
For more information on scope of practice policy, visit NCSL’s Scope of Practice Policy Resource Center.
Recruitment and Retention
States may pursue strategies to recruit new individuals into health care professions or retain existing professionals in the workforce. Recruitment and retention strategies may include career pathways or apprenticeships, financial incentives (such as loan repayment or tax incentives) and addressing burnout or violence against health care workers.