Federal programs expanded the behavioral health workforce, and HRSA needed to understand how those investments were shaping treatment access. 

The opioid crisis placed extraordinary strain on the nation’s behavioral health workforce, particularly in rural and underserved communities where access to treatment was limited. To address this gap, the Health Resources and Services Administration’s Bureau of Health Workforce (BHW) expanded its efforts to increase the number of clinicians trained in substance use disorder (SUD) treatment. These efforts included enhancements to the National Health Service Corps (NHSC) Loan Repayment Program and expanded behavioral health training initiatives.

The new programs aimed to build a pipeline of qualified practitioners capable of delivering evidence-based SUD services, including opioid use disorder treatment. BHW needed an independent evaluation to determine whether these investments were achieving their intended goals: strengthening the workforce, increasing treatment capacity, and improving care in the communities most affected by the opioid crisis.

NORC evaluated program performance by combining surveys of clinicians, training sites, and students with analysis of administrative data. 

To assess the effectiveness of BHW’s expanded loan repayment and training programs, NORC conducted a mixed-method evaluation between 2020 and 2022. The evaluation included annual web-based surveys of NHSC clinicians, NHSC sites, grantees, and students, as well as surveys of sites participating in the Behavioral Health Workforce Education and Training, Opioid Workforce, and Graduate Psychology Education programs.

NORC complemented the survey data with analyses of BHW administrative datasets and publicly available sources to evaluate changes in clinician distribution, training experiences, and service delivery outcomes. This layered approach captured perspectives from current clinicians, training sites, and emerging professionals while grounding the findings in quantitative data.

Through this design, NORC provided BHW with evidence on how the expanded programs operated across settings and how they contributed to national efforts to strengthen the SUD treatment workforce.

The evaluation documented expanded treatment capacity and stronger care integration across community health centers and rural settings.

The evaluation found that BHW’s program expansions increased the availability of integrated SUD, opioid use disorder, and mental health services across community health centers, teaching hospitals, and rural organizations. Expanded training and loan repayment opportunities helped grow the clinical workforce in high-need areas and created more sustainable pathways for future behavioral health professionals.

NORC’s findings informed BHW’s understanding of how its investments translated into broader service availability, enhanced care integration, and improved support for underserved populations. The results positioned HRSA to refine its strategies for addressing remaining SUD treatment gaps.