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as required by most states for most professions. Supervision may be easier to arrange in states where it is permissible to be supervised by a member of another profession. Another way of facilitating supervision is to explicitly allow telephone and tele-health technologies to be employed in supervision. A few states, such as Idaho, Wyoming and Colorado, explicitly allow electronic supervision, acknowledging its necessity for rural practice sites. In rural states where electronic supervision is not permitted, professional associations, state rural health associations, offices of rural health, and Medicaid programs should work together to effect changes in licensure laws to allow it.

5. The effect of changes in reimbursement, supervision, and regulation of these professions on the geographic distribution of practitioners must be evaluated. Unfortunately, effects cannot be accurately assessed with current workforce data. Few states have accurate data on the practice locations of all mental health professionals in a format that would enable such analysis, and there is no systematic data gathering at the federal level. The dearth of good data has resulted in most states continuing to use psychiatrists as the only profession considered in the process of designating mental health professional shortage areas (Bird et al. 2001). To address the inability of policymakers to accurately estimate the supply of mental health professionals at a level of geography that allows rural shortages to be clearly documented, the National Rural Health Association has recommended:

The Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute of Mental Health (NIMH), should form a joint task force to address issue of access to mental health in rural areas. This group should be charged with addressing the collection of current, accurate data on the rural mental health workforce, revising the criteria for mental health professional shortage area designation, and addressing access to mental health services for the rural uninsured and underinsured (NRHA, 2002).

This recommendation has been on NRHA’s agenda for two years, but none of these agencies has taken the initiative to act on it, or to suggest an alternative means for addressing our inability to measuring workforce supply.

7. 6. On July 1, 2002, New Mexico will become the first state to grant prescriptive authority to psychologists (“New Mexico adopts”, 2002). The American Psychological Association, as well as the state affiliate in New Mexico, has argued that New Mexico’s rural population and the dearth of psychiatrists outside of Albuquerque and Santa Fe make a compelling argument for prescriptive authority for psychologists. Since the New Mexico law will require


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