Table 4.

Potential Policy Levers

Level	Potential policy levers	Barrier addressed
Agency context	Creating cross-fertilization opportunities between agencies Providing technical assistance to share lessons across programs	Lack of feedback between programs Lack of connections among grantee agency programs and with other systems (mental health boards, clinical training programs)
State government context	Conducting consistent data collection and program evaluation (including quantitative and qualitative methods) that explore financial, historical, and logistical experiences in the licensing process Creating an innovation center that includes technical assistance and cross-fertilization efforts Creating a stakeholder advisory board	Lack of data to describe problem to key stakeholders, including policy makers, state mental health board representatives, and national license exam boards Lack of feedback between programs Lack of connections among grantee agency programs and other systems (boards, clinical training programs)
Political context	Creating a stakeholder advisory board Developing state-agency collaboration (with MDH/loan forgiveness programs) Promoting legislation that requires mental health boards to keep demographic data	Decreases isolation between systems of government and creates a political entity to promote legislation and policy changes Creates baseline data to assess severity and pervasiveness of problem
Social context	Including ethnicity-specific mental health provider advocacy groups in the stakeholder advisory board and collaborating with these advocacy groups for grant program development and data collection efforts	Allows advocacy groups to provide feedback to various systems Provides advocacy groups with ways to continue facilitating mentoring that can assist in licensing process