models to promote, with the understanding that some of these may need be modified to reach underserved communities.

Task 5 Analyze reimbursement issues and develop recommendations for change, in part, by

• a literature review on reimbursement for mental health services delivery and interview of payers (Medicare, Medicaid, and private insurers) to determine current policy and practices regarding reimbursement; and

• a determination of who is currently underwriting the array of psychosocial services required by cancer patients and families; e.g., service agencies, philanthropy, volunteerism, peer counseling, small service charges, etc.

Task 6 Analyze workforce issues, including

• review literature on current capacity of psychosocial service delivery in community setting.

• develop estimates of overall capacity required in the community in order to meet need, via modeling or other methods, using existing health workforce data and prevalence data of psychosocial problems.

• assess expertise in various disciplines to deliver required services (e.g., psychiatry, psychology, social work, nursing, pastoral care, oncology).

Task 7 Develop training recommendations, including

• Examine literature to identify best practice training programs aimed at improving access in the community.

• Contact professional associations for data on training of oncologists about mental health, on training of mental health specialists about chronic disease.

• Training recommendations should address

  • stigma for both patients and providers;

  • accreditation; questions on licensure board exams (medical, nurse, Social work) in addition to training programs;

  • community care providers, i.e., psychosocial service providers (psychiatrists, psychologists, nurses, rehabilitation specialists, noncancer physicians, social workers, pastoral counselors) not affiliated with cancer treatment centers. The goal is to understand what training may be needed for people who neither work