Behavioral-health providers in Pennsylvania face financial instability because of inconsistent rate increases, affecting staff recruitment and retention.

In a survey from the Pennsylvania Council of Children, Youth and Family Services, one provider stated when increases occur, 70% goes to salaries, 20% to occupancy, and 10% to insurance.

Nancy Kukovich, CEO of the nonprofit youth services provider Adelphoi, recommended improved Behavioral Health Managed Care Organizations review processes for rate increase requests, citing insufficient state oversight over the rate request process.

She said their evidence-based multisystemic therapy is in need of a master's degree-level therapist, but due to lack of funding it's been difficult to recruit for this position.

"Its general claim to fame is behavioral health, but it is intense enough that it can keep kids out of the deeper end of the system," Kukovich explained. "They don't have to go to residential. They can get this really intensive service in their home. So, it's of great value to some of the counties, but it's not an inexpensive program."

The survey found Behavioral Health Managed Care Organizations sometimes offer increases during fund surpluses or when federal funds, such as the American Rescue Plan Act, are available. But the raises have not kept pace with providers' budget needs because of market competition and years of minimal increases.

Kukovich pointed out Adelphoi works with five Behavioral Health Managed-Care Organizations and has not received a rate increase in years. She noted they request the rate increase from the organizations and before approving an increase, they typically request information from providers to determine the value of the program.

"They go through a big process of trying to figure out, do we have enough of the service already? Do we need more of it? Is it something that's really important?," Kukovich outlined. "Then we usually have to fill out a whole lot of paperwork about what our costs are, what salaries look like, etc. We submit that information. We find out whether or not we get a rate increase."

Amy Fenn, senior director of Pennsylvania community-based services for Pittsburgh-based provider Pressley Ridge, oversees a variety of programs, including in-home mental health, child welfare, juvenile justice and others. She said the inconsistent rate increases ultimately affects their ability to attract and retain quality staff.

"The main thing is always salaries, because we give merit increases every year," Fenn emphasized. "Without rate increases, we're continuing to have higher costs but we still never feel like we can pay people as much as we as we should be, paying them as much as the work is worth, because without those regular rate increases, we just can't keep up with the expenses."

The survey shows behavioral health providers are competing with school-based jobs offering better pay and hours. To stay competitive, providers have raised salaries by up to 11%, despite limited funding. It recommends linking salary increases to actual costs and exploring flexibility within Behavioral Health Managed Care Organizations.


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A new study provides New York State with an outline of necessary updates to its school funding formula.

The Rockefeller Institute study called for improving several areas such as the Regional Cost Index, which has not been updated in 18 years. Other focus areas include the poverty metric, which does not give a comprehensive picture of students' needs.

Randi Levine, policy director for Advocates for Children of New York, said other updates should have been considered.

"We're disappointed that there are no recommendations to add weight for students experiencing homelessness and students in foster care so that schools can better meet their needs to provide per-pupil funding for preschoolers in pre-K and 3-K," Levine explained.

She added the provisions could be passed through bills introduced by lawmakers.

More than 155,000 New York State public school students were homeless during the 2022-2023 school year. Of those, 120,000 were New York City Public School students. Columbia University found the current Foundation Aid formula uses poverty numbers from the 2000 Census and cost-of-living averages from 2006.

The Rockefeller Institute study suggested numerous ways for lawmakers to update the school funding formula. However, Levine argued some of them must be assessed for their efficacy, including a recommendation to update the poverty measure and provide a different way to measure it.

"The study provides a few different ways of doing that," Levine observed. "The study notes one of the proposals for how to change that weight would result in New York City seeing a projected decrease of around $392 million."

Other recommendations in the report included using a scaling aid approach to better supply funding for students with disabilities, a new adjustment based on instruction service hours for English Language Learners and letting school districts use Foundation Aid dollars for general education purposes, rather than regimented direct spending.


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New York could see major effects from President-elect Donald Trump's proposed budget cuts.

Elon Musk and Vivek Ramaswamy's Department of Government Efficiency is set to slice $2 trillion in federal spending. While their focus is cutting agency budgets and the government's workforce, safety nets will be in their crosshairs.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said states will have flexibilities if cuts occur, but they will make using services harder.

"In practice, these flexibilities will mean things like cutting back eligibility, adding red tape so that it's harder for families and people to get through the process, which cuts down on enrollment," Alker explained. "We know that from the unwinding that we've just been through."

She added benefits could be limited and providers who see a lot of low-wage working families might face reimbursement cuts. There has been consideration to cut Medicaid's expansion match rate to a regular rate, which would move most costs to states. Estimates show New York's cost for expansion group under a reduced federal match rate could be more than $5 billion, if it occurs.

The Supplemental Nutrition Assistance Program could face cuts as well.

Mayra Alvarez, president of the Children's Partnership, said the proposed changes outlined in Project 2025 could make the program harder to access while increasing inefficiencies.

"Everything from increasing time limits for the program for adults without dependents," Alvarez outlined. "Also, eliminating categorical eligibility, which would remove the state options of increasing the gross income limits from 130 % of the poverty line to up to 200%."

In 2022, 53% of SNAP participants in New York were families with children, and close to 3 million people statewide relying on the program. Nationwide, SNAP has helped lift more than 3.4 million people out of poverty in 2023.

In the Wyoming governor's new supplemental state budget, the biggest line item by far is wildfire recovery.

Gov. Mark Gordon on Monday gave a virtual speech to kick off several days of agency budget meetings, in which legislators request supplements to the 2025-2026 biennial budget adopted in March.

Gordon noted the historic nature of the 2024 wildfire season, which he said burned 850,000 acres across the state and cost more than $55 million in suppression efforts. The price tag emptied several state coffers, he said, and he requested $130 million be added to the new budget for similar purposes.

"Without further appropriation, Wyoming will not have sufficient unobligated funds to effectively respond to future fires or other potential emergencies such as flooding or rapid runoff or massive winter and spring snowstorms," Gordon contended. "Which as we know are not uncommon to Wyoming."

The funds would also help with recovery efforts after wildfire, such as preventing invasive plant species from taking over burned landscapes and providing assistance to restore lost infrastructure and stabilize watersheds.

Gordon also requested funds to both mitigate past federal actions and prepare for future ones. One example is the federal COVID-era American Rescue Plan Act, designed to fund local governments' infrastructure projects. The deadline for the plans was this year. Many proposed project in Wyoming were delayed, Gordon said, because of "federal deadlines and supply-chain issues." He asked for more than $20 million in mineral royalty grants to fill the gaps.

"The unprecedented influx of federal programs, beginning with the CARES Act, skewed Wyoming's homegrown approach to addressing community emergencies and needs," Gordon argued. "This is the time we can return to the more conservative and direct approach our state is accustomed to."

Gordon also asked for two additional senior attorneys to be funded for the Attorney General's Office to continue challenging federal regulations, which, he said, "hinder our ability to manage agriculture, energy, water and wildlife."


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