3 days ago
'Going to have a huge impact': Behavioral health professionals sound alarm on potential funding cuts
Editor's note: Federal Fallout is a Tribune-Democrat news series addressing the potential local impact of funding cuts.
JOHNSTOWN, Pa. – Behavioral health providers are sounding the alarm regarding proposed federal cuts and the impact they may have on those who need those services.
Funding cuts could mean a decrease in Medicaid spending by more than $720 billion over the next 10 years, as outlined in the U.S. House-passed proposed spending bill.
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If Medicaid funding is changed, that could lead to roughly 7.6 million more people being uninsured, according to health care policy group KFF. Mental health grants for school districts could also be affected.
For Johnstown mental health provider Alternative Community Resource Program, cuts could lead to a decrease in operations or limiting services, ACRP President and Executive Director Frank Janakovic said.
ACRP provides 18 programs to youths in six counties, including Cambria and Somerset, with more than 270 employees. Those programs range from intensive behavioral health services and outpatient psychiatric clinics to early intervention, blended case management, family-based mental health services and in-school supports.
For the past 35 years, the program has offered assistance to the community. Janakovic said 80% to 85% of the organization's annual budget comes from Medicaid and Medicare, with the remainder made up of grants and contracts with school districts.
In 2024, ACRP served more than 6,000 people.
That's why Janakovic is concerned with the proposed slashes in federal funding.
'That's going to have a huge impact, not only on ACRP ... but the people that most need it,' Janakovic said.
He added that cuts would affect not just individuals, but families, too.
'Lifeline for many'
Janakovic said Medicaid is the largest payer of mental health services and substance use disorder care in the country.
The nation is still reeling from an overdose crisis as demand for behavioral health services continues to rise, especially among youth.
'Changes to our Medicaid program could jeopardize access to life-saving behavioral health care and worsen the already devastating mental health, suicide, addiction and overdose crises in rural, suburban and urban communities across Pennsylvania,' according to the Pennsylvania Department of Human Services website.
'Families facing serious mental health challenges or addiction could see their loved ones lose critical access to treatment and recovery supports that save lives.'
Proposed adjustments may also affect 'working families who are a part of the behavioral health workforce by creating more turbulence for an essential field – impacts that can extend across our economy,' the department said.
According to the National Health Law Program, up to 35% of people enrolled in Medicaid have mental health conditions and more than 20% have moderate to severe conditions.
The NHLP describes Medicaid expansion as 'a lifeline for many people with mental health disabilities.'
Cambria County has 35,186 residents who are enrolled in Medicaid, according to state DHS data, and there are 15,487 in Somerset County.
There also are 2,831 people in Cambria County who qualify for $9.2 million in Medicaid expansion assistance for behavioral health services created by the Affordable Care Act for low-income working-age adults.
In Somerset County, there are almost 1,300 who qualify for that service totaling $3.7 million, the state DHS reports.
Medicaid covers approximately 3 million Pennsylvanians – 39% of whom are classified as children or younger than 21.
Reimbursements and staff retention
Janakovic said another hurdle ACRP faces is the reimbursements that the group does receive have remained stagnant for the past year.
That has a ripple effect throughout the operation, he said, that may lead to staff retention issues when there is already a shortage of available therapists. Janakovic said ACRP could reach a point where the organization cannot operate the programs without a loss.
Julia Dello, Reaching Educational Achievements with Clinical Mental Health executive director, said private contracts and staffing are concerns.
REACH is a nonprofit, clinical mental health counseling agency that serves school districts in Cambria and Somerset counties and one in Indiana County. Dello said the organization is not in a position to deal with Medicaid, but these changes may affect how REACH counselors refer clients to other providers.
Additionally, as partner districts finished proposed budgets this spring, the nonprofit saw at least two decreased elementary services due to pending Pennsylvania budget uncertainty, as well as the potential closure of the U.S. Department of Education, as ordered by President Donald Trump.
The Trump administration also announced in May a $1 billion cut to school-based mental health services grants, nonprofit First Focus on Children reported.
'The districts that we had those ending contracts have not taken their decisions lightly,' REACH Clinical Director Ang Carr said. 'That's why they waited until the last moment. They didn't want to have to choose between a teacher and a school counselor from REACH.'
'Not having access'
She also said moving the focus from helping students to potential funding or program adjustments is detrimental.
'It comes down to a lot of students not having access to what they need,' Carr said.
REACH began in 2018, and this is the first year any district has chosen not to renew a contract. Dello said every school the counselors work with values the mental and behavioral health programs provided by the group.
Services range from an embedded clinician in a school building or district to crisis assessments, mental health awareness campaigns and safety planning.
The clinicians greet the students in the morning and wish them well when they leave for the day.
'The relational part is all that the students see,' Carr said, adding that REACH counselors become trusted adults on whom students rely. That's especially important for elementary-age students, to whom the counselor teaches emotional coping and similar strategies, she added.
'If they don't have access to (mental health supports),' Carr said, 'whether it's in school or out of school, the impact is going to be across the whole person and who that student is.'
