Healthcare Workforce, Rural Healthcare Access Featured in Pennsylvania Governor’s Budget Proposal

On Tuesday, February 4, Gov. Josh Shapiro delivered his annual budget address to the Pennsylvania General Assembly. Gov. Shapiro’s budget proposal serves as the initial step in a months-long budgeting process, but its most important purpose is a statement of the Shapiro administration’s priorities this year. Following are highlights of the governor’s address that may have notable impacts on Community Health Centers:

Addressing Rural Health Care Worker Shortages – Specific proposals include:

• $5 million to support workforce initiatives to educate, train, and recruit nursing professionals.

• Increase base funding by $20 million to counties to provide critical behavioral health services and address deepening workforce shortages. This is the third year of the administration’s three-year commitment to invest $60 million into the county behavioral health system.

• $15 million in new funding for the Primary Health Care Practitioner program. Of this $10 million to expand the Primary Care Loan Repayment Program, broadening the program’s geographic eligibility requirements and supporting behavioral health care workers in all regions of Pennsylvania. An additional $5 million would be used to expand programs to address workforce shortages specific in rural areas.

• Supporting full practice authority to nurse practitioners who work under a licensed physician for at least three years. This legislation has passed the State Senate in previous years but has not cleared the House of Representatives.

Investing in Apprenticeships and Other Paths to Success

Many CHCs in Pennsylvania are now offering apprenticeships and other forms of on-the-job training. The governor’s proposal includes:

• A dedicated $12.5 million Workforce and Economic Development Network appropriation, leveraging $10 million in existing funds and $2.5 million in new state funds to train additional workers.

• $2 million for the creation of the Career Connect program, a statewide program to build internships at Pennsylvania employers.

Addressing Structural Challenges at Rural Hospitals

The Governor convened a rural health care working group in 2023 (including several PACHC members and staff) to find a solution to this problem. Based on those conversations, the Governor’s proposed budget:

• Leverages a $10 million investment to draw down an additional $26 million in federal matching funds to provide immediate relief to Pennsylvania hospitals.

• Invests another $10 million in state funds to help meet rural hospitals’ needs.

• Adds $20 million for a new appropriation – ‘Patient Safety and Support for Hospitals’ – to “address barriers to care” at all hospitals.

Continuing to Make Mental Health Reforms

The Governor is calling on the General Assembly to send a bill to his desk that closes a loophole that allows insurance companies to deny coverage for mental health services provided to students inside the walls of a school, even though those same services would be covered in a mental health professional’s office across the street.

Transitions from Incarceration

The budget proposal also includes $4.8 million to provide Medical Assistance coverage for individuals transitioning from incarceration to the community. This is one of the federal 1115 waiver components (“Keystones to Health”) approved by CMS.

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