In November 2024, the Centers for Medicare & Medicaid Services (CMS) announced that it approved the Department of Human Service’s waiver to provide continuous eligibility for children in Medicaid up to age 6. CMS, however, also moved the 0-6 continuous eligibility from the state’s proposed Keystones of Health section 1115 demonstration waiver to a section 1115 waiver covering former foster youth to ensure passage while other aspects of Keystones of Health (such as housing, re-entry, and nutrition) are still in discussion. While advocates are celebrating the win for 0-6 continuous eligibility, the former foster youth waiver expires in September 2027. Advocates continue to work for full implementation implemented that is sustained beyond 2027.
The final budget contained an increase of $26 million in the Child Care Services line. Most of the increase in this year’s budget will maintain the child care subsidy exit income increase to 300 percent of the Federal Poverty Income Guidelines or 85 percent of the State Median Income. The remaining funds will be used by the Office of Child Development and Early Learning to increase the child care subsidy reimbursement rate to the federally recommended 75th percentile of the cost of child care services. While this increase will help buffer inflationary pressures on child care providers, it will not address the workforce crisis in the sector. The Start Strong PA child care campaign worked hard advocating for a dedicated recruitment and retention program supported by recurring funds and is disappointed in the lack of investment in the workforce behind the workforce.
Pennsylvania’s statewide advocacy effort dedicated to Early Intervention Part C is pleased with progress made during the 2024 session, including the Office of Child Development and Early Learning’s undertaking of a rate study. Advocates also, for the first time, successfully obtained comprehensive disaggregated data at statewide and county levels, which will significantly assist advocacy efforts moving forward. In addition, an increase of $9.1 million was included in the FY 2024-25 budget for the Early Intervention Part C (infants and toddlers) program in the DHS budget. The Pennsylvania Department of Education budget’s Early Intervention Part B (age three to five) program includes an increase of $32.9 million to improve well-being, health, and educational outcomes. Finally, a bill to add a positive screen for maternal depression and anxiety to the list of eligible conditions for early intervention tracking nearly made it to the governor’s desk, with it passing the House but stalling in the Senate. Advocates are working to ensure the bill is enacted in the 2025-26 legislative session.
In 2024, through a public/private funding, Pennsylvania established its own perinatal TiPS program, which will offer remote behavioral and psychiatric guidance for providers who interface with the perinatal population. The program is in the implementation phase and will officially launch in Spring 2025. Three grantees have been selected statewide with a planned go-live date of the Perinatal TiPS line being March 1, 2025.