Alliance Alert: The Alliance for Rights and Recovery welcomes this important new report from InUnity Alliance, which highlights the significant financial, administrative, and workforce challenges facing ºÚÁϲ»´òìÈ’s mental health and substance use service system. While many of the findings focus on provider operations, the real impact is felt by the people who rely on these services every day. When programs operate at a deficit, payments are delayed, staff positions go unfilled, and administrative burdens consume valuable resources, people seeking help often face longer wait times, fewer available appointments, reduced service options, and greater difficulty accessing support when they need it most.
The report demonstrates how financial strain throughout the behavioral health system ultimately affects access to services. Providers reported dozens of mental health and substance use programs operating at a loss, nearly 70-day average waits for insurance reimbursement, extensive time spent navigating prior authorizations and denials, and thousands of Medicaid recipients experiencing coverage disruptions during recertification. The result is a system where people frequently wait months for services, experience interruptions, or are unable to access supports until they reach a crisis point.
The Alliance believes the report’s four priority recommendations offer an important framework for improving access to services across ºÚÁϲ»´òìÈ. These include identifying financially unsustainable programs before services are lost, addressing insurance and grant payment delays, strengthening and expanding the workforce by allowing professionals to practice at the full scope of their credentials, and reducing Medicaid coverage disruptions that prevent people from accessing services.
Many of these recommendations align with issues the Alliance has long advocated on, including sustainable funding for community-based services, reducing administrative barriers created by managed care, strengthening peer support and recovery services, expanding the behavioral health workforce, and ensuring people maintain uninterrupted access to Medicaid and other healthcare coverage. These challenges become even more important as ºÚÁϲ»´òìÈ prepares for upcoming federal Medicaid eligibility and community engagement requirements that could create additional barriers for people seeking services.
The Alliance will continue working with InUnity Alliance and other statewide mental health and substance use organizations to advance meaningful reforms that address the root causes of service delays and improve access to support. We will be encouraging state leaders to act on the report’s recommendations while also identifying additional opportunities to strengthen community-based services, improve coordination, and support providers in meeting growing community needs.
We also plan to engage our members in discussions about the report’s findings and recommendations. The perspectives of people utilizing services, family members, peer professionals, providers, and advocates will be critical in identifying practical solutions and ensuring that reforms are focused on improving outcomes for the people who depend on these services.
At its core, this report is a reminder that provider sustainability and service access are inseparable. When providers struggle, people struggle. Strengthening the financial stability, workforce capacity, and operational effectiveness of ºÚÁϲ»´òìÈ’s behavioral health system is essential to ensuring that every person can access timely, voluntary, recovery-oriented mental health and substance use services in their community.
Behind Behavioral Health Providers’ Funding Woes
By Maya Kaufman and Katelyn Cordero | Politico | June 10, 2026
Behavioral health providers across ºÚÁϲ»´òìÈ are running at a deficit while spending thousands of hours pursuing insurance payments and delayed grant revenue, according to a new analysis by InUnity Alliance, which was shared exclusively with POLITICO Pro.
Service providers waited 70 days, on average, to receive payment from insurers and collectively spent tens of thousands of hours dealing with prior authorization and claims denials, the alliance’s report found.
Medicaid managed care plans were a particularly sore subject, with providers reporting complicated claims processes and frequent delays of required reimbursement rate increases.
Payment delays also extended to state and county grants, prompting organizations to borrow money and end up with an average of $90,000 in unreimbursed interest, according to the report.
InUnity Alliance, which represents over 150 organizations that provide mental health and addiction services, surveyed 50 providers and drew from fiscal reports and focus groups to compile the analysis.
The survey data reflects the timeframe between July 2024 and July 2025.
Across 22 of the surveyed organizations, 39 addiction and 81 mental health programs were operating at a deficit. Fourteen of the 50 survey respondents said they had less than three months of cash on hand.
The financially unsustainable programs included assertive community treatment, community-oriented recovery and empowerment, and personalized recovery-oriented services.
To address the issues, InUnity Alliance is recommending greater flexibility and timely execution of grant contracts, regular reviews of rate methodologies and expanded scope of practice for behavioral health professionals to practice at the top of their licenses.
Read the Report’s Executive Summary below and see full report attached:
