Gov. Josh Shapiro wants to spend hundreds of millions over the next five years to expand access to mental health treatment in a wide-ranging plan that tackles suicide prevention, student wellbeing and community programs.

And, he’s calculated a new way to pay for some of it: raise the state’s 911 fee to support the 988 National Crisis and Suicide Hotline system and boost funding for 14 prevention call centers across the state.

“It has become clear that mental health is just as important as physical health,” Shapiro said, noting the lasting impacts of the pandemic. “Pennsylvanians need somewhere to turn in a moment of need.”

Residents pay $1.65 each month to phone companies for 911 services. This surcharge would increase to $2.03, of which 5 cents would compensate the 988 system.

Future increases will be tied to inflation to ensure operating costs for emergency medical services receive enough state support – an idea that Republican lawmakers fear will worsen the state’s financial problems in the coming years, The Center Square previously reported.

In total, he hopes to give counties $50 million more to fund emergency services, which have increased 23% over the last seven years, he said, despite flat state support. This, in addition to staffing shortages, means Pennsylvania’s EMS system teeters on the brink of collapse.

Lawmakers have offered other ideas to help bridge the funding gap, including redirecting vehicle fees or hotel taxes to support emergency services. Local officials also said organizing EMS at a county level, versus a municipal level, would ease the burden.

Other elements of Shapiro’s plan focus on the youth mental health crisis, which is only growing in Pennsylvania, The Center Square previously reported.

The budget proposal would offer $100 million to school districts to hire qualified mental health professions that students “can trust, in places that are families to, and without shame or stigma.”

The funds would be distributed in three ways: $80 million for School-Based Mental Health Support Block Grants; $10 million for paid clinical internships; and $10 million for training of school-based mental health professionals.

Community-based mental health services would also see an increase of $20 million, with additional funds in successive years for a total $60 million by2027.

Pennsylvania’s counties provide a spectrum of mental health services which Shapiro says are critical to the well-being of its residents. State support, however, has not kept up with the increasing demand for those services and worker shortages induced by a tight labor market.

Shapiro wants to use $4 million to create community-based programs that would serve people who do not require the level of treatment offered at Norristown and Torrance State Hospitals, or who are being discharged from those institutions.

By supporting these initiatives, Shapiro says Pennsylvania can reduce or prevent delays in admissions to state facilities for those who require competency determinations or restorations. Doing so keeps the state in compliance with the Department of Human Services interim settlement agreements and keeps individuals out of incarceration, he said.

To address the unique safety and mental health issues facing the agriculture community, Shapiro proposes spending $200,000 to supplement federal support for a mental health hotline and specialized training and outreach. According to CDC data published in 2020, farmers die by suicide in higher rates than most other occupations.