anshulagarwal12 wrote: Added to worries about budget cuts and cost of living increases , the administrators of public health care facilities must contend with the possiblity of a strike by employees.

a. added to worries about budget cuts and cost of living increases . The two parts are not parallel; one is noun and the other is a clause. It should be increases in the cost of living
b. In addition to worry about cuts in the budget and as the cost of living increases. Same problem as in A
c. Added to their worrying about budget cuts and cost of living increases. Same problem as in A
d. In addition to worrying about budget cuts and increases in the cost of living . Correct

Also I feel A and C changes the meaning. The Starting modifier is a participle phrase and It seems to suggest that Administrators are added to worry about budget and increases in the cost.

Kindly advise.

Answers a and c are incorrect because of the incorrectly formulated modifiers which sound as if the administrators were added to worries.
Answer b is incorrect because the two phrases connected with and are not parallel, the first being a phrase and the second being a clause.
Answer d is correct. The two sides of the structure are PARALLEL ("worrying about budget cuts" and "increases in the cost of living").

IMO E.
Parallel.