New Database Tracks How 10s of Millions in Opioid Settlement Dollars Are Being Spent in Pennsylvania
Jason Snyder
RCPA Submits Comments to IRRC in Support of OTP-Related Regulation Change
On behalf of its opioid treatment program (OTP) provider members, RCPA submitted comments to the Independent Regulatory Review Commission (IRRC) in support of a final-omitted regulation that would allow an initial physical examination required for prescribing, administering, and dispensing controlled substances through an OTP to be conducted via telehealth under certain circumstances under Pa. 49 Code § 16.92.
This final-omitted regulation would enable the Pennsylvania Department of Drug and Alcohol Programs (DDAP) to grant a statewide exception to 28 Pa. Code § 715.9(a)(4), which today requires Pennsylvania OTPs (called narcotic treatment programs in DDAP regulations) to conduct a face-to-face determination of whether an individual is currently physiologically dependent on an opioid.
IRRC will consider the final-omitted regulation at a public meeting on December 5.
In its comments, RCPA wrote:
“Enabling OTPs to conduct the initial examination required as part of induction into methadone or buprenorphine treatment through telehealth significantly improves and expedites patient access to the gold standard treatment for OUD without sacrificing quality or safety. In a treatment environment where finding qualified physicians, physician assistants and certified registered nurse practitioners is challenging, telehealth bridges a significant gap. Physicians would no longer need to be physically on site at the OTP where treatment is to take place to examine a patient as part of the induction process. Rather, from anywhere in the commonwealth, a physician can examine more patients, who can then begin treatment with medication faster at a facility near their home. In fact, with this final-omitted regulation, OTPs will have the ability to accommodate same-day or walk-in admissions instead of scheduling intake appointments days later.”
The final-omitted regulation, submitted by the Department of State, Bureau of Professional and Occupational Affairs, State Board of Medicine, along with comments in support from the Department of Drug and Alcohol Programs and RCPA, can be viewed on the IRRC website.
Registration Open for 32nd Annual Forensics Rights and Treatment Virtual Conference
Registration is now open for the 32nd Annual PA Forensic Rights and Treatment Conference, titled “What We Know: Myths or Facts.” Sponsored by Drexel University’s Division of Behavioral Healthcare Education, College of Medicine, the virtual conference will be held December 4 and 5 with both live and pre-recorded presentations addressing topics such as trauma-informed care; working with victims of trafficking and partner violence; neuro and gender diversity; and identifying methods to enhance belonging and inclusion.
The conference brochure includes the schedule, workshop descriptions, plenary bios, and registration information. CE credits will be available.
For more information, email Drexel or visit the BHE conferences website.
Pennsylvania Developing Statewide Maternal Health Strategic Plan
To address Pennsylvania’s high maternal mortality rate, the Commonwealth, through a partnership with Governor Shapiro’s office and the Departments of Health, Human Services, Drug and Alcohol Programs, and Insurance, is developing a statewide Maternal Health Strategic Plan. Interested stakeholders are invited to share their opinion through the Commonwealth of Pennsylvania’s Maternal Health Strategic Plan survey, which will remain open through November 4.
The vision for Pennsylvania’s Maternal Health Strategic Plan is a Pennsylvania where every pregnant and birthing person has easy access to high-quality perinatal, birth, and postpartum care that is person-centered, comprehensive, equitable, and affordable and that results in healthy outcomes and long-term good health and well-being.
DDAP Announces Availability of $9 Million for Recovery Support Services
The Pennsylvania Department of Drug and Alcohol Programs (DDAP) announced the availability of $9 million in funding to expand or enhance recovery support services for individuals in recovery from opioid use disorder (OUD) and other substance use disorders (SUD).
DDAP will award approximately six grants of up to $1.5 million each. Applicants must have at least two years of experience as of July 1, 2024, in providing recovery support services and be able to demonstrate the capacity to provide those services to individuals in recovery from OUD and other concurrent SUDs.
DDAP is placing a focus on health equity as a part of this grant opportunity. Based on a variety of criteria from the Pennsylvania Department of Health’s 2022 overdose death data, DDAP will select two grantees located in Philadelphia, two grantees located in Allegheny County, and two grantees from the remaining 19 qualifying counties located within Pennsylvania with a crude death rate higher than the state average.
Funding for these grants is provided through the federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) State Opioid Response (SOR) IV grant program. The SOR program aims to help reduce unmet treatment needs and opioid-related overdose deaths nationwide through state-by-state allocations.
You can send questions electronically regarding the grants and the application process.
DEA Expected to Extend Telehealth Flexibilities for Controlled Substances a Third Time
This week, the Drug Enforcement Agency (DEA) submitted a final rule regarding virtual prescribing of controlled substances to the White House’s Office of Management and Budget (OMB). Though the final rule is not yet publicly available, the OMB registry posting, titled “Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” suggests an extension is coming that will go beyond the current expiration date of December 31, 2024.
Without a new rule or extension of the current flexibility beyond December 31, virtual prescribing of controlled substances without a prior in-person evaluation would no longer be allowed.
DEA received more than 38,000 public comments following its proposed rule in February 2023 for telemedicine prescribing of controlled substances. Subsequently, the telehealth flexibilities were extended to the current December 31, 2024, expiration date.
RCPA will continue to monitor progress on the final rule and communicate the details of the final rule once it is made public.
DDAP Surveying Providers on Workforce Issues Per Act 66 Requirement
Act 66 of 2023 requires the Pennsylvania Department of Drug and Alcohol Programs (DDAP) to conduct quarterly evaluations on workforce issues, including the barriers to entry into the workforce and efforts to address it. Results from this survey, which also asks providers which of the regulatory flexibilities enabled through Act 66 they are using, will be used to provide an annual report to the General Assembly. The report will only include aggregated – not provider-specific – data. Surveys must be completed by Oct. 25, 2024. The survey is available online. Email all questions regarding this survey to DDAP’s Bureau of Program Licensure.
Virtual Trainings Offered on Best Practices for Treating Xylazine-Associated Wounds
The Pennsylvania Department of Health (PA DOH) and Philadelphia Department of Public Health (PDPH), in collaboration with the Center for Forensic Science Research & Education (CSFRE), are providing virtual trainings to clinicians and non-clinicians on best practices for caring for individuals with xylazine-associated wounds. These trainings are offered at no-cost to attendees.
The trainings will be offered in two separate two-hour sessions for individuals and organizations working in Pennsylvania.
DOS, DDAP Poised to Enable Tele-Induction of Narcotic Medications at OTPs
Last Thursday (October 3, 2024), the Pennsylvania Department of State’s Board of Medicine submitted to the Independent Regulatory Review Commission (IRRC) a final-omitted regulation that would allow an initial physical examination required for prescribing, administering, and dispensing controlled substances to be conducted via telehealth under certain circumstances under 49 Pa. Code § 16.92. A final-omitted regulation does not require a public comment period and is in essence an expedited process for proposing a regulation change. IRRC will hold a public meeting on November 21 to approve or disapprove the regulation.
This final-omitted regulation would enable the Pennsylvania Department of Drug and Alcohol Programs (DDAP) to grant a statewide exception to 28 Pa. Code § 715.9(a)(4), which today requires Pennsylvania OTPs (called narcotic treatment programs in DDAP regulations) to conduct a face-to-face determination of whether an individual is currently physiologically dependent on an opioid.
In its Regulatory Analysis Form, the Department of State’s Board of Medicine wrote:
“This final-omitted rulemaking amends the Board’s regulations at § 16.92 by allowing the initial physical examination required for prescribing, administering, and dispensing controlled substances to be conducted by means of telehealth for those patients being admitted into an Opioid Treatment Program (OTP) for treatment of opioid use disorder with either buprenorphine or methadone, provided that the health care provider determines that an adequate evaluation of the patient can be accomplished via telehealth and a full in-person physical examination is completed within 14 days after admission to the OTP. This standard is the same physical examination standard utilized as a result of the Bureau of Professional and Occupational Affairs regulatory waiver issued during the COVID-19 epidemic, which proved to be safe and effective during and after the COVID-19 epidemic. This final-omitted regulation also conforms the Board’s regulations to the Federal opioid use disorder treatment standards as the Board does not wish to unnecessarily maintain a more stringent standard than required by Federal law for OTPs given the continued opioid crisis in this Commonwealth.”
In February 2024, the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) published a final rule amending the federal regulations for the certification of OTPs in 42 CFR Part 8. The changes to the federal rules were used temporarily to improve access to treatment during the COVID-19 federal public health emergency. SAMHSA has now made those changes permanent, and DDAP intends to implement the updated federal rules and reduce barriers to treatment, as described in its latest Licensing Alert 07-2024. This final-omitted regulation is part of the commonwealth’s process for aligning with the final rule on 42 CFR Part 8.
DDAP to Discuss Changes to PA’s NTP Regulations in ASAM Technical Assistance Webinar on Monday
The Pennsylvania Department of Drug and Alcohol Programs (DDAP) will host its monthly ASAM Technical Assistance webinar at 10:00 am Monday, October 7. Staffers from the Bureaus of Quality Assurance and Administration, County Program Oversight, and Program Licensure will provide updates, including information about changes to 42 CFR Part 8, impacts to licensing, and how those changes align with the ASAM Criteria.
Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page.
If you want to receive email notification of upcoming ASAM Technical Assistance webinars, email DDAP’s ASAM Resource Account.
The following information can be used to connect to each month’s webinar, including Monday’s.
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