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Authors Posts by Jason Snyder

Jason Snyder

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DDAP Modifies ASAM Transition Web Page, Archives Addendums That Outlined IOP Ratio and Daily Therapeutic Hour “Expectations”

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) has overhauled its ASAM Transition web page, removing previous references to “expectations for contractual compliance” in areas of ASAM Criteria where DDAP originally went beyond the Criteria as explicitly written. Newly revised information, including an updated “Guidance for the Application of The American Society of Addiction Medicine, 3rd Edition, 2013 in the Pennsylvania Substance Use Disorder Treatment System for Adults” and “ASAM Frequently Asked Questions” document, references the 1:15 intensive outpatient (IOP) counselor-to-patient ratio and the six to eight daily therapeutic hours at residential level of care as a DDAP “recommendation.”

The change is significant because, according to the Pennsylvania Department of Human Services (DHS) Office of Mental Health and Substance Abuses Services (OMHSAS), per its HealthChoices Behavioral Health Program Standards and Requirements for Primary Contractors document, “the Primary Contractor and its BHMCO must ensure that the SUD providers in the network comply with program standards in the ASAM Criteria, included but not limited to admission criteria, discharge criteria, interventions/types of services, hours of clinical care, and credentials of staff as set forth in the ASAM transition requirements found at https://www.ddap.pa.gov/Professionals/Pages/ASAM-Transition.aspx.” In other words, providers were expected to be in compliance with any information published as an expectation on that page.

For months following DDAP’s testimony in Commonwealth Court that the IOP and daily therapeutic overreaches were simply “guidelines,” the provider community remained unclear on whether they would be required to comply with the “guidelines” as part of their contracts with the BHMCOs. Still, providers have not yet seen the evaluation tool that will be used to audit their compliance with ASAM Criteria despite DDAP’s expectation that they be “substantially aligned” with those Criteria by Jan. 1, 2022.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) is now offering “Co-Occurring Conditions: Promising Practices and Approaches.”

Co-occurring conditions are no longer the exception but the expectation, requiring treatment programs to design services that address the interrelationship among complex physical, psychiatric, and substance use conditions. This curriculum will review up-to-date principles, terminology, screening, assessment, treatment considerations, and programming guidelines, and the interactive program will engage participants through discussion and small group exercise. This six-hour virtual course is divided into two parts in DDAP’s Training Management System.

Participants of this course will:

  • Describe the foundations of integrated treatment;
  • Highlight key treatment considerations;
  • Employ screening and assessment for COD; and
  • Critique integrated treatment plans.

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The Pennsylvania Department of Human Services is extending the public comment period for the renewal of the Section 1115 Medicaid Demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration” (Project Number: 11-W-003083/3). The public comment period, which was originally slated to end on Feb. 15, 2022, is now extended to March 10, 2022, so the public can see the clarifications made in the Demonstration Extension page on the DHS website. The effective dates of the current approved demonstration are Oct. 1, 2017, through Sept. 30, 2022. The extension requested will be for an additional five years through Sept. 30, 2027.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) has added a third option to its list of approved ASAM Criteria education.

For more information on ASAM, visit DDAP’s website.

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Anthem Foundation is making up to $30 million available over the next three years to support substance use disorder programs that address an array of care and service options, including prevention and early intervention, crisis response and interventions, long-term intervention, and community resources and recovery supports.

Qualified nonprofit organizations with a history of proven, programmatic community initiatives are invited to apply for funding. Although Pennsylvania has not been specifically identified as a local area of focus, Pennsylvania providers can qualify under the National Programs of Emphasis category. More information about funding guidelines and eligibility is available. The deadline to submit applications is January 31, 2022.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) announced today that Dr. Michael Lynch, UPMC Health Plan Medical Director of SUD Services, has been named Medical Director of DDAP. DDAP’s announcement follows last Wednesday’s announcement by RCPA of the creation of the new position.

Dr. Lynch, who will continue his full-time role with commercial insurer UPMC Health Plan, is board-certified in emergency medicine, medical toxicology, and addiction medicine.

In this position, Dr. Lynch will advise and assist DDAP in the development of policy and procedures related to medical best practice as well as advances related to substance use disorder (SUD) treatment, including:

  • Providing technical assistance to SUD treatment providers and physicians in PA’s system of care, including the application of the ASAM criteria;
  • Developing projects to improve delivery of care to individuals with SUD;
  • Researching and reviewing new technologies and procedures, reviewing pertinent medical literature, and presenting findings and recommendations to appropriate entities regarding SUD, opioid use disorder, and medication-assisted therapies;
  • Educating stakeholders and providers relative to medication-assisted therapies as well as drug, alcohol, and narcotic treatment regulations; and
  • Developing new workflows and processes to increase quality improvement measures for DDAP and treatment providers.

Dr. Lynch graduated from the University of Notre Dame and University of Pittsburgh School of Medicine before completing his residency in emergency medicine and fellowship in medical toxicology at the University of Pittsburgh. He is an assistant professor of Emergency Medicine and Pediatrics at the University of Pittsburgh and works in the emergency departments at UPMC Presbyterian and Mercy Hospitals. The toxicology service at UPMC is one of the busiest in the country, seeing patients at five Pittsburgh hospitals as well as providing inpatient addiction and telemedicine treatment. Dr. Lynch is the Medical Director of the Pittsburgh Poison Center and of SUD Services at UPMC Health Plan, and he continues to serve on the Boards of Directors for the PA College of Emergency Physicians and the American Association of Poison Control Centers.

UPMC Health Plan is the commercial insurance arm of UPMC. Community Care Behavioral Health, UPMC’s behavioral health managed care organization, is a sister company and the largest behavioral health Medicaid payer in the commonwealth. Both UPMC and Community Care Behavioral Health are RCPA members.

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Over the last several months, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) has been working toward implementation of a new treatment locator resource called ATLAS® (Addiction Treatment Locator, Assessment, and Standards Platform). Pennsylvania is now currently in the data collection phase for all licensed treatment facilities to be included in ATLAS (though provider participation is not mandatory). As the deadline of January 28, 2022, approaches for completion of the Treatment Data Survey (TDS) portion of the initiative, DDAP Secretary Jennifer Smith highlights the value of this resource to treatment providers and patients. You can read Secretary Smith’s letter here.

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The Pennsylvania Department of Human Services (DHS) is making available for public review and comment the proposed renewal application for the extension of the Section 1115 Medicaid Demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration” (Project Number: 11-W-003083/3). The effective dates of the current approved demonstration are October 1, 2017, through September 30, 2022. The extension requested will be for an additional five years, through September 30, 2027.

In 2016, the CMS Medicaid and CHIP Managed Care Final Rule eliminated Pennsylvania’s ability to use $55 million in federal funding to pay for residential SUD treatment. However, the Commonwealth was able to preserve the funding through an approved Section 1115 Waiver Demonstration. It is within this waiver that Pennsylvania committed to transitioning to ASAM Criteria as a condition for approval of the waiver.

The following links provide information regarding this extension request, extension application, public input process, schedule of public hearings, and other relevant information:

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Dr. Michael Lynch, UPMC Health Plan’s Medical Director of Substance Use Disorder (SUD) Services, has been named Medical Director of the Department of Drug and Alcohol Programs. Dr. Lynch also serves as Medical Director of the Pittsburgh Poison Center.

DDAP has not yet officially announced Dr. Lynch’s position but is planning to. Yesterday, Dr. Lynch announced his position on LinkedIn, which indicates he will continue in his other current roles.

UPMC Health Plan is the commercial insurance arm of UPMC. Community Care Behavioral Health, UPMC’s behavioral health managed care organization, is a sister company. Both UPMC and Community Care Behavioral Health are RCPA members.

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The Centers for Medicare & Medicaid Services (CMS) has approved the Pennsylvania Department of Human Services’ (DHS) proposed minimum rates for each ASAM level of care. The rates are effective Jan. 1, 2022. According to DHS, the behavioral health managed care organizations must increase the rate being paid to any provider currently below the minimum. Providers being paid above the minimum will not be reduced to the minimum.

The rates have been posted and can be accessed through DHS’ website under “Behavioral HealthChoices Provider Resources.”

RCPA will share any additional information on the minimum rates as it becomes available. Please contact RCPA Drug and Alcohol Division Director Jason Snyder with any questions.

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