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Authors Posts by Jason Snyder

Jason Snyder

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The Pennsylvania Department of State (DOS) has reversed course and extended its waiver allowing for an initial prescription of buprenorphine without an in-person physical exam. DOS had announced previously that the waiver would expire on June 30, 2022; however, DOS’s waiver will now continue until the last day of the federal public health emergency declaration, unless the exemptions are ended sooner by the Substance Abuse and Mental Health Services Administration (SAMHSA) or the US Drug Enforcement Administration (DEA).

On Sept. 4, 2020, DOS issued a waiver suspending the State Board of Medicine’s regulation at 49 Pa. Code § 16.92(b)(1), which requires an initial physical examination of a patient prior to prescribing buprenorphine for the treatment of opioid use disorder. This waiver was sought specifically to complement the Department of Drug and Alcohol Programs’ (DDAP) suspension of 28 Pa. Code § 715.9(a)(4) and “relates to Federal exemptions granted under the Federal public health emergency (PHE) declaration,” specifically the exemptions granted by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Drug Enforcement Agency (DEA).

Therefore, in accordance with section 2102-F(a.3) of the Pennsylvania Administrative Code of 1929 (amended by Act 14 of 2022), the Department of State’s waiver will continue until the last day of the federal public health emergency declaration, unless the exemptions are ended sooner by SAMHSA or the DEA. This waiver will not expire on June 30, 2022. More information about the federal public health emergency can be found here.

It is important to note that, to be considered within the acceptable and prevailing standard of care, the physician/prescriber must be following the applicable SAMHSA/DEA guidelines.

Pennsylvania has not received notification that the PHE will be terminated on July 15. The commonwealth expects the PHE to be extended again. If this occurs, this waiver and others tied to or related to the PHE will be extended until mid-October 2022.

Additional information:

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In 2017, Governor Wolf signed Senate Bill 446 into law as Act 59, which gave the Department of Drug and Alcohol Programs (DDAP) the power and duty to license drug and alcohol recovery houses that receive referrals from state agencies or state-funded facilities or receive federal or state funding. That legislation gave DDAP the authority to take enforcement action and issue fines against operators of unlicensed recovery houses that receive public funding. Last December, DDAP announced that it had published regulations for the licensure program for drug and alcohol recovery houses was accepting applications. Those regulations stated that the provision for issuance of fines would not take effect until 180 days after they were published.

Thursday, June 9, marked 180 days after publication of the regulations. View Information Bulletin 01-22 for requirements for recovery house licensure.

DDAP’s goal is to continue working with recovery houses to attain licensure and will not be looking to penalize houses that are actively working through that process. DDAP and the Single County Authorities (SCAs) share a common goal of causing the least amount of disruption to the lives of individuals in recovery and are hopeful that more houses will continue to submit applications and increase the capacity of licensed recovery houses in Pennsylvania.

To that point, SCAs may continue to act on existing contracts with recovery houses regardless of licensure status through June 30, 2022. Beginning July 1, 2022, SCAs may not execute new contracts with unlicensed houses. For existing contracts that run beyond July 1, SCAs can no longer pay unlicensed houses and should be looking to transition residents to licensed houses and other living arrangements unless the house shows a timely, good faith effort to apply for licensure.

More information on the recovery house application process can be found on the DDAP website. DDAP is also offering a free one-day training workshop designed to answer the various questions associated with the application process. Participation in the workshop results in a decrease in the amount of time it takes to approve applications, resulting in the license being issued sooner to those applicants who participate. To register for the workshop, please email or call 717-783-8675.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) on Thursday visited Pennsylvania’s first licensed recovery house to highlight the importance of becoming licensed. Beginning June 9, 2022, DDAP will have the authority to impose fines on operators of unlicensed recovery houses that receive public funding.

“The Wolf Administration is dedicated to ensuring that Pennsylvanians are supported through all phases of their recovery journey,” said Special Assistant to the DDAP Secretary Steve Ross. “Without recovery housing standards or protections, there are unknown numbers of substandard facilities exploiting this vulnerable population. These regulations are a significant step in ensuring safe, supportive housing for Pennsylvanians in recovery from substance use disorder.”

Audio, photos, and the full press release from the event are available here.

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Today, the National Council for Mental Wellbeing released the results of its first comprehensive consumer survey on access to mental health and substance use care, showing there are significant unmet needs, far more than physical health needs.

Results from the 2022 Access to Care survey, conducted by The Harris Poll, show a staggering 43 percent of U.S. adults who say they needed substance use or mental health care in the past 12 months but did not receive that care. They identified numerous barriers that stand between them and needed treatment. You can download the full survey results here.

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In recognition of Mental Health Awareness Month, the Pennsylvania Insurance Department is highlighting its continued work to ensure that insurers operating within the commonwealth are following state and federal parity laws, allowing those faced with mental health or substance use disorders continued access to needed care.

Under the Affordable Care Act (ACA) and Mental Health Parity and Addiction Equity Act (MHPAEA), health insurance plans and insurers must offer mental health and substance use disorder benefits that are no less restrictive than their coverage for medical or surgical care. These benefits include quantitative limitations (copays, deductibles, and limits on inpatient or outpatient visits that are covered) and non-quantitative limitations (pre-authorizations, providers available through a plan’s network, and what a plan deems “medically necessary”).

Read the full press release.

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Considering the increasing rates of overdose deaths in the United States and to ensure that all people have access to a robust continuum of care and evidence-based services to improve their health, the National Council for Mental Wellbeing continues to build support for a wide range of overdose prevention and harm reduction strategies. A few program and resource examples of this include:

In addition to funding 16 harm reduction pilot projects and efforts to increase the number of sites next year as well as to branch out to mental health and substance use treatment partners, the National Council has also recently become a partner of the National Harm Reduction Technical Assistance (TA) Center.

National Council is conducting a survey and key informant interviews to better understand how to inform program implementation with its members. National Council requests that respondents complete this survey to help the organization understand the technical assistance needs related to harm reduction among prevention, treatment, and recovery organizations. The survey should take no longer than 10 minutes to complete and is anonymous.

By completing this survey by close of business June 3, respondents will also have the chance to enter an optional raffle to win a free registration for NatCon23, the National Council’s annual conference, which is being held in Los Angeles, CA.

Please contact Yoon Hyung Choi with any questions or to express interest in being interviewed as a key informant.

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Beginning June 9, 2022, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) will have the authority to impose fines on operators of unlicensed recovery houses that receive public funding.

View the Recovery House Licensure Information Bulletin here.

DDAP’s recovery house licensure program is live as of December 11, 2021. You can learn more about recovery house licensing and how to apply on the DDAP licensing web page. This message is to remind all recovery houses in Pennsylvania, as well as entities who refer individuals to recovery houses, of several requirements of the Recovery House Law (Act 59 of 2017), including the approaching June 9 deadline.

Requirements to Obtain a License:

Recovery houses must obtain a license from DDAP if:

  1. They are receiving federal or state funding;
  2. They are receiving referrals from publicly-funded facilities; and/or
  3. They are receiving referrals for individuals whose substance use disorder (SUD) treatment is funded with federal or state funding.

*Recovery houses that are not required to obtain a license may still choose to do so.

Referral Requirements:

  • State or county courts must give first consideration to recovery houses that are licensed by DDAP when making residential recommendations for individuals under their supervision.
  • Treatment providers making recovery house referrals for publicly-funded clients must refer to recovery houses that are licensed by DDAP.
  • Any state agency or state-funded facility making recovery house referrals must refer to recovery houses that are licensed by DDAP. A “state-funded facility” is any facility that receives any type of funding from a state agency. For example, this may include an SUD treatment facility that receives funding from their Single County Authority, Managed Care Organization, or a grant from a state agency. It also includes state and state-funded agencies that make referrals for residential settings, such as the criminal justice, juvenile justice, and child welfare systems.

Names, locations, and additional details about each DDAP-licensed recovery house in Pennsylvania are regularly updated on DDAP’s Facility Locator. Select “Recovery House” under the Facility Type Search drop-down on the left-hand panel, and narrow your search by location if desired. A searchable map will also be made available on the DDAP website in the coming weeks.

Fines for Unlicensed Recovery Houses That Receive Public Funds:

Furthermore, the recovery house law requires that DDAP impose fines (up to $1,000 for each violation) on unlicensed recovery houses that are “funded, in whole or in part, by a department or a Federal, other State, or county agency.” This requirement was incorporated in the regulations at 28 Pa. Code § 717.14. As detailed in the Preamble to the regulations, this section will become effective 180 days after publication of the regulations in the Pennsylvania Code & Bulletin on December 11, 2021. Beginning June 9, 2022, DDAP will have the authority to impose fines up to $1,000 per day on operators of unlicensed recovery houses that receive public funding.

Training:

To further assist recovery home operators in the application process, the Bureau of Program Licensure offers a free one-day training workshop designed to answer the various questions associated with the application process. Participation in the workshop results in a decrease in the amount of time it takes to approve applications, resulting in the license being issued sooner to those applicants who participate. The workshop is offered a minimum of once every month. Additional sessions are scheduled based upon interest or need. Requests to register for the training should be sent via email. Call 717-783-8675 with questions.

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Since 2017, Pennsylvania has taken several steps to increase naloxone access for people and communities across the commonwealth who need it the most. With a recent increase in drug overdose deaths (the majority of which are opioid- and fentanyl-related), Pennsylvania is anticipating a significant supply of naloxone in the coming months. The Department of Drug and Alcohol Programs is encouraging individuals, organizations, and agencies to learn how to access this naloxone at no cost.

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The next RCPA Drug and Alcohol Committee meeting, originally scheduled for Tuesday, June 14, has been rescheduled to Tuesday, June 21, 2022. The meeting will held from 9:30 am – 12:00 pm and be composed of two parts:

  • The provider member-only portion is set for 9:30 am – 11:00 am.
  • The all-member portion will be held from 11:00 am – 12:00 pm.

The meeting will be hybrid, with attendees able to join virtually or in person. Please note that we require attendees to be fully vaccinated for COVID-19 to attend in person. In-person attendance will be closed after the first 25 in-person registrants. Masking and social distancing protocols will be followed per the CDC guidelines at the time of the meeting.

Register here for the meeting.

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