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Authors Posts by Jason Snyder

Jason Snyder

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Image by succo from Pixabay

The Pennsylvania Senate today passed HB 1563 and HB 1561, sending the substance use disorder and mental health confidentiality-related bills to Gov. Wolf to sign into law. He is expected to sign both.

Both bills align Pennsylvania’s confidentiality laws with federal confidentiality laws, including 42 CFR and HIPAA. Barring a Gov. Wolf veto of HB 1563, Pennsylvania’s 4 Pa Code 255.5 will be eliminated.

Advocates of improved care coordination and integration have long pointed to 4 Pa Code 255.5 as a barrier, citing the limited amount of information allowed to be shared and the few entities with whom it could be shared, even with patient consent.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) today announced the availability of $3 million in funding for entities to provide pregnancy support services to address the needs of pregnant and postpartum women with substance use disorder (SUD).

Eligible applicants can find the project summary and budget on the Funding Opportunities page of the DDAP website. Approximately three to five grants, up to $600,000 each, will be awarded to help provide services, streamline care, and assure that this population is connected with the most appropriate resources to reach long-term recovery.

All applications must be submitted via email by 11:59 pm on Friday, July 29, 2022. Applications will be competitively reviewed and scored based upon the applicant’s adherence to the funding announcement guidelines and a timely submission to DDAP.

The grants are part of $59 million in federal funding awarded to Pennsylvania through the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Substance Abuse Prevention and Treatment Block Grant Program.

Questions regarding the grants and the application process can be emailed to DDAP.

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The Substance Abuse and Mental Health Services Administration (SAMHSA) announced today it is extending its opioid treatment program (OTP) exemption for an in-person physical evaluation for buprenorphine treatment for a period of one year from the end of the COVID-19 Public Health Emergency (PHE). The extension goes into effect upon the expiration of the COVID-19 PHE.

Read the full announcement.

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Today, the Department of Drug and Alcohol Programs (DDAP) was joined by national nonprofit Shatterproof and substance use disorder treatment provider Gaudenzia to announce the expansion of the free and confidential Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS) to Pennsylvania.

ATLAS evaluates addiction treatment facilities’ use of evidence-based best practices based on the Shatterproof National Principles of Care, includes an assessment to understand the appropriate level of care, and offers an easy-to-use dashboard to allow those in need and their loved ones to search for and compare facilities using criteria such as location, services offered, and insurance accepted so they can find the best treatment for their unique needs. ATLAS is fully available in English and Spanish.

“We are grateful for ATLAS and the team at Shatterproof for making the submission process so easy,” said Dr. Dale Klatzker, President and CEO at Gaudenzia, Inc. “It is vital that we reduce barriers to treatment, and this tool provides an easy way for those in need to seek and quickly find a treatment option that will work best for them.”

Forty Gaudenzia treatment locations and a total of 515 substance use disorder treatment facilities across the state have submitted their information to be included in ATLAS. An additional open enrollment period for facilities who missed the first deadline will be available in fall 2022.

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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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