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Authors Posts by Jim Sharp

Jim Sharp

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Press release from the Centers for Medicare & Medicaid Services:

The Centers for Medicare & Medicaid Services (CMS) has announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under President Trump’s Working Families Tax Cuts legislation (Public Law 119-21) to strengthen and modernize health care in rural communities across the country. In 2026, states will receive first-year awards from CMS averaging $200 million, within a range of $147 million to $281 million. This unprecedented federal investment will help states expand access to care in rural communities, strengthen the rural health workforce, modernize rural facilities and technology, and support innovative models that bring high-quality, dependable care closer to home.

Awardees and Funding Amounts

The Rural Health Transformation Program’s $50 billion in funds will be allocated to approved states over five years, with $10 billion available each year from 2026 through 2030. As directed by Public Law 119-21:

  • 50% of the funding is distributed equally among all approved states. This provides states with a strong foundation to begin implementing their Rural Health Transformation Plans; and
  • 50% is allocated based on a variety of factors. As described in the Notice of Funding Opportunity, those factors include individual state metrics around rurality and a state’s rural health system, current or proposed state policy actions that enhance access and quality of care in rural communities, and application initiatives or activities that reflect the greatest potential for, and scale of, impact on the health of rural communities. All scoring factors are outlined further in the Notice of Funding Opportunity.

Read the full press release here.

Pennsylvania submitted their plan to CMS in November, and the plan is currently being evaluated. CMS made funding awards to all 50 states, with Pennsylvania receiving $193,294,054.

RCPA continues to work with the Department of Human Services (DHS) in answering questions from members as well as gaining an understanding on the implementation values for PA specific initiatives from both funding allocation pathways.

If you have any questions, please contact RCPA COO Jim Sharp.

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This is a reminder that RCPA will be holding a membership benefits webinar on Wednesday, January 14, 2026, at 1:00 pm, as an opportunity for members to orient themselves with all that RCPA membership includes. This is not just for new and future members. For current members, there may be benefits associated with our membership that you may not be aware of, including targeted meetings and groups that are held throughout the year.

Registration is required; please register here to attend the webinar. Attendees will have the opportunity to:

  • Virtually meet the dedicated RCPA Policy Staff and RCPA lobbyists;
  • Discuss the 2026 Legislative and Administrative priorities;
  • Preview RCPA divisional committee and subcommittee meetings and what they offer;
  • View the RCPA member-only website;
  • Review exclusive yearly educational and networking events; and
  • Understand the value of the National Council and ANCOR memberships included with RCPA membership.

Visit the RCPA member benefits web page for more information, or contact Tieanna Lloyd for benefit details.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has released the proposed Mental Health Procedures regulations, which are open for public comment. The posting on the Independent Regulatory Review Commission (IRRC) website can be found here.

The proposed regulations are to be in compliance with Act 32 of 2022. OMHSAS is choosing to go beyond the updates required by Act 32 and is doing a full alignment of the chapter with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to increase the clarity of the regulations for stakeholders.

Starting December 6, 2025, and closing January 5, 2026, the public may submit written comments regarding the proposed rulemaking to the Department via email. Please be aware that all public comments must be published verbatim on the IRRC website with the name of the commenter included. OMHSAS fully supports and encourages individuals with lived experience to comment on the regulation. However, please ensure you are comfortable with the content of your comment being made public, with your name attached to it.

RCPA has conducted an internal review of the proposed regulations and is seeking member feedback and comments to be included in our submission. Members are encouraged to review and provide recommendation and guidance on the impacts of the proposed regulations on your organization.  Agencies may submit separately or in conjunction with RCPA.

Comments may also be submitted to RCPA COO and Mental Health Policy Director Jim Sharp by January 2, 2026, OR to the following address:

Department of Human Services
OMHSAS – Bureau of Policy, Planning, and Program Development,
Attention: BPPPD
Commonwealth Tower, 11th Floor
303 Walnut Street
Harrisburg, Pennsylvania 17105

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Message from the Office of Mental Health and Substance Abuse Services (OMHSAS):

The Pennsylvania Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) is issuing the bulletin OMHSAS-25-05 “Behavioral Health Clinic Services Provided Outside of the Clinic,” effective November 12, 2025, following changes to Federal Regulation 42 CFR 440.90(d).

OMHSAS 25-05 announces an amendment to Pennsylvania’s Medicaid State Plan which allows all behavioral health clinics that are enrolled in the Medical Assistance (MA) Program, who deliver services through the fee-for-service and managed care systems, to provide clinically appropriate services outside of the clinic. Behavioral health clinics include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and methadone maintenance clinics.

Furthermore, OMHSAS-25-05 also announces the abrogation of 55 Pa Code §§ 1153.14(6) (relating to noncovered services) and 55 Pa. Code 1223.14(11) (relating to noncovered services) by Act 46 of 2025.

The guidance in OMHSAS-25-05 is separate from any “telehealth only” licensure and guidance that may be in place. The changes discussed in this bulletin also do not apply to the existing Mobile Mental Health Telehealth (MMHT) services.

Questions and comments can be directed to OMHSAS via email. RCPA members can also contact RCPA COO and MH Policy Director Jim Sharp with any questions.

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RCPA is excited to host a membership benefits webinar on Wednesday, January 14, 2026, at 1:00 pm, as an opportunity for members to orient themselves with all that RCPA membership includes. This is not just for new and future members. For current members, there may be benefits associated with our membership that you may not be aware of, including targeted meetings and groups that are held throughout the year.

Registration is required; please register here to attend the webinar. Attendees will have the opportunity to:

  • Virtually meet the dedicated RCPA Policy Staff and RCPA lobbyists;
  • Discuss the 2026 Legislative and Administrative priorities;
  • Preview RCPA divisional committee and subcommittee meetings and what they offer;
  • View the RCPA member-only website;
  • Review exclusive yearly educational and networking events; and
  • Understand the value of the National Council and ANCOR memberships included with RCPA membership.

Visit the RCPA member benefits web page for more information, or contact Tieanna Lloyd for benefit details.

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Message from the Center for Connected Health Policy (CCHP):

On November 10, 2025, the U.S. Drug Enforcement Administration (DEA) posted a fourth temporary extension of the COVID-19 telemedicine flexibilities for prescribing controlled substances. These flexibilities were set to expire at the end of the year. Although the DEA has not yet released the full text of the extension — including how long it will last. At this point, the final rule is still pending regulatory review. Historically, extensions have added a year of continued flexibility, though this extension could be shorter. For context, the previous extension, issued in November 2024, extended the telemedicine allowances through December 31, 2025. Until the fourth extension rule is approved and the complete text published, the duration and any potential policy adjustments remain unknown.

As background, permanent federal law under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 largely prohibits the prescribing of controlled substances without an initial in-person examination. While the statute outlines several exceptions under the defined “practice of telemedicine,” these apply primarily when a patient is located in a hospital or clinic or in the presence of another practitioner. As a result, these exceptions do not cover the routine model of telehealth widely used today, in which the patient (and sometimes the provider) participate from home settings. Importantly, the in-person requirement under the Ryan Haight Act applies only to the initial visit, and the DEA has never required subsequent in-person encounters. While the full details are not yet available, it is likely that the forthcoming temporary extension will mirror previous ones by continuing to suspend the initial in-person visit requirement for the period of the extension.

It is important to note that these DEA extensions affect only federally-controlled substance prescribing rules. States maintain their own requirements, which may include stricter requirements for in-person visits prior to the prescribing of controlled substances. Please check the Online Prescribing category of CCHP’s Policy Finder to reference state specific requirements.

Additionally, the DEA’s in-person prescribing requirement is separate from Medicare’s policy requiring an in-person visit within six months prior to an initial telehealth mental health service and annually thereafter. That Medicare mental health requirement — often confused with the DEA’s prescribing standard — is tied to Medicare reimbursement rules and applies only to Medicare beneficiaries and providers seeking reimbursement for mental health services through Medicare if their situations do not meet certain exceptions, not to all patients. Additionally, this Medicare in-person visit requirement is currently waived until January 30, 2026 (as passed in the most recent government funding bill), whereas the DEA’s in-person requirement, which is the topic of this particular newsletter and the new fourth extension rule, governs all practitioners prescribing controlled substances nationwide, regardless of payer.

If RCPA members have any questions, please contact RCPA COO and Mental Health Policy Director Jim Sharp.

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Message from PA DHS:

Under new federal rules, to keep or become eligible for SNAP benefits, some recipients will have to meet work requirements that include working, volunteering, or participating in an education or training program for at least 20 hours a week (or 80 hours each month) AND report that they are meeting these work requirements.

To help SNAP recipients and applicants find out if they need to meet this requirement, the Pennsylvania Department of Human Services (PA DHS) has launched a new online screening tool.

By answering a simple set of yes or no questions, SNAP applicants and recipients can find out if they need to meet the work requirements, if they are already meeting the work requirements, or if they are eligible for an exemption.

The screening tool is not a final determination of whether someone is meeting the work requirements or is eligible for an exemption, but it can help recipients and applicants have a more informed conversation with their caseworker.

The new work requirements will apply to Pennsylvanians who:

  • Are between 18-64 years old;
  • Do not have a dependent child under 14 years old; and
  • Are considered physically and mentally able to work.

In addition, being a veteran or a current or former foster youth age 18–24 will no longer be an exemption.

Some people may still be exempt from work and reporting requirements if they meet a different exemption. You can learn more about these work reporting requirements, who they affect, and more about exemptions at DHS’s website.

State Budget Investments Help Fight Food Insecurity

Pennsylvania’s charitable food network and our agricultural community are vital to keeping our neighbors and communities fed. Governor Shapiro’s 2025/26 budget delivers major investments to combat hunger, strengthen the charitable food network, and support Pennsylvania farmers. The budget includes a historic $11 million increase for food security, including:

  • $3 million for the State Food Purchase Program and $1 million for the Pennsylvania Agricultural Surplus System (PASS);
  • $2 million for a new state Food Bucks program to supplement SNAP; and
  • $5 million in new funding to Pennsylvania food banks.

Help Us Spread the Word

PA DHS has developed a communications toolkit to help Pennsylvanians understand the changes happening to SNAP.

We ask RCPA members, advocates, and stakeholders to view and share the toolkit, which includes sample text, social media posts, and more.

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From Pennsylvania Capital-Star “Pa.’s Rural Health Application Reveals Priorities in Federal Funding Request,” November 20, 2025:

Pennsylvania is hoping to secure its own slice of a $50 billion rural health fund in the face of federal Medicaid cuts, with a focus on bolstering a beleaguered workforce and expanding health access for more than two million people.

The Rural Health Transformation Fund was a last-minute addition to President Donald Trump’s summer budget bill that imposed Medicaid work requirements and cut upwards of $51 billion in funding to the commonwealth over the next decade. That new fund is worth roughly 37% of the estimated lost Medicaid funding in rural areas…

The 67-page application requests up to $200 million in annual funding over the next five years, totaling $1 billion. Its six focuses include: technology and infrastructure, workforce, maternal health services, behavioral health services, aging and access, and emergency medical services and transportation.

The U.S. Department of Human Services is expected to award funding by the end of the year.

Key objective targets are:

  • Access to care: More than 85% of Pennsylvanians can get a routine primary care appointment within four weeks and urgent care appointments within one week.
  • Digital connectivity and telehealth: More than 85% of rural hospitals and clinics will have broadband and telehealth functionality. More than 50% of rural hospitals and clinics connected via Fast Healthcare Interoperability Resources.
  • Workforce adequacy: Reduce rural hospital vacancy rates by 10% for key direct care roles. Add three new rural training programs.
  • System sustainability: More than 60% of systems partnered with rural Community Health Centers for specialty care.
  • Health outcomes: Reduce the number of pregnant women living in rural areas with inadequate prenatal care by 20%.

From the PA Rural Health Transformation (RHT) Program Application:

Pennsylvania’s rural health transformation strategy is grounded in a balance of statewide coordination and regional leadership and collaboration. Pennsylvania’s “Health Hub” state agencies (Human Services, Health, Aging, Insurance, Drug and Alcohol Programs), and other partner agencies will establish clear strategic priorities focusing on access, workforce, maternal health, aging, behavioral health, EMS and infrastructure. Pennsylvania will leverage statewide technical expertise, evaluation, and financial oversight and support. Strong regional rural care collaborative will be composed of a roster of regional stakeholders that prioritize local needs, develop effective local sustainable solutions, and leverage existing resources and assets.

Pennsylvania will leverage established regional entities that coordinate regional economic development. These Partnerships for Regional Economic Performance (PREP) organizations are long-standing, quasi-governmental organizations that convene regional stakeholders, administer federal and state grants, collect local data, report outcomes, and catalyze public and private partnerships for regional economic development. They bring established governance structures, convening power, and a track record of successful cross-sector collaboration. PREPs (Figure 2) will convene regional stakeholders to create Rural Care Collaborative (RCCs) to align initiatives with regional economic planning and development – making the RHTP investments sustainable and promoting long-term partnerships.

If you have any questions, please contact RCPA COO and Mental Health Policy Director Jim Sharp.

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