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Jim Sharp
Shapiro Administration Releases Report, Recommendations to Improve Coordination of Care, Services for Children and Young Adults with Complex Needs
The Pennsylvania Department of Human Services (DHS) today released recommendations from its Blueprint Workgroup, an interdisciplinary group comprised of representation from state and local governments, health care, education, service providers, managed care, and family advocates. The workgroup sought to evaluate challenges children and youth with complex, co-occurring physical and behavioral health care needs, and their families experience like accessing care and services that adapt to a youth’s changing circumstances and needs, lessening the likelihood of child welfare system involvement, reducing trauma experienced by instability, prioritizing emotional wellbeing, and supporting family- and youth-driven care and choice.
“The detailed recommendations outlined by the Blueprint Workgroup set a course that now allows DHS and partners at the local level and systems of care to begin the work necessary to see how we make change happen so children with complex needs get the care that improves their quality of life, and the family is supported as they navigate these systems,” said Dr. Val Arkoosh, Secretary of DHS. “Systems of care should uplift those we seek to help, not create confusion and consequences from lack of coordination. The Blueprint Workgroup recommendation align our focus around the children and families we must always prioritize, and I am grateful for the work to this point and moving forward that will build a better future for children and families in Pennsylvania.”
Read the full press release, including details on the Blueprint Workgroup’s priorities, here.
RCPA will continue its work on the complex care needs through our Residential Services Steering Committee and ongoing efforts for the implementation. If you have any questions, please contact RCPA Policy Director Jim Sharp.
ICWC Technical Assistance Session Follow-Up
RCPA Issues Telehealth Legislative Update
RCPA is pleased to report several successful collaborative efforts this week, including a meeting with DHS, OMHSAS, and a delegation of House and Senate Representatives. We reviewed proposed language for a new bill that would address the 4 walls standard for ongoing telehealth with practitioners not within the 4 walls of a clinic. The bill will also include language previously introduced on the Psychiatric Outpatient Regulatory requirements for the 50% in-office time for clinics and the use of advanced practice professionals to meet those time requirements.
The language for both target areas was approved by all parties and will now move on to the House Human Services Committee. RCPA has a meeting scheduled for early next week to review the finalized version prior to its introduction. We have also met with Senate counterparts to support the measure.
Lastly, RCPA continues its dialogue with OMHSAS for guidance and clarification, including sharing members’ and stakeholders’ feedback. We have had the opportunity to speak with our BH-MCO members and understand OMHSAS Deputy Secretary Jen Smith will be meeting with that group and the county contractors on the processes moving forward.
We are hopeful for an expedited legislative solution that will aid OMHSAS in making any resulting policy, practice, or program changes that will support the initiative. We are extremely encouraged by the system’s efforts and focus this week and will continue to provide key updates to members and stakeholders.
If you have any questions, please contact RCP Policy Director Jim Sharp.
Registration Open for 2024 PCCD CJAB Conference; RCPA SUD Policy Director Jason Snyder to Speak at Plenary Session on April 9
The Pennsylvania Commission on Crime and Delinquency (PCCD) announces the opening of registration for the 2024 Criminal Justice Advisory Board (CJAB) Conference, themed “An Evolving Justice System: Adapting and Navigating New Directions.” The conference is scheduled for April 9 – 10, 2024, at the Penn Stater Hotel and Conference Center in State College. The event will convene criminal justice, behavioral health, and treatment partners for a dynamic one and a half-day gathering. Featuring a lineup of national and local experts, discussions will center on emerging issues impacting criminal justice and behavioral health systems, offering innovative strategies and collaborative solutions.
Registration and conference details are available on the 2024 CJAB Conference page on PCCD’s website. Additionally, notable sessions include a plenary by Jason Snyder, RCPA SUD Policy Director, on April 9, and a workshop on SUD confidentiality facilitated by RCPA, which will include representatives from the SUD treatment and criminal justice systems on April 10. Attendees should be aware that the discounted room rate deadline is Friday, March 8, 2024.
PA 1115 Demonstration Post-Award Forum to Provide Updates on FFCY and SUD Services on March 8
The Pennsylvania Department of Human Services (DHS) is hosting a post-award forum regarding the federal Section 1115 Demonstration, which includes Medicaid coverage for out-of-state former foster care youth and substance use disorder (SUD) services. It will take place at 1:00 pm – 2:30 pm on Friday, March 8, 2024, via WebEx. The forum aims to gather public feedback on the progress of these initiatives, both of which were approved by the Centers for Medicare & Medicaid Services (CMS). The Former Foster Care Youth (FFCY) component allows Medicaid coverage for individuals under 26 who were in foster care in another state upon turning 18. The SUD component provides funding for essential SUD services, including residential care.
Register for the forum here. Written comments are also acceptable until the same date. For inquiries, contact Shivani Patel. Further details and the announcement can be found here. Please contact RCPA Policy Director Jim Sharp for any further questions.
Shapiro Proposes Mental Health Services Funding for 2024/25 Budget
During this week’s budget presentation by Governor Shapiro, funding for mental health services was addressed as a priority for vulnerable Pennsylvanians. RCPA is working to review the preliminary funding recommendations listed below, and we hope to have greater line-item insight from DHS Secretary Arkoosh’s address this Friday.
Please note that registration is now open for the DHS 2024/25 Budget Briefing. You can register to view the briefing here. Additionally, the DHS House and Senate Budget Hearings will be March 5 and 6, 2024, respectively, and RCPA has been asked to provide questions for the testimony. The DHS budget book is available here.
Lastly, as part of our RCPA Mental Health Steering Committees and Work Groups, we will review recommendations as we develop our strategic budget advocacy campaign over the next several months in our meetings with stakeholders and legislators.
We offer the following as the initial review of yesterday’s budget presentation:
2024/25 Budget: Mental Health Program Recommendations:
This budget recommends the following changes: (Dollar Amounts in Thousands) for Mental Health Services
- $20,000 — To replace nonrecurring prior-year carryover funding.
- $5,750 — Initiative to expand diversion and discharge for individuals with mental illness currently in the criminal justice system.
- $18,259 — To continue current programs.
- $20,000 — To restore one-third of base funding to counties.
- $3,443 — To replace federal funding received in 2023/24.
- $5,000 — Initiative to maintain walk-in mental health crisis for COVID-19 response stabilization centers serving multiple counties.
- $1,250 — To annualize prior-year expansion of home and community-based services.
- $1,600 — Initiative to provide home and community-based services for 20 individuals currently residing in state hospitals.
- $305 — To annualize prior-year expansion of diversion state hospitals and discharge programs.
- $10,000 — Initiative to provide support to the 988 network for mental health services.
- $85,607 — To increase appropriations.
School-Based Mental Health
This year, the Shapiro Administration looks once more to address the needs of student mental health with a $100 million investment. This new set of funds comes on the heels of $90 million recently allocated to schools, with monies originally set aside for adult mental health services targeted through the now defunct 2022 Behavioral Health Commission.
The funding mechanism for the distribution of these funds has yet to be determined if it is approved by the General Assembly. The last two rounds of school-based mental health funding have been allocated to individual districts through noncompetitive grants. The concerns have been that the funds, if not earmarked for the development of service delivery pathways, will go to building staff infrastructure in the form of social workers. While there are advantages to having these professionals in the buildings, they alone cannot address the student needs for assessment and treatment services
RCPA supports the funding being designated through the schools but will work with legislators to encourage developing a coordinated system of care coupled with a longer-term financial strategy with the schools, community-based providers, Student Assistant Programs (SAP), and county involvement in SAP coordination.
Early Intervention Services
As part of our initial budget discussions with OCDEL, we were concerned that there would not be an interim rate increase for 2024/25 as we work through the new Early Intervention rate methodology. We see in the budget that there is an increase of $16 million, nearly 9% over last year’s number. It is also projected that more children and families will be served in this coming year, and we will work with the administration to, at a minimum, continue to fund the ARPA-supported 3% increase from over the last three years.
County Child Welfare
It is projected that the County Child Welfare budget will essentially be flat, with less than a 1% increase. As the child welfare systems await the DHS Blueprint recommendations on addressing the extensive number of services for youth with complex care, especially those in congregate care, it was surprising there was not a designated funding allocation to support this initiative. This remains a priority to fund these programs.
County-Based Mental Health Funding
It was disappointing that the Shapiro Administration failed to deliver on last year’s “down payment” of the 2022/23 allocation of $20 million towards the county base. Up until last year, the county-based mental health system has gone more than a decade without a base rate increase. Last year’s $20 million represented only a 3% increase over the 2022/23 base funding. This year’s $20 million will equate to less.
We will continue, as part of our advocacy strategy, to support an allocation that is projected to be in the neighborhood of $1.2 billion to create a sustainable platform for county-based mental health service delivery.
OMHSAS Announces Updated Eligibility for Certified Peer Specialist Role
The Office of Mental Health and Substance Abuse Services (OMHSAS) successfully collaborated with the Centers for Medicare & Medicaid Services (CMS) to revise Pennsylvania’s State Medicaid Plan for Certified Peer Specialists (CPS). The changes aim to enhance workforce opportunities, break down barriers, and establish a robust crisis system. The updated qualifications for aspiring CPS include:
- Elimination of the self-identification requirement for Serious Mental Illness, replaced with an attestation of a mental health diagnosis and a stage of recovery to support others;
- Removal of the high school diploma requirement and instead, as part of the Pennsylvania Certification Board (PCB) application, applicants will be providing narratives on how they achieved recovery and wellness; and
- The mandatory recent employment or volunteer experience within the last three (3) years has been removed.
Details on these changes can be found in the updated State Plan here (scroll down to 0013 Attachment 3.1A-3.1B, page 88). OMHSAS will issue a forthcoming bulletin, and inquiries can be sent electronically.
If you have further questions, please contact RCPA Policy Director Jim Sharp.
Important Telehealth Update
RCPA is pleased to report that there has been significant progress as stakeholders work together in developing solutions for expanded telehealth flexibility. RCPA has met with members of the General Assembly, OMHSAS, the Governor’s office, the National Council on Mental Wellbeing; as well as other member associations and providers; all committed to a collaborative effort to address the continuation of the telehealth service deliverables as outlined in our PA tele-behavioral health bulletin.
Next week, the principals will meet to review the legislative pathways and bill specifics in addressing the current 4 walls requirements. It has been determined the vehicle to this will be to amend our current draft legislation that initially was created to address the psychiatrist in office time requirement.
We have spoken at length with our partners at the National Council for Mental Wellbeing, and they have provided an insightful overview of this from a federal lens; including the fact that Pennsylvania is only one of more than 15 states working with CMS and their legislature to meet the systems needs of their Medicaid population. The National Council also reported that the legislative process is the pathway most supported at the federal level to address the matter.
We are hopeful for an expedited legislative solution that will support OMHSAS in making any resulting policy, practice, or programmatic changes that will support the initiative. We are extremely encouraged by the system’s efforts and focus this week, and the developing short-term plan. RCPA continues, as recommended earlier in the week, for providers to be patient, review your contingency plans, and focus your primary efforts on servicing those entrusted to your care.
RCPA will continue to partner with all members and stakeholders and provide updates as we proceed.
If you have questions, please contact RCPA Policy Director Jim Sharp. The next RCPA Telehealth Operations Committee meeting will be rescheduled for earlier in February and we will be sending that information out early next week. Please share this information with your stakeholder networks.
Free Virtual Family Peer Support Specialist Training
The Free Virtual Family Peer Support Specialist Training, scheduled for February 20, 21, 22, 27, and 28, 2024, is designed for primary caregivers seeking to become Family Peer Support Specialists (FPSS). This comprehensive, five-day training, via Zoom, utilizes the Family-Run Executive Director Leadership Association (FREDLA) Parent Peer Support Provider Practice Model, covering core competencies and skills practice across six phases of family peer support.
To qualify, participants must be parents or primary caregivers of a child, youth, or young adult with past or present involvement in the Mental Health/Behavioral Health System. The deadline to register is February 6, 2024. A completion certificate is offered upon training conclusion. For those interested, contact Wanda Cummings, Family Peer Support Specialist Training Program Coordinator.
If you have any questions, please contact RCPA Policy Director Jim Sharp.
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