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Authors Posts by Jim Sharp

Jim Sharp

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0 1798

The Pennsylvania Independent Regulatory Review Commission (IRRC) has completed their review of existing Intensive Behavioral Health Services (IBHS) regulations codified at 55PA. Code chapters 1155 and 5240, as requested by the RCPA IBHS Steering Committee.

The RCPA IBHS Regulatory Reform Recommendations, submitted on November 29, 2022, requested the commission to review the IBHS regulations under section 8.1 of the Regulatory Review Act, which provides that the commission may review any existing regulation which has been an effect for at least three years.

The commission has noted the burden placed on providers by the Department of Human Services regulation, but while they appreciated our concerns, the commission’s role is to determine whether existing regulations, as a whole, remain in the public interest. In the commission review letter, they determined that further action by the commission is not warranted in this matter.

We have been in contact with OMHSAS throughout this two-year period, and the commission provided the department with guidance as part of the review process. Despite the ruling from the IRRC, OMHSAS has agreed that they will reopen the IBHS for review as announced by OMHSAS Deputy Secretary Jennifer Smith at the RCPA Conference last week. RCPA will be reviewing the recommendations to calibrate those areas that continue to create barriers to access that have arisen since the recommendations created in the Fall of 2022.

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

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The process to route cell phone calls to the 988 Suicide & Crisis Lifeline based on the caller’s approximate location, versus by area code, has started; FCC to vote next month on a final rule that would require all U.S. wireless carriers to implement geo-routing with specific timelines

The 988 Suicide & Crisis Lifeline announced that the process to start routing cellular phone calls to 988 contact centers based on the caller’s approximate location, versus by area code — known as “geo-routing” — began last week with two major U.S. wireless carriers that combined make up about half of all wireless calls to 988. The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) and the 988 Network Administrator, Vibrant Emotional Health, have been working with all of the major U.S. cell phone carriers for more than a year to improve call routing to 988 so that callers on a cell phone can be connected more locally to centers that are better equipped to provide nearby resources and services.

These new rules, if adopted by a vote from the full commission next month, would require all U.S. wireless carriers to implement geo-routing. In addition, the rules will also establish an implementation timeline for geo-routing calls to the 988 Lifeline of 30 days following the effective date of the rule for nationwide wireless providers and 24 months after the effective date of the rule for smaller, non-nationwide providers.

More than 200 contact centers across the country provide support through the 988 Lifeline network. Geo-routing connects cell phone callers to the closest 988 contact center to the caller’s physical location. Geo-routing differs from geolocation in that it does not provide a precise location of the caller, allowing callers to maintain their location privacy. Studies have shown that after speaking with a trained crisis counselor, most callers feel more hopeful and less depressed, suicidal, and overwhelmed.

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

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The Collaborative Family Healthcare Association (CFHA) and the Value-Based Care Work Group have created a value-based survey that is being distributed across the US to seek insights into the current state of value-based care, identify existing gaps, and explore opportunities for better alignment between payment models and clinical practice.

The target audience includes health systems, quality and administration professionals, primary and specialist care providers, and funding sources such as payers, policymakers, foundations, and grants.

The results of the 5-minute survey, which you can view here, will be shared with members as accompanying review is completed. If you have any questions, please contact RCPA COO and MH Policy Director Jim Sharp.

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The Pennsylvania Department of Human Services (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) will be holding quarterly public meetings for anyone interested in discussing the topic of peer support services (PSS) working in the mental health realm. These meetings will provide a regularly scheduled opportunity for OMHSAS representatives to give PSS updates and information as well as answer questions and obtain essential insight and feedback from stakeholders.

The first quarterly meeting will be held on October 8, 2024, at 9:00 am – 10:00 am. The TEAMS meeting link is available here. Going forward, these meetings will be held on the second Tuesday in the months of January, April, July, and October 2025. Attendees will receive general updates and discussion topics OMHSAS will send ahead of time. Meeting links will also be provided in advance of each meeting.

Recommendations for agenda topics or questions can be submitted via email and must be submitted at least two weeks prior to the meeting date. The email account will be monitored, and the sender will receive a reply if more information is needed. Responses will not be provided if additional information is not needed.

If you or your colleagues would like to be added to an OMHSAS Listserv to receive the quarterly invitations, please go to the Listserv DHS website, then select the “join or leave the list” link.

Meeting Dates:

  • Tuesday, October 8, 2024, 9:00 am
    • Topic: Introductions, Welcome, & OMHSAS Updates
  • Tuesday, January 14, 2025, 9:00 am
    • Agenda Topics Due December 30, 2024
  • Tuesday, April 8, 2025, 9:00 am
    • Agenda Topics Due March 25, 2025
  • Tuesday, July 8, 2025, 9:00 am
    • Agenda Topics Due June 24, 2025
  • Tuesday, October 14, 2025, 9:00 am
    • Agenda Topics Due September 30, 2025

OMHSAS is open to ideas and suggestions on maximizing the effectiveness of these meetings.

These quarterly meetings are not a replacement for the Mental Health Planning Council quarterly meetings. Those meetings will continue in addition to these newly established meetings.

OMHSAS appreciates your review and hope you will join them for these PSS discussions. Questions pertaining to these meetings should be submitted via email.

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Legislation for Telehealth Flexibilities Introduced:
HB 2560 To Address Psychiatry Time Requirements and “4 Walls”

RCPA is pleased to announce that yesterday, September 10, State Representative Tina Pickett (R-District 10) introduced House Bill 2560, which was referred to the House Health and Human Services Committee. The legislation is focused on addressing two critical telehealth considerations, including an update of the outpatient psychiatric outpatient time requirements and the Federal Medicaid payment standard known as the “4 Walls.” The latter would abrogate DHS 55 Pa. Code § 1153.52 Payment Conditions for Various Services and 55 Pa. Code § 5200.52 Treatment Planning. By addressing the “4 Walls” requirement, telehealth services by a practitioner can be delivered outside the physical outpatient clinics and will be categorized under licensed mobile mental health services.

On a parallel track, the Center for Medicare and Medicaid Services (CMS) has proposed a final rule exception that would eliminate the “4 Walls” requirements among several other actions. On September 9, 2024, RCPA submitted comments regarding the Medicaid Clinic Services 4 Walls Exceptions on behalf of our membership in support of the proposed exception to eliminate this Medicaid standard.

Additionally, the bill requires that providers who want to deliver telehealth services 100% must maintain a written agreement with a geographically proximate outpatient psychiatric clinic that operates a physical facility and provides in-person services at the outpatient psychiatric clinic within 40 miles or 60 minutes travel from the residence of the individual receiving services AND that the written agreement must include a provision that a referred individual must be seen by the geographically proximate outpatient psychiatric clinic within 10 days of the referral.

Finally, the bill addresses the required 50% psychiatric in-clinic time requirements of 55 Pa. Code Chapter 5200 for Psychiatric Outpatient Clinics. The proposed legislation outlines that required psychiatric time may be provided in person or by the use of telebehavioral health technology by psychiatrists, as specified by department regulations. Advanced practice professionals may also provide a portion of the psychiatric time, as specified by department regulations, either in person or by the use of telebehavioral health. Onsite supervision requirements can be performed by either a psychiatrist or an advanced practice professional. Lastly, the legislation permits DHS to issue waivers to fully remote providers so they can serve patients covered by private insurance.

The introduction of the bill represents a unified effort with OMHSAS, our partners in the Pennsylvania General Assembly, and stakeholders across the Commonwealth to enhance our system’s capacity to deliver services to those most in need. We ask that you join us in working with your legislators to pass this critical legislation.

RCPA will continue to update members as the legislation advances. If you have any questions, please contact RCPA COO and Mental Health Director Jim Sharp.

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An excerpt from Pennsylvania’s Suicide Prevention Month Guide Start the Conversation:

September is Suicide Prevention Month, with the week of September 8–14 identified as National Suicide Prevention Week. September 10 is recognized as World Suicide Prevention Day in countries around the world. This year marks the beginning of a new three-year theme focused on changing the narrative on suicide, which involves moving beyond awareness to starting conversations and taking action. Across sectors and settings, changing the narrative requires both culture and systemic change to provide meaningful education, advocate for resources, and prioritize suicide prevention in an ongoing way.

Read the Start the Conversation guide to learn how to speak with others about suicide prevention as well as gain access to toolkits and resources.

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The Rehabilitation and Community Providers Association (RCPA), in conjunction with our provider members and partner stakeholders, have written to PA Senator Casey and PA Senator Fetterman to express our full support for ensuring the mandated inflationary increases are preserved for the Pennsylvania Office of Vocational Rehabilitation (OVR) so that critical OVR employment programs will continue for working and job-seeking Pennsylvanians with disabilities. Vocational rehabilitation funding is essential in Pennsylvania to maintain services that support the advancement of employment. We are fortunate that our state legislature has consistently funded Pennsylvania OVR in a manner that has allowed OVR to collect the full federal match and even draw down more when there is a surplus.

If the mandated inflationary increases are rescinded, Pennsylvania’s OVR funding will be cut by millions of dollars, adversely impacting working and job-seeking Pennsylvanians with disabilities. Specifically, approximately $13M would be eliminated from a limited $200M budget, or 6.5%. The resources provided to PA OVR are too valuable and already limited. This potential action forces Pennsylvania to prioritize allocations at the expense of critical employment and related services. Maintaining funding levels is crucial for advancing employment for individuals with disabilities.

Should you have any questions, please feel free to contact Intellectual/Developmental Disabilities Division Director Carol Ferenz or IDD Policy Analyst Cathy Barrick.

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Message from the Juvenile Court Judges’ Commission (JCJC):

The Juvenile Court Judges’ Commission (JCJC) is pleased to announce the 2024 James E. Anderson Pennsylvania Conference on Juvenile Justice will be held at the Hilton Harrisburg on Wednesday, November 6 – Friday, November 8, 2024. Resource Day will be held on Friday, November 8, from 8:00 am – 11:00 am.

JCJC is inviting you to join them as an exhibitor at Resource Day, where your organization can interact with a wide variety of conference attendees, including, but not limited to, juvenile court judges, juvenile court hearing officers, juvenile probation staff, attorneys, providers, and other system stakeholders.

Students and faculty from colleges and universities across the Commonwealth will be invited to attend on Resource Day to learn about the important work being done in Pennsylvania’s juvenile justice system. Please consider utilizing this time to network with possible future system professionals.

JCJ is also excited to announce a new addition to this year’s conference, as providers will be able to showcase their programs throughout the day on Thursday, November 7, though the use of banners, displays, or other promotional techniques. These unstaffed displays will be freestanding (nothing attached to walls) throughout the common areas of the hotel. Examples could include freestanding flags, banners, or signage/posters of programs. Specific details will be provided upon registration for the event.

If you are interested in being an exhibitor during Resource Day, please contact Michael Yoder, Juvenile Court Judges’ Commission, via email or at (717) 874-1149. Please note that there are no fees to participate in Resource Day.

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The OMHSAS Bureau of Children’s Behavioral Health Services presented the Psychiatric Residential Treatment Facility (PRTF) regulation informational webinar for systems stakeholders.

This webinar highlighted significant sections of the proposed PRTF regulations prior to the public comment period. The proposed PRTF regulation will codify the minimum licensing standards, Medical Assistance (MA) participation requirements, and payment conditions for PRTFs that provide medically necessary behavioral health treatment to children, youth, or young adults under 21 years of age with a behavioral health diagnosis.

RCPA Children’s Residential Services Committee met after the webinar to review these highlights and to begin preparing recommendations. Our committee will continue to meet over the next 60 days in anticipation of the regulations release to develop our public comments, recommendations, and testimony.

If you have any questions or would like to join our committee, please contact RCPA COO and Mental Health Policy Director Jim Sharp. View the webinar recording here.

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