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Authors Posts by Jim Sharp

Jim Sharp

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Photo by Markus Winkler on Unsplash

In response to the recent developments on the delivery of telehealth services and its intersection with Federal Medicaid payment standards outlined in the “4 walls” requirements, RCPA has widened its efforts in addressing the barriers currently in place. It has been determined that the most effective route to address this would be through legislation. The necessary changes cannot be achieved through a revised Tele-Behavioral Health Bulletin.

RCPA has been working with a bipartisan team of legislators on an updated version of Act 76 to address our limited access to psychiatric services through utilization of our advanced practice professionals. We are working with the Office of Mental Health and Substance Abuse Services (OMHSAS), our stakeholders, and the legislative committees to introduce a bill that would address both the psychiatric office time and the “4 walls” service delivery barriers.

Our members’ feedback over the last few days and during the OMHSAS telehealth forum on Monday has provided an invaluable backdrop to our efforts. RCPA is focused on working with our legislators and stakeholders to introduce this bill, and we will look to our members for support with these efforts. Additionally, we continue our daily efforts with our partners at OMHSAS, who are jointly committed to creating this viable and sustainable effort to preserve Medicaid service access to those most vulnerable in our Commonwealth.

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

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The Centers for Medicare & Medicaid Services (CMS) has announced $50 million in grants to enhance school-based health services for children, particularly focusing on mental health. The grants, made possible by the Bipartisan Safer Communities Act (BSCA), will provide up to $2.5 million each to 20 states through Medicaid and the Children’s Health Insurance Program (CHIP). CMS aims to connect millions of children to critical healthcare services, emphasizing the convenience of school-based care and its impact on children’s health and educational outcomes. The grants, supporting preventive, behavioral, and physical healthcare, hope to encourage more states to cover school-based health services and enhance existing programs. The application deadline for the grants is March 25, 2024. For further details, visit the grant’s information web page. The full press release is available on the CMS website.

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The Centers for Medicare & Medicaid Services (CMS) has released a set of frequently asked questions (FAQ) supplementing the 2021 State Health Official (SHO) letter about extending postpartum coverage in Medicaid and the Children’s Health Insurance Program (CHIP). The FAQ offer guidance to state Medicaid programs on the new option allowing states to provide 12 months of extended postpartum coverage to pregnant individuals in Medicaid and CHIP. They clarify what constitutes full benefits during this extended eligibility period and address whether states need to submit a state plan amendment (SPA) for coverage modifications. For more details, view the FAQ here.

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Governor Shapiro and Pennsylvania’s Department of Drug and Alcohol Programs have announced an $18 million funding initiative to assist practitioners in the substance use disorder (SUD) treatment, prevention, case management, and recovery support services workforce. The SUD student loan repayment program aims to address workforce shortages by providing loan repayment opportunities to retain professionals in the field. This initiative, funded by the Opioid Settlement Fund and Pennsylvania’s Medical Marijuana Program Fund, supports practitioners, including physicians, nurses, counselors, and case managers. Applications must be submitted by March 1, 2024, through the online portal. Practitioners are eligible for up to $75,000 for full-time practice or $37,500 for half-time practice. The program prioritizes those in rural areas with SUD workforce shortages and counties with underserved minority populations. For more information and application details, visit the DDAP Funding Opportunities page. Questions can be sent electronically.

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The U.S. Department of Health and Human Services (HHS) is offering online trainings to enhance cultural competency for mental health and substance use disorder (SUD) professionals, particularly in serving historically marginalized populations. These trainings, available through the Improving Cultural Competency for Behavioral Health Professionals program, aim to increase awareness of cultural and language competency, biases, and clients’ cultural identities and needs. The four courses, with an estimated completion time of 4–5.5 hours, cover topics such as self-awareness, understanding clients’ cultural identities, and providing culturally and linguistically appropriate interventions and services. The training is free but requires registration.

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The Office of Children, Youth, and Families (OCYF) is continuing to offer free Trauma Intensive Courses to support individuals and teams in their professional development. These courses provide essential training in trauma awareness and healing. Options include Train-the-Trainer Sessions and sessions on processing pain as well as facilitating healing. Participants can deepen their understanding and skills in trauma-informed care, with limited seats available. To register for these courses, visit the course registration page. Additionally, various trauma-related workshops are open for registration, covering different aspects of trauma. For more information, visit the Lakeside Global Institute — Trauma Workshops 2024 page.

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RCPA attended the Office of Mental Health and Substance Abuse Services (OMHSAS) telehealth webinar on Monday, January 29, alongside many provider members, regarding the Federal payment conditions related to the delivery of telehealth services and the requirement that the physicians or clinicians must present in the office, or that the client must be in the office during the telehealth session, to meet the guideline. It was explained that despite the standards outlined in the current OMHSAS Telebehavioral Health Bulletin, under the Federal “4 walls” statute, this is a required Federal Medicaid payment condition. These requirements cannot be waived.

The purpose of today’s call was twofold: explaining the “4 walls” requirements, and for providers to give vital feedback to OMHSAS on the impacts, challenges, and barriers to accessing services that this may create for consumers and families. This Medicaid standard remains in effect, and RCPA recommends provider members review their operating practices to ensure compliance.

During this time, RCPA will continue its efforts and work with OMHSAS, the HealthChoices partners, and stakeholders to ensure access to services via telehealth. You can review today’s OMHSAS telehealth webinar slide deck. We are also looking to obtain a recording of the webinar to share with our members.

If you have questions, please contact RCPA Policy Director Jim Sharp. The next RCPA Telehealth Operations Committee meeting is scheduled for Tuesday, February 27; however, we will be reviewing if we need to meet sooner based on current information.

Please share this information with your stakeholder networks.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) is holding a series of virtual conversations on Monday, January 29, to discuss opportunities in modernizing tele-behavioral health services within the Commonwealth. These meetings will be held using Microsoft Teams, and time will be allotted for discussion. To facilitate discussions most efficiently, OMHSAS will hold three meetings based on stakeholder type: BH-MCO/Primary Contractor/County Mental Health Administrators, licensed service providers, and individuals who access services and their families. Please choose the most appropriate webinar for you. The licensed service providers forum will be at 11:00 am. Attendance will be taken so that feedback can be cataloged accordingly.

These conversations will drive OMHSAS closer to finding solutions to the complicated work of increasing access to behavioral health services that are utilizing tele-behavioral health platforms and ensuring service recipients have a choice. This first conversation will focus on psychiatric outpatient clinic services and telehealth.

Join on your computer, mobile app or room device
Visit here to join the meeting
Meeting ID: 290 432 891 13
Passcode: 6nz9cp
Download Teams | Join on the web
Or call in (audio only)
+1 267-332-8737,,985858579#   United States, Philadelphia
Phone Conference ID: 985 858 579#

OMHSAS looks forward to you joining this critical conversation. If you have questions, please contact RCPA Policy Director Jim Sharp.

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