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Authors Posts by Jim Sharp

Jim Sharp

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In recent years, the Office of Mental Health and Substance Abuse Services (OMHSAS) had received concerns regarding the Bureau of Children’s Behavioral Health Services (Children’s Bureau). Four major themes emerged from this feedback relating to communication, regulations and policy, operational consistency, and system partner engagement. Last spring, OMHSAS engaged Mercer Consulting to conduct a study of the Children’s Bureau that included three two-hour focus groups with OMHSAS system partners, including representatives from RCPA. The primary goal of the review was to identify ways in which OMHSAS can improve internal operations as well as communication and collaboration.

On Tuesday, Deputy Secretary Dennis Marion shared both an executive summary of the Mercer Independent Study as well as his description of the steps forward that OMHSAS has initiated in response to the concerns and findings. The action items outlined by Deputy Secretary Marion are:

  • Review and consolidation of regulations related to Behavioral Health Rehabilitation Services (BHRS). OMHSAS will engage with stakeholders to draft regulatory changes with the expectation that proposed BHRS regulations will be released for public comment in mid-2017.
  • Strategic reorganization of OMHSAS leadership. On March 7, Shannon Fagan joined OMHSAS as Children’s Bureau director, and Sherry Peters became director of the Bureau of Policy, Planning, and Program Development.
  • Organization-wide effort to improve consistency and quality. Moving forward, OMHSAS senior staff will focus on identifying areas of potential improvement, developing strategies to strengthen internal and external processes, promoting an organizational culture of collaboration, coordination, communication, and cohesiveness, and monitoring progress towards addressing the concerns voiced by OMHSAS stakeholders.
  • Emphasis on family and stakeholder engagement. The involvement of PACA, RCPA, BH-MCOs, and their contractors, played an integral role in working to identify issues of concern.
  • A redefining of “customer service.” To address concerns relating to responsiveness and professionalism, internal meetings have been held to stress the importance of holding OMHSAS staff to high standards of customer service.
  • Renewed focus on communications. In response to concerns regarding effectiveness of internal and external communications, Shanna Klucar was appointed as executive assistant to the deputy secretary on January 30.

OMHSAS invites RCPA members and other stakeholders to share comments and concerns regarding Children’s Behavioral Health Services to Shannon Fagan, bureau director, as well as the RCPA Children’s Division. In addition, members may contact OMHSAS leadership Sherry Peters and Shanna Klucar with more general comments and concerns.

The Department of Human Services (DHS) Medical Assistance Online Provider Enrollment Application information is now electronic, online, and available to provider organizations. The improvements and modernization of the PROMISe system have been strongly encouraged by RCPA and a significant goal of DHS. Some of the benefits of online enrollment application submissions are:

  • Allowing documents that previously had to be mailed or faxed to be uploaded directly to the portal;
  • Permitting providers see the status of their submissions; and
  • Decreasing wait time to review applications.

The information you will need to submit an application for enrollment:

  • Access the online enrollment application
  • Review the training guide
  • Review the frequently asked questions document for important clarifications
  • A “Help” feature is available at any time during the completion of an application
  • Supplemental Services require the Behavioral Health Managed Care Organization to attest that a provider is credentialed

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The Juvenile Court Judges’ Commission (JCJC) and the Awards Committee of the PA Council of Chief Juvenile Probation Officers are pleased to announce that nominations are now being accepted for the 2016 JCJC Awards Program. This year program categories for which your program may be eligible include:

  • Residential Program of the Year
  • Community Based Program of the Year
  • Meritorious Service Award

As in previous years, all nominations must be submitted by county juvenile probation departments. If you would like to have your program or volunteer nominated, please contact a chief juvenile probation officer to discuss the possibility of submitting a nomination. Formal nomination materials must be postmarked by Monday, May 2, 2016.

The JCJC will once again sponsor a Youth Awards Program as part of this year’s Annual Training and Awards Program, to honor the youth selected as winners. The Youth Awards Committee is accepting nominations for the Outstanding Achievement Contest and the Creative Expression Contest. The Creative Expression Contest category will include either a written, poster, or video entry in two age categories; 15 & under and 16 & over. Entry forms for this category will be available soon on the JCJC website. Please contact Keith A. Graybill at (717) 705-9006 or by email if you have any questions or need assistance.

This week the Pennsylvania Department of Human Services (DHS) announced several new initiatives to reduce the use of psychotropic medication among our state’s most vulnerable children. Speaking at The Children’s Hospital of Philadelphia, DHS Secretary Ted Dallas reported on the partnership of DHS with the Pennsylvania Chapter of the American Academy of Pediatrics and the Pennsylvania Psychiatric Society. A state-commissioned PolicyLab study that found that in 2012 in Pennsylvania, the use of psychotropic medications was nearly three times higher among 6-18 year olds in foster care than among youth in Medicaid overall. Based on this study and the collaborative effort mentioned above, Pennsylvania has initiated the following:

  • Best practice guidelines are being developed for clinicians regarding comprehensive assessments of behavior and treatment interventions;
  • Managed care organizations will be required to give prior authorization for antipsychotic medications for children;
  • A new electronic dashboard will make it easier for DHS to monitor what medications children are taking and improve care coordination;
  • In April, DHS will open a telephonic child psychiatric consultative service to help prescribing physicians, physician assistants, and nurse practitioners appropriately prescribe psychotropic medication for children; and
  • In July, the department will begin training child welfare caseworkers and caregivers on the appropriate use of psychotropic medication.

“The inappropriate use of these powerful medications for children in the foster care system compounds the trauma experienced by children who have been the victim of abuse and neglect and is simply unacceptable,” Dallas said, “The recommendations and analysis from PolicyLab provide Pennsylvania with an invaluable roadmap to improve the safety and quality of life for foster children served by the Medicaid system.”

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The presentation materials, handouts, and recordings of the February 3 joint meeting of the RCPA Children’s and Mental Health Committees, as well as the Children’s Committee meeting, are now available. Materials include documents relating to the panel presentation on the needs and opportunities in early childhood services, and other documents referenced in the committee meeting discussions.

Last Friday, at the state’s Act 62 External Work Group meeting, the Office of Mental Health and Substance Abuse Services (OMHSAS) released and reviewed the data collected by HealthChoices contractors during the April 2015 survey of autism spectrum disorder (ASD) service capacity. This point-in-time survey reflects what was at that time the level of ASD service capacity for the delivery of behavior specialist consultant and applied behavior analysis services.

Among the highlights in this data are service access trends as of April 2015, showing:

  • A 19% level of service access delays of more than 31 days, with delays ranging by managed care organizations from 14% to 30% for children that had been accepted, evaluated, and authorized for services.
  • The level and reasons given for staff recruitment challenges, showing a significant level of hiring challenges among providers, with the predominant reasons being the licensure requirements of
    • At least one year of experience involving functional behavior assessments of individuals under 21 years of age; and
    • At least 1,000 hours of in-person clinical experience with individuals with behavioral challenges or experience in a related field with individuals with an ASD.

During review and discussion of the data, OMHSAS Deputy Secretary Marion indicated that OMHSAS will begin to meet with the managed care organizations, to more closely analyze the data, and discuss approaches and solutions to the service access and professional labor pool challenges in provider networks.

In an effort to promote “Government that Works,” the Office of Child Development and Early Learning (OCDEL) has made it a priority to integrate early childhood education services, so that providers can offer multiple OCDEL services to families without duplicating paperwork, and families can more easily access the services they need. To lead and promote this approach to improving and streamlining bureaucratic and operational challenges faced by providers and families, OCDEL has produced a short video overview with Deputy Secretary Michelle Figlar.

Providers are also being asked to share their experiences with OCDEL programs to help shape this work. It is critical for the RCPA Children’s Steering Committee and work groups to hear how OCDEL programs work for providers and families. Input from providers of early childhood care will significantly inform and influence this work. For RCPA members, it will be vital that providers of early childhood mental health, behavioral consultation, autism, and pediatric rehabilitation services, that need to be delivered in a coordinated and collaborative manner, help to inform this process. RCPA members who serve young children are encouraged to complete a short survey by Monday, February 8. The survey includes five pages of questions and should take an average of five minutes to complete. For more information, visit the PA Keys website.

OCDEL has made stakeholder engagement one of its priorities to assure high quality services for children and families. For a listing of all open stakeholder engagement opportunities, please visit the PA Keys website.

The Physical Health Managed Care Organizations (PH-MCOs) serving Pennsylvania’s HealthChoices Medicaid program are now inviting psychiatric service providers to submit a response for the Telephonic Psychiatric Service (TiPS) Request for Proposals (RFP). The PH-MCOs will contract for TiPS that will provide real time telephonic consultative services to primary care providers (PCPs), and other prescribers of psychotropic medications, for children under the age of 21. A TiPS provider is responsible for establishing and maintaining a team of behavioral health professionals who will be available to respond to inquiries from PCPs seeking assistance in providing pediatric behavioral health care. Qualified applicants must have a TiPS staff which includes one full-time equivalent child psychiatrist, one full-time equivalent behavioral health therapist, and one full-time equivalent care coordinator. Now available are the RFP, and supplemental information, including pediatric membership by plan/zone, and a 2014 Health Affairs article on a similar program in Massachusetts. A vendor fair for interested respondents is being held on Tuesday, January 26 in Mechanicsburg. See the RFP for additional details. All questions should be directed to MCO Coalition Consultant, Emily Katz.