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Earlier this week, the Senate Parliamentarian advised lawmakers that several provisions in the budget reconciliation bill will not be able to pass with a simple majority vote. This includes the Senate’s proposed reductions to state provider taxes that were expected to result in billions of cost savings to the federal government. Senate Republicans now have several options to consider before moving forward, including removing key Medicaid provisions in the bill or re-drafting and re-submitting them to try to earn Parliamentarian approval. Other policies that were ruled unallowable under the Byrd Rule included the exclusion of specific groups of immigrants from Medicaid and withholding federal funds from states that use their own funds to provide coverage.

Senators are expected to vote in the coming days. While Pennsylvania Federal legislators are hearing the message from RCPA and other state associations, they are hearing very little from the constituencies in their home districts.

To assist with outreach and to help tailor the letter provided above, National Council and RCPA have provided additional resources below:

  • Find your US legislators here.
  • Call or write to your legislators here.

Your outreach TODAY is critical. If hundreds of billions of dollars are cut:

  • Millions of people are expected to lose access to lifesaving care and services;
  • Community behavioral health providers, operating on the thinnest of margins already, will face additional financial hardship; and
  • The cuts are unlikely to save any money overall because costs will simply shift to states, who will be forced to try and make up the funding difference.

Specific proposals under consideration, like mandatory work requirements and provider tax policy changes, are expected to create huge administrative burdens that are likely to result in eligible people losing their coverage, plus massive funding losses for states that could result in reduced availability of mental health and SUD services.

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Photo by The Climate Reality Project on Unsplash

The 2025 IM4Q Annual Statewide Training (AST) will be held on July 29 – 30 at the Harrisburg Hilton. While it is understood that travel costs may be prohibitive at this time, please remember the IM4Q Manual lists attendance at the AST as a responsibility for all IM4Q local program coordinators and AE leads. Funds should be allocated for the AST each year, even though the AST now alternates between in-person and virtual attendance. Monitors, board members, and supports coordinators are also encouraged to attend as able. SCs may again register two for the price of one.

Registration, especially for the in-person years, is crucial. Registration numbers are used to calculate the number of information packets to be created for attendees and the amount of food needed for the meals that are included. The deadline for registration is July 16, so please use the registration link in the agenda to register at your earliest convenience.

In addition, if hotel rooms are needed, please make your reservations now. The block of rooms at the special rate can only be guaranteed until July 7. Contact info for the Harrisburg Hilton is also included on the agenda.

Questions regarding registration and hotel reservations should be sent to Mary Kay Cunningham electronically.

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RCPA is excited to host a membership benefits webinar on Thursday, July 10, 2025, at 10:00 am, 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 occur throughout the year.

Registration is required; please register here to attend the webinar. Items we will review include the below and much more:

  • Virtually meet the dedicated RCPA Policy Staff and RCPA lobbyists;
  • Discuss the 2025 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 Association 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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Checklist concept - checklist, paper and pen

In alignment with key quality metrics and the implementation of “Everyday Lives: Values into Action,” all Administrative Entities (AE), Support Coordination Organizers (SCO), and Providers are required to complete a Quality Assessment & Improvement (QA&I) self-assessment of their performance on the provision of services and supports to individuals annually. The QA&I self-assessment requirement applies to all entities, regardless of the type of review (i.e., full review or record review only).

Exception: The QA&I Self-Assessment will be optional for SCOs scheduled to receive a full review in C3Y1, due to the concurrent demands of preparing for Performance-Based Contracting (PBC).

On July 1, 2025, a hyperlink will be sent to the email address of the entity’s primary contact from the QA&I Process mailbox ([email protected]) with the subject line “Action Required! The QA&I Cycle 3, Year 1 Self-Assessment – (Entity) is now available!” If the primary contact does not receive this email, please check spam and junk mail folders to ensure the email did not filter to one of those folders in error. If the entity’s primary contact does not receive the link by the end of the day on July 1, please email the QA&I Process mailbox for assistance.

All self-assessments must be submitted electronically to ODP via QuestionPro utilizing the hyperlink. Each entity must complete the applicable self-assessment by COB August 31, 2025. An entity shall submit only ONE self-assessment for their entire agency.

If an entity does not complete a self-assessment, a Directed Corrective Action Plan (DCAP) will be issued and ODP and/or the AE may elect to conduct a full review regardless of an organization’s regularly scheduled full review within the three-year cycle.

Please direct any inquiries, issues, or concerns regarding this communication to the QA&I Process mailbox. Read the ODP Announcement for more details.

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The Office of Developmental Programs (ODP) contracts with Temple University Harrisburg to deliver the ODP Certified Investigator Program. ODP and Temple University have developed a new online training module that provides an additional learning opportunity designed to enhance investigatory skills and supplies helpful resources to Certified Investigators (CI), Administrative Review Committee members, CI Peer Reviewers, Incident Management (IM) Representatives, and others involved in the incident investigation process.

The Death Investigation lesson has been added to the “Additional Learning Opportunities” section on the MyODP PA ODP Certified Investigator Program home page.

For any questions, please contact Temple University.

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The Centers for Medicare & Medicaid Services (CMS) issued an alert about a fraud scheme that uses phishing fax requests, which falsely claim to be from CMS staff, to obtain medical records and documentation for auditing purposes.

CMS does not initiate audits by requesting medical records via fax, and if you receive a suspicious request, do not respond. If you have additional questions about this alert, please reach out to Karissa Bjorkgren of CMS via email.

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The Office of Developmental Programs (ODP) has released Bulletin 00-25-02: Individual Eligibility for the Consolidated, P/FDS, Community Living and Adult Autism Waivers and the accompanying attachment.

The purpose of this bulletin is to communicate:

  • The requirements and procedures for evaluating an individual’s eligibility for services and supports provided through the Consolidated, Person/Family Directed Support (P/FDS), Community Living Waivers (ID/A Waivers), and the Adult Autism Waiver (AAW); and
  • The requirements and procedures for re-evaluating an individual’s eligibility for the ID/A Waivers.

Additional resources to assist with the evaluation and re-evaluation of HCBS eligibility for services and supports are available on MyODP’s website.

This bulletin obsoletes Office of Developmental Programs 00-19-04: Individual Eligibility for the Consolidated, P/FDS and Community Living Waivers.

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Message from Rep. Dan Williams’s Office:

HARRISBURG, June 24 – Bipartisan legislation introduced by state Rep. Dan Williams, D-Chester, that would help Pennsylvanians take advantage of new federal Medicaid rules that give patients and clinicians more telehealth options for behavioral health services passed the PA House today with overwhelming support.

“The longstanding and outdated ‘four walls’ requirement has limited Medicaid reimbursement to services within the physical walls of a clinic,” said Williams. “This only creates barriers to care, particularly in rural areas and regions experiencing mental health workforce shortages.”

The Centers for Medicare and Medicaid Services gave states the option to waive the requirement on Jan. 1. In response, the Pennsylvania Department of Human Services has submitted a State Plan Amendment to adopt this flexibility, which is currently awaiting federal approval.

House Bill 1590 would repeal state regulations that conflict with the new federal flexibility. Importantly, the bill would not change existing rules requiring in-person treatment hours for outpatient behavioral health clinics.

“Under this bill, Pennsylvania can fully implement the change, expanding access to behavioral health services and reducing care gaps for our vulnerable populations across the Commonwealth,” Williams said.

The bill now moves to the state Senate for consideration.

It is important to note that, at this time, OMHSAS is awaiting approval from CMS. To address the Federal Medicaid payment conditions in the Pennsylvania statute, there was a need for this legislation to permit services be covered under Medicaid, and HB 1590 would achieve this. It is also important to reiterate that this bill will not change outpatient behavioral health clinic rules requiring in-person treatment hours. The passage of this bill will address these conditions for outpatient clinics as well as the delivery of SUD services.

Both the CMS SPA approval and the legislation would be retroactive to January 1, 2025.

Until then, the completion of both the SPA and the legislation on 4 walls flexibilities will remain in place. RCPA is grateful to have partnered with OMHSAS, House legislators, and other stakeholder associations on the development of this bill. We will continue our efforts in getting the legislation to the Governor’s desk.

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

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