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0 2020
Photo by Markus Winkler from Pexels

Earlier this year, Community Care Behavioral Health (CCBH) notified Behavioral Health Services of Somerset and Bedford Counties, Inc. (BHSSBC) of their intent to withdraw from servicing the HealthChoices contract with the counties. In April, BHSSBC announced that they are working to transition its subcontract from CCBH to Magellan Behavioral Health Services of Pennsylvania, Inc., one of five behavioral health managed care organizations (BH-MCO) in the commonwealth, with an effective transition date of November 1, 2025. The primary goal is to provide a seamless transition for providers to prevent any disruption in the delivery of crucial behavioral health and/or substance use disorder services to their members.

All parties will continue to work collaboratively in an effort to promote the delivery of high-quality behavioral health and substance use disorder services to the community.

BHSSBC is one of 24 primary contractors in Pennsylvania’s Behavioral HealthChoices program. The Pennsylvania Department of Human Services (DHS) receives federal Medicaid funding and enters contracts with these primary contractors, who then enter contracts with BH-MCOs, which, among other responsibilities, manage a network of behavioral health providers.

Read BHSSBC’s latest correspondence here.

Contact RCPA Policy Associate Emma Sharp with any questions.

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Trauma-informed care in the Office of Children, Youth and Families (OCYF) has emphasized the importance of trauma-informed approaches in providing technical assistance, training, policy, guidance, support, and monitoring procedures. OCYF has developed and collected many trauma tools and resources that may be helpful for child welfare stakeholders and providers as they proceed on their trauma-informed care continuum, such as their monthly Trauma Tip Sheet.

In the January 2025 Trauma Tip Sheet, the US Surgeon General’s Framework for Workplace Mental Health & Wellbeing was introduced, and different topics have been explored in the following months. The May 2025 Trauma Tip Sheet highlights the topic of “Mattering at Work,” and can be read here.

Contact RCPA Policy Associate Emma Sharp with any questions.

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Colleen Stuart, CEO of Venango Training & Development Center, Inc. and RCPA Board Chair, was presented the “Outstanding Community Partner Award” by the Venango County Human Services Advisory Board of Directors at an annual dinner on April 16. The award is given to community partners in recognition and support of reciprocal collaboration that align to enhance the quality of life for county residents. Colleen was recognized for going above and beyond in meeting the needs of the county residents. Board President Dr. Ray Feroz also recognized and thanked her for 35 years of dedicated service to Venango County. RCPA congratulates Colleen on her achievements!

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Photo by Sincerely Media on Unsplash

The PA Lifesharing Coalition has announced the 13th Annual Lifesharing Conference! The conference will be held at The Alloy, a Doubletree Hotel by Hilton, at King of Prussia, PA, on October 6 and 7. The early bird registration fee is $225 through July 30. After July 30, registration will be $250. You can view the Save the Date flyer for more details.

In addition, the PA Lifesharing Coalition has shared a Call for Proposals for the conference. Take the opportunity to present your knowledge to an eager audience looking to gain new skills and expand their knowledge. Each breakout session will be between 45-60 minutes long, including 10-15 minutes for Q&A and discussion. Topics of interest include but are not limited to: aging individuals, medically complex children, respite services, recruiting lifesharing providers/families, safe use of technology, self-care, and best practices. View the Call for Proposals for details. Proposal forms are due by Friday, May 30, 2025.

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The Brain Injury Advisory Board, established under section 1252 of the Federal Traumatic Brain Injury Act of 1996 (42 U.S.C. § 300d-52), will hold their next public meeting on May 2, 2025, from 10:00 am – 3:00 pm. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network (PaTTAN), 6340 Flank Drive, Harrisburg, PA 17112 in the Cumberland conference room.

Meeting materials will be sent out before the meeting and will also be available on the Board’s website as well as at the meeting location. Questions should be directed to Nicole Johnson electronically.

The Department of Health’s (DOH) Head Injury Program (HIP) strives to ensure that eligible individuals who have a traumatic brain injury receive high quality rehabilitative services aimed at reducing functional limitations and improving quality of life. The Board assists the Department in understanding and meeting the needs of persons living with acquired brain injuries, both traumatic and nontraumatic, and their families. This quarterly meeting will provide updates on a variety of topics, including the number of people served by HIP. In addition, meeting participants will discuss budgetary and programmatic issues, community programs relating to traumatic and nontraumatic brain injuries, and available advocacy opportunities.

For additional information or for persons with a disability who wish to attend the meeting and require an auxiliary aid, service or other accommodation to do so, contact Nicole Johnson, Division of Community Systems Development and Outreach, via email or at (717) 772-2763. For individuals with speech and/or hearing-impairments, contact V/TT (717) 783-6514 or the Pennsylvania Hamilton Relay Service at (800) 654-5984.

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In a presentation to the Medical Assistance Advisory Committee today, Office of Mental Health and Substance Abuse Services (OMHSAS) Deputy Secretary Jen Smith shared data that shows a significant increase over the past three years in behavioral health managed care organization (BH-MCO) decisions to deny services to their members or contracted providers.

In addition to denial data for calendar years 2022 through 2024, the report also provides data on grievances and complaints and defines what each of those is. Notably, the 2024 data does not include the fourth quarter of the year.

The most egregious service type denials are seen in two categories: 1) non-hospital residential withdrawal management, rehabilitation and halfway-house services for drug/alcohol abuse or substance use disorders; and 2) IBHS for children and adolescents with mental health or substance use disorders. Although the IBHS denials appear down slightly in 2024, when the fourth quarter data is added, the number is likely to increase. On the SUD side, even without fourth quarter data, denials for the non-hospital residential substance use disorder treatment services are up 45 percent over 2023.

The presentation breaks down the number of denials per year per BH-MCO since 2022.

The increases in denials in 2024 occurred at the same time OMHSAS acknowledged a significant miscalculation of capitation rates, resulting in underfunding of the behavioral health system, including primary contractors and BH-MCOs, by hundreds of millions of dollars.

Deputy Secretary Smith cautioned that there are multiple factors to consider when reviewing the data and increase in denials, including Pennsylvania’s SUD treatment system’s ongoing alignment with ASAM Criteria and the increased BH-MCO scrutiny on providers and individual BH-MCO interpretation of ASAM Criteria.

The full presentation is available here.

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