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Pennsylvania saw a large Election Day turnout in certain areas of the Commonwealth, so before sending out the Election Day update, RCPA wanted to wait so we could report to you the most accurate information available.

As of today, November 8, 2024, there are still two seats in question. One is the US Senate race between the Incumbent Sen. Bob Casey (D) and his opponent, Dave McCormick (R). The other seat in question is in Cambria County between Incumbent State Rep. Frank Burns (D) and his opponent, Amy Bradley (R).  More information on these two races is available below.

Election Results

President

Trump (R) – 50.5%
Harris (D) – 48.5%

Donald Trump won the race to be the 47th President of the United States. Trump saw increased support this election with Black and Latino men. The rural areas of the Commonwealth offset any Democrat leads in the urban areas, and in many urban areas Trump limited the Democrats’ winning margins.

US Senate

McCormick (R) – 49%
Casey (D) – 48.5%

This race has been called by the Associated Press (AP) in favor of Dave McCormick, but Sen. Casey has not conceded the race yet. According to AP, McCormick is currently winning by about 30,000 votes. AP believes the remaining votes will break in favor of McCormick. We will keep the members posted as events unfold.

The Republicans have flipped the US Senate and currently have a 52-seat majority, with the possibility of gaining two more seats (Pennsylvania and Arizona).

US House

The US House is projected to stay in Republican control by a 222–213 majority. In Pennsylvania, two  US House seats flipped from Democrat to Republican in Northeast PA and the Lehigh Valley (see results below).

District 7 (Lehigh Valley)
Ryan MacKenzie (R) – 50.7%
Incumbent Susan Wild (D) – 49.3%

District 8 (NEPA)
Rob Bresnahan (R) – 51%
Incumbent Matt Cartwright (D) – 49%

District 10 (Cumberland, Dauphin, Perry, York Counties)
Incumbent Scott Perry (R) – 50.8%
Janelle Stelson (D) – 49.2%

PA Senate

The Republicans went into Election Day with a 28–22 seat majority and came out of the election with the same majority.

PA House

The House Democrats went into Election Day with a majority of seats, 102–101. As of today, November 8, 2024, one race will decide whether the Democrats maintain control of the House or the Republicans assume majority control.

The race in question is in Cambria County, between Incumbent Democrat Frank Burns and his Republican opponent, Amy Bradley. As of today, Burns holds a 936 vote lead with approximately 97% of the vote in. As of this writing, the AP called the race for Rep. Burns, but challenges will probably be filed by the Bradley campaign.

Next Week

The House will be in session next Tuesday and Wednesday, and the Senate will be in session Wednesday and Thursday. It is believed no major legislation will be voted on and both chambers will hold leadership elections for the 2025/26 legislative session.

If you have any questions, please contact Jack Phillips, Director of Government Affairs.

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Removes Barriers to Delivering Telehealth Outside the Clinics

On Friday, November 1, the US Centers for Medicare and Medicaid Services (CMS) released a final rule for calendar year 2025 that will give states the option to cover Medicaid telehealth behavioral health clinic services delivered outside the “four walls.” Previously, under 42 CFR § 440.90, the “Four Walls Rule,” it was required that during Medicaid outpatient behavioral health clinic telehealth services, either the patient or the clinician had to be physically onsite at the clinic.

CMS waived this requirement during the Public Health Emergency (PHE). Now that the PHE has ended, CMS has released this final rule to allow states to cover behavioral health outpatient clinic services outside the four walls. The final rule should take effect on January 1, 2025. In the meantime, it is the expectation that telehealth services will continue to be delivered as per current operating standards to ensure service access to individuals.

CMS amended the Medicaid clinic services’ regulation to authorize Medicaid coverage for clinic services furnished by IHS/Tribal clinics outside the “four walls” of their facility. In addition, states implementing the Medicaid clinic services’ benefit can opt to cover clinic services furnished outside the “four walls” of behavioral health clinics or clinics located in rural areas. For clinics located in rural areas, based on comments received, CMS is finalizing an approach to defining “rural area” where states will select either a definition used by a federal agency for programmatic purposes, or a definition adopted by a state agency with a role in setting state rural health policy.

For more information, view the CY 2025 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule (CMS 1809-FC) Fact Sheet and the full Final Rule.

RCPA will be reviewing the implications of this final form ruling for Pennsylvania and our ongoing efforts to expand telehealth services through legislative action. RCPA offers thanks to our members, as well as DHS/OMHSAS, County Primary Contractors, BH-MCOs, the National Council on Mental Wellbeing, and our stakeholder groups and associations for their collaborative advocacy to remove the “4 Walls” barriers to equity and access through telehealth.

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

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Photo by Michael Schofield on Unsplash

The While House issued a press release announcing that the Access Final Rule will be released later today. These regulations include:

  • The Nursing Home Minimum Staffing Rule, which will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day of total staffing, including a defined number from both registered nurses (0.55 hours per resident per day) and nurse aides (2.45 per resident per day);
  • Introducing the requirements of the rule in phases to make sure nursing homes have the time they need to hire staff, with longer timeframes for rural communities;
  • Ensuring adequate compensation for home care workers for HCBS operations of in-home care (both Personal Assistance Services and Community Habilitation) by “requiring that at least 80 percent of Medicaid payments for home care services go to workers’ wages. This policy would also allow states to take into account the unique experiences that small home care providers and providers in rural areas face while ensuring their employees receive their fair share of Medicaid payments and continued training as well as the delivery of quality care;”
  • The state requirement to be more transparent in how much they pay for home care services and how they set those rates, increasing the accountability for home care providers; and
  • The creation of a state home care rate-setting advisory group made up of beneficiaries, home care workers, and other key stakeholders to advise and consult on provider payment rates and direct compensation for direct care workers.

We will continue to monitor the details of these regulations and Pennsylvania’s plans to comply. If you have any questions, please contact Fady Sahhar.

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Image by Werner Moser from Pixabay

On November 7, 2023, RCPA submitted comments to the Department of Labor’s Hour and Wage Division regarding the proposed rule “Defining and Delimiting the Exemptions for Executive, Administrative, Professional, Outside Sales, and Computer Employees (RIN 1235-AA39).” While we understand the need to modernize and update the Fair Labor Standards Act exemption regulations, RCPA strongly urges DOL to re-examine the proposed new salary threshold in a manner that considers the unique pressures on health care providers, as well as regional variations in the cost of living and average salary for human services providers. As currently written, the proposal unfortunately does not consider the implications of current health care funding for safety net services. Thus, the current proposal would have a potentially devastating effect on health care organizations serving low-income individuals with serious and complex disorders and disabilities, resulting in the need for service cutbacks and program closures.

You can read the full comments here.

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