On Tuesday, June 21, 2016, RCPA President & CEO Richard Edley testified before a joint hearing of the PA Senate Labor & Appropriations Committees, regarding the adverse effects of the Federal Department of Labor’s (DOL) Overtime Exemption Rule.
The Department of Human Services (DHS) is implementing a number of measures related to services for children and adolescents with behavioral health needs. The full text of their announcement is available for review and a summary of key elements of the DHS action plans are highlighted below:
Behavioral Health Rehabilitation Services (BHRS)
Applied Behavioral Analysis (ABA)
Behavior Specialist Licensure
A recent edition of the Pittsburgh Post-Gazette focused on the planning efforts by Highmark Insurance to assure health care parity and the economic and health care value of integrated health care.
The Post-Gazette article notes that “behavioral health care is still provided under a “separate and unequal” system, eight years after enactment of a federal law that meant to curb such disparity,” noted Patrick Kennedy in a meeting with a group of Pittsburgh-area health insurance caseworkers. “But that may start to change by fall when employer compliance monitoring is expected to begin for the Mental Health Parity and Addiction Equity Act,” the 49-year-old former Rhode Island congressman told about 20 case managers at Highmark Health. Mr. Kennedy was upbeat, saying a renaissance was at hand as employers and insurers learn about the cost-saving value of behavioral health coverage. “The business model isn’t there yet. This is going to take time,” he said. “Let’s find the value so it makes sense for insurance companies.”
In a related effort, the Pennsylvania Parity Coalition will be meeting this week with the Pennsylvania Insurance Department, to discuss the implementation and monitoring of commercial insurance plans as part of the federal parity requirements in the move toward integrated health care. RCPA, along with leading provider and consumer advocacy groups and representatives of ParityTrack, supported by the Kennedy Forum, make up the core leadership of the Pennsylvania Parity Coalition.
Leaders in mental health and suicide prevention research are working to implement a grant to study an evidence-based approach to youth suicide prevention. They are now looking for a project coordinator (masters or doctoral level preferred) and a research assistant (BA level) to run a large, school-based suicide prevention study with teachers in urban and suburban middle and high schools in Pennsylvania. This project will study a promising prevention model by recruiting 30 schools and training over 1,000 teachers.
The work of the research team will involve identifying schools, working with school personnel to plan the training, implementation of the assessment system, coordinating the training, and collecting pre-, post-, and follow-up quantitative and qualitative data. Both the project coordinator and research assistant are 18-month positions starting September 1. Interested individuals should send their resumes with cover letters to Guy Diamond, PhD and Matthew Wintersteen, PhD.
RCPA has played a long-standing role in the Pennsylvania Youth Suicide Prevention Initiative and works in collaboration with state and local organizations to reduce the risk and rate of youth suicide in communities across the Commonwealth.
For several years, RCPA has worked in collaboration with the Pennsylvania Psychiatric Leadership Council (PPLC). Most recently the PPLC expanded its activity and interest in supporting and promoting child psychiatric services and psychiatrists in rural Pennsylvania.
The Office of Vocational Rehabilitation (OVR) is conducting a comprehensive statewide needs assessment designed to meet and satisfy the state plan requirements in the Rehabilitation Act of 1973, as amended, and the Workforce Innovation and Opportunity Act. As part of this assessment, the Institute on Disabilities at Temple University is asking Pennsylvania employers and workforce professionals to complete a brief survey to identify how OVR can better support employers and employees across Pennsylvania.
This project is being conducted in cooperation with the Pennsylvania Rehabilitation Council and with the assistance of the Institute on Disabilities. If you are an employer or a workforce professional you are encouraged to complete this brief survey by Monday, August 1. Once you’ve completed the survey, you can enter in a drawing to win a $20 Target gift card.
The Institute on Disabilities is also seeking employer stakeholders to participate in brief phone interviews and share their expertise with the Institute. Interested employers can email or call 215-204-9544.
Integration is a hot topic and buzzword in health care. And, integrated primary and behavioral health care is the best approach to care for people with complex health care needs. But do you have an elevator speech when someone asks you about integrated care? What do you tell new staff during orientation and how do you communicate the value to potential partners and your board of directors? Join this webinar to go back to the basics of primary and behavioral health care integration and learn how to effectively communicate the importance of integrated care and the benefits to the people you serve.
Last week Insurance Commissioner Teresa Miller reiterated to consumers that enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) is a priority for her department. Miller also encouraged consumers to understand what benefits they are entitled to under the law and to file complaints with the Insurance Department if they believe they are not getting proper insurance coverage. “The Pennsylvania Insurance Department takes this law very seriously, and we will us our statutory authority to enforce parity requirements on plans over which we have jurisdiction,” said Commissioner Miller.
The MHPAEA of 2008 requires health insurance plans to contain the same level of coverage for mental health and substance use disorders as for medical or surgical care. This coverage includes quantitative limitations (copays, deductibles, and limits on inpatient or outpatient visits that are covered) and non-quantitative limitations (pre-authorizations, providers available through a plan’s network, and what a plan deems “medically necessary”).
One important step toward a well-integrated system of health care, both physical and behavioral, is full implementation of the letter and spirit of MHPAEA. RCPA is actively working with health care advocates as part of the state’s Parity Coalition to assure consumers and providers/practitioners that Medicaid, CHIP, and private health plan coverage include quantitative and non-quantitative parity.
For more information on the MHPAEA or to file a complaint or ask a question, visit the insurance department website or call 877-881-6388.
The Office of Mental Health and Substance Abuse Services (OMHSAS) has released a draft bulletin and related documents for review and comment. The purpose of the draft bulletin and related forms is to inform behavioral health managed care organizations and providers of the procedures for requesting Applied Behavioral Analysis (ABA) using Behavioral Specialist Consultant-Autism Spectrum Disorder (BSC-ASD) and Therapeutic Staff Support (TSS) services. The draft documents describe the minimum qualifications needed to provide ABA using BSC-ASD and TSS services, and the procedure code and modifier combinations that can be used to bill for services when such services are used by appropriately qualified individuals to provide ABA.
Confirmation of Knowledge and Skills to Provide Applied Behavioral Analysis
Attestation for BHRS Providers That Provide ABA Using BSC-ASD and TSS Services
This draft bulletin is being shared at this time for public comment. Comments should be sent to OMHSAS by Friday, July 8.
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