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Substance Use Disorder

The Department of Human Services (DHS) Secretary Val Arkoosh met with systems stakeholders to provide an overview of the Governor’s proposed 2025/26 DHS budget. The Secretary began by reviewing the accomplishments of DHS under the administration and highlighted areas around Medicaid, systems enhancements, and the expansion in the delivery of services to Pennsylvanians.

The projected spending across DHS showed an investment of $21.17B, with the following breakdowns:

  • $7.13B for Long-Term Living;
  • $6.4B for Medicaid/healthcare delivery;
  • $3.22B for ID/A;
  • $1.72B for Human Services and County Child Welfare; and
  • $1.04B for Mental Health and Substance Use Disorders.

This budget number represents a $1.95B increase over last year’s executive budget. The most significant increases included:

  • $927M for Long-Term Living;
  • $7.23M for Medicaid/healthcare delivery;
  • $1.84M for ID/A;
  • $74M for Child Development; and
  • $32M for Mental Health and Substance Use Disorders.

RCPA submitted questions during the webinar in an effort to gain greater clarity on the proposed $2.4B increase in the Health Choices capitation. Several questions remain unanswered, including:

  • Are these dollars allocated towards physical health, behavioral health, or both?
  • What is the spending strategy for the 2024/25 supplemental appropriations? Is that part of the $2.4B?

There was clarification on the proposed $170M increase in the ID/A budget, but Secretary Arkoosh stipulated that this was not new investments but rather funds to sustain last year’s increase.

The remainder of the webinar was spent outlining current DHS initiatives, including the Keystones of Health 1115 Waiver, which was approved in December 2024. This year’s priority will focus on reentry services as well as planning for future implementation. The Secretary concluded her comments supporting the minimum wage increase, reinforcing the workforce infrastructure, and tackling Commonwealth-wide challenges.

The DHS Bluebook is scheduled for release in the coming weeks and will provide line item details of the budget. RCPA will continue to work with DHS and PA legislators on the budget specifics and our ongoing advocacy efforts. You can view the DHS budget webinar here.

RCPA will continue to update members on the budget as information becomes available. If you have further questions, please contact your RCPA Policy Director.

Join RCPA as we host the 2025 Annual Conference Striving to Thrive from September 9 – 12 at the Hershey Lodge. The event is a highlight for the Pennsylvania behavioral health, brain injury, children’s, intellectual and developmental disabilities, medical rehabilitation, and physical disabilities and aging provider communities. RCPA staff and the Conference Committee are excited to release this year’s Sponsors, Exhibitors, and Advertiser Brochure, which features new opportunities to get in on the action and network with providers. Booth self-selection will also be available for exhibitors and exhibiting sponsors. In order to be considered for self-selection, a completed contract with payment must be submitted.

Network and Compete in Connections Hall
Connections Hall activities take place during the two busiest days of the conference, and many networking opportunities are available throughout the event. You’ll also be able to compete and have a chance to win “Best of Show!”

Exciting New Sponsorship Opportunities
RCPA is privileged to have the backing of the finest organizations in the field for our conference. Through the use of sponsorship circles, RCPA is able to honor all supporting organizations.

Sign Up Now!
Sponsors, exhibitors, and advertisers who wish to be listed on the website, the mobile app, and in the conference program must submit all materials by August 20.

The association looks forward to welcoming you at the conference! Space and opportunities are reserved on a first-come, first-served basis, and no reservation is considered complete without payment. If questions remain, please contact Carol Ferenz, Conference Coordinator.

Message from ANCOR:

A second federal judge has blocked the freeze on federal spending noticed earlier in the week through a memo from OMB.

The order directs the Trump Administration not to “pause, freeze, impede, block, cancel, or terminate defendants’ compliance with awards and obligations to provide federal financial assistance to the states, and defendants shall not impede the states’ access to such awards and obligations” until further arguments can be heard.

The order does not prevent the review of federal programs, only the freeze on federal spending during the review. The OMB memo was rescinded prior to the issuance of the order, but the judge expressed earlier in the week that he was not persuaded that withdrawing the memo removed the underlying harm.

A hearing is expected Monday on the previous restraining order issued earlier in the week. We’ll keep you posted as we learn more.

Lydia Dawson, JD
ANCOR | Vice President of Government Relations
571-932-5375

Earlier this month the Drug Enforcement Agency (DEA) issued a Notice of Proposed Rulemaking (NPRM) for Special Registrations for Telemedicine and Limited State Telemedicine Registrations. DEA is seeking public comment by March 18, 2025.

RCPA is considering whether it will submit comments. If you have comments about the proposed rule that you would like to make part of any RCPA response or if you would like to discuss the proposed rule, please contact RCPA SUD Treatment Services Policy Director Jason Snyder.

The NPRM introduces three types of Special Registrations for Telemedicine:

  1. A Telemedicine Prescribing Registration, authorizing qualified clinician practitioners to prescribe Schedule III-V controlled substances via telemedicine;
  2. An Advanced Telemedicine Prescribing Registration, authorizing qualified, specialized clinician practitioners (i.e., psychiatrists, hospice care physicians, physicians rendering treatment at long-term care facilities, and pediatricians for the prescribing of medications identified as the most addictive and prone to diversion to the illegal drug market) to prescribe Schedule II-V controlled substances via telemedicine; and
  3. A Telemedicine Platform Registration, authorizing covered online telemedicine platforms, in their capacity as platform practitioners, to dispense Schedule II-V controlled substances. To satisfy the statutory requirements, DEA would also require the special registrant to maintain a State Telemedicine Registration for every state in which a patient is treated by the special registrant, unless otherwise exempted. The State Telemedicine Registration would be issued by DEA, not the states, and operate as an ancillary credential, contingent on the Special Registration held by the special registrant.

Public comments are also requested on additional patient protections for the prescribing of Schedule II medications by telemedicine, including:

  • Whether the special registrant should be physically located in the same state as the patient being prescribed Schedule II medications;
  • Whether to limit Schedule II medications by telemedicine to medical practitioners whose practice is limited to less than 50 percent of prescriptions by telemedicine; and
  • The appropriate duration needed for the rules’ provisions to be enacted.

The special registration rule will also require the establishment of a national prescription drug monitoring program (PDMP) to help the health industry protect against abuse and the diversion of controlled substances into the illegal drug market. A national PDMP will provide pharmacists and medical practitioners with visibility of a patient’s prescribed medication history.

The Office of Mental Health and Substance Abuse Services (OMHSAS) is providing the YouTube link from their last quarterly PSS Stakeholders Call that was held on January 14, 2025, as well as the presentation that was reviewed, for any interested stakeholders or individuals.

The next meeting is scheduled for Tuesday, April 8, from 10:00 am – 11:00 am. A meeting invite will be distributed closer to the meeting date.

Recommendations for agenda topics or questions can be submitted electronically to the OMHSAS Peer Support Services inbox and must be submitted at least two weeks prior to the meeting date.

Please reach out to RCPA Policy Associate Emma Sharp with any questions.

Photo by René DeAnda on Unsplash

RCPA provided some late updates yesterday on the Federal funding freeze, and late last evening, the National Council for Mental Wellbeing provided members a legal interpretation on the rescinding of the Office of Management and Budget (OMB) M-25-13 and the issuance of the new memorandum M-25-14.

The following is from the National Council:

On Wednesday afternoon, the White House Office of Management and Budget issued a new memorandum—M-25-14 — that rescinded the pause to federal funding contemplated in a previous memorandum first issued on Monday night.

The new memorandum, which was directed to “heads of executive departments and agencies,” features a two-sentence statement reading: “OMB Memorandum M-25-13 is rescinded. If you have questions about implementing the President’s Executives Order, please contact your agency General Counsel.”

In the short term, M-25-14 certainly relieves some of the confusion and anxiety that swept across the federal grants world since Monday night. Our previous client alerts have chronicled the chaos that emerged late Monday and throughout the day on Tuesday.

However, in our review, there are still five key Executive Orders issued by the Trump Administration not affected by the rescission of M-25-13. Those EOs include:

While the upheaval following the issuance of M-25-13 may have prompted the Trump Administration to change course and move away from pausing all federal funding, we certainly anticipate that federal grants in the above-listed areas will remain subject to a comprehensive review and new standards. Federal grantees with programs in these specific areas should undertake a detailed review and be prepared for future agency actions.

Federal grantees should continue to keep apprised of the Administration’s actions, orders, and statements relating to federal funding — as the rescinded memorandum likely foretells future clashes as the Administration attempts to exert control over federal spending.

Chuck Ingoglia
President & CEO
Strategic Leadership
National Council for Mental Wellbeing


In addition, ANCOR sent the following information last night:

In what’s turning from a whirlwind couple of days into a whirlwind week, there were notable updates today on the OMB memo on the freeze of certain federal funding issued earlier in the week. 

Today OMB withdrew the memo with a simple rescission statement after a federal judge temporarily blocked the funding freeze for open awards and current spending. The order remains in effect until February 3 when a hearing is scheduled to determine next steps.  

As you may have seen, later in the day, Press Secretary Karoline Leavitt posted to X, “[t]his is NOT a rescission of the federal funding freeze. It is simply a rescission of the OMB memo. Why? To end any confusion created by the court’s injunction. The President’s EO’s on federal funding remain in full force and effect, and will be rigorously implemented.” Without further specificity regarding the implicated executive orders, the situation remains fluid with the potential for later memos or other interpretive guidance which the White House maintains is authority held within the executive branch.

In other litigation, U.S. District Judge Jack McConnell made statements in court today indicating that another restraining order may be coming. With the memo rescinded, the Department of Justice Special Counsel argued the case is no longer relevant. However, the judge did not appear persuaded and asked for a draft protective order for response and consideration. 

We’ll continue to keep you posted as we know more and hope to see you Friday (1/31) for our extended Members-Only Weekly Briefing at 12:30 pm ET to provide updates and review all available information together. See login information below:
Join Zoom Meeting: ancor-org.zoom.us/j/… 
Meeting ID: 870 2745 7284 
Passcode: 977618 


In recent communications from the OMB, these actions will not impact programs that provide direct benefits to individuals and are explicitly excluded from the pause and exempted from this review process. In addition to Social Security and Medicare, already explicitly excluded in the guidance, mandatory programs like Medicaid and SNAP will continue without pause.

RCPA will continue to communicate new developments with members as they emerge. If you have any questions, please contact your RCPA Policy Director.