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Substance Use Disorder

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On January 30, the Biden Administration announced that the COVID-19 national emergency and public health emergency (PHE) will both expire on Thursday, May 11, 2023. Under Act 30 of 2022, the Department of Drug and Alcohol Programs’ (DDAP) regulatory suspensions that are “related to federal exemptions granted under the federal public health emergency declaration” were extended until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.” In other words, Act 30 aligned the timing for DDAP’s regulatory suspensions with the deadline for flexibilities granted by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) — not with the deadline of the PHE itself.

Below is a description of each currently suspended regulation and what DDAP knows about efforts to make these changes permanent at the federal level.

Methadone Take-Home Supply

Current regulatory suspension: Under the federal PHE, SAMHSA is currently allowing up to 28 days of take-home medications for patients on stable dosages, as deemed appropriate by their physician. DDAP’s regulation 28 Pa. Code § 715.16(e) (prohibiting narcotic treatment programs [NTPs] from permitting a patient to receive more than a two-week take-home supply) is currently suspended under Act 30.

Expiration of the PHE: In November 2021, SAMHSA announced that the methadone take-home flexibilities will be extended for one year after the end of the PHE (now May 11, 2024). DDAP submitted its written concurrence with this exemption in February 2022. Furthermore, SAMHSA issued a notice of proposed rulemaking in December 2022 that proposes modifying regulations related to methadone take-home supply up to 28 days, among other changes.

Buprenorphine Telehealth

Current regulatory suspension: Under the federal PHE, SAMHSA and the DEA are currently allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth. DDAP has two related regulations that are currently suspended under Act 30:

  • 28 Pa. Code § 715.9(a)(4): Requires NTPs to make a face-to-face determination before admission to treatment for those clients who will receive medication to treat opioid use disorder (OUD).
  • 28 Pa. Code § 715.6(d): Requires NTPs to have narcotic treatment physician services onsite.

Expiration of the PHE: In March 2022, the DEA announced that it is currently working to make its teleprescribing regulations permanent. In June 2022, SAMHSA announced to State Opioid Treatment Authorities that flexibilities around telehealth evaluations before buprenorphine treatment at NTPs, specifically, will be extended for one year after the end of the PHE (now May 11, 2024).

SAMHSA and DEA have made clear that support for these flexibilities has been overwhelmingly positive, decreased stigma associated with OUD, and enhanced care for patients. Given the information above, DDAP does not anticipate any lapses in these flexibilities at either the federal or state level but will continue to provide updates and guidance as available.

Resources

If you have any further questions, please contact the Bureau of Program Licensure at (717) 783-8675 or via email.

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As discussed in the recent RCPA Telehealth Operations Work Group meeting, the Office of Mental Health and Substance Abuse Services (OMHSAS) announced a telehealth funding opportunity. To participate in this funding, or for additional details, please visit this website.

OMHSAS will accept funding requests beginning today, February 1, 2023. RCPA recommends all members interested in this funding to review the announcement as soon as possible.

If you have questions or concerns related to this opportunity, please send via email. If you have any other questions, please contact RCPA Policy Director Jim Sharp.

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Photo by Kane Reinholdtsen on Unsplash

The 2023 RCPA Conference, which will be celebrating our 10-year anniversary as a leader in shaping policy and enhancing lives, will be held October 10 – 13 at the Hershey Lodge for a statewide audience. The Conference Committee is seeking workshop proposals in every area for possible inclusion, particularly those that assist providers in developing and maintaining high-quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations that:

  • Highlight new policy, research, and treatment initiatives, such as telehealth innovations, suicide prevention, and employing people with disabilities;
  • Provide specific skills and information related to individual and organizational leadership development and enhancement;
  • Discuss advanced ethics practices;
  • Address system changes that affect business practices, including integrated care strategies, value-based purchasing, acquisitions/mergers, and alternative payment models;
  • Provide guidance on building a culture of a committed workforce, including recruitment and employee development as well as effective remote workforce strategies;
  • Offer concrete skills and tools to operate more efficient, effective agencies; and
  • Inspire ideas for organizations to be leaders in their field.

The committee welcomes any proposal that addresses these and other topics essential to rehabilitation, mental health, substance use disorder, children’s health, aging, physical disabilities, and intellectual/developmental disabilities & autism. Members are encouraged to consider submitting and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.

The Call for Proposals (featuring a complete listing of focus tracks) and accompanying Guidelines for Developing Educational Objectives detail requirements for submissions. The deadline for submissions is Monday, March 13, 2023, at 5:00 pm. Proposals must be submitted electronically on the form provided; confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals unable to meet this expectation should not submit proposals for consideration.

Individuals are welcome to submit multiple proposals. Notification of inclusion will be made via email by Friday, May 12, 2023. Questions may be directed to Carol Ferenz, Conference Coordinator.

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The Finance & Reimbursement Committee would like to remind members that recipients of Federal Provider Relief Fund Phase 4 payments must report on the use of those funds by March 31, 2023.

Per the HRSA website, PRF Phase 4 is under the following timeframes:

  • Payments Received Period: 7/1/2021 – 12/31/2021
  • Period of Availability: 1/1/2020 – 12/31/2022
  • Reporting Time Period: 1/1/2023 – 3/31/2023

For further information, please visit the HRSA website.

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Photo by Christina @ wocintechchat.com on Unsplash

RCPA’s Behavioral Health Division committees and work groups are the foundation of our legislative and advocacy efforts on behalf of members. Member involvement in these groups provides unique perspectives on operational and service-level experiences that shape our positions and strategies.

There are larger bi-monthly Substance Use Disorder (SUD) and Adult and Children’s Mental Health Division meetings that include stakeholder updates and discussions. DDAP, OMHSAS, OCYF, and guest speakers from across the continuum of human services typically participate in these meetings. Additionally, we have several active specific work groups that include:

SUD Committees Adult MH Committee
Opioid Treatment Programs Adult Mental Health Steering Committee
Centers of Excellence 988/Crisis Services
SUD Regulatory Reform ACT Program
SUD Legislative Regulatory Reform
Children’s MH Committees Combined SUD/MH Committees
Children’s Steering Committee Telehealth
IBHS Work Group Criminal Justice
Children’s Residential Services Value-Based Purchasing
School-Based Behavioral Health ICWC/CCBHC
Early Intervention Workforce
Family-Based Services Ad Hoc Group

Several of the groups are open only to provider members, while others include any interested member. Participation in the groups is open to individuals that you feel best fit the needs of your organization. If you would like to participate in any of the committees or work groups, please contact your Behavioral Health Division Directors Jim Sharp or Jason Snyder. We look forward to collaborating with you in the future.

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