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Substance Use Disorder

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Last week, Governor Shapiro presented his proposed budget for 2024/2025. The PowerPoint with the Human Services Spending Overview outlines the priorities, and the recording is available on the DHS YouTube channel.

RCPA staff will continue to advocate for appropriate levels of funding for our members’ services in the community. We will keep you updated with information as the process continues. If you have any questions, please contact your RCPA Policy Director.

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RCPA is pleased to report several successful collaborative efforts this week, including a meeting with DHS, OMHSAS, and a delegation of House and Senate Representatives. We reviewed proposed language for a new bill that would address the 4 walls standard for ongoing telehealth with practitioners not within the 4 walls of a clinic. The bill will also include language previously introduced on the Psychiatric Outpatient Regulatory requirements for the 50% in-office time for clinics and the use of advanced practice professionals to meet those time requirements.

The language for both target areas was approved by all parties and will now move on to the House Human Services Committee. RCPA has a meeting scheduled for early next week to review the finalized version prior to its introduction. We have also met with Senate counterparts to support the measure.

Lastly, RCPA continues its dialogue with OMHSAS for guidance and clarification, including sharing members’ and stakeholders’ feedback. We have had the opportunity to speak with our BH-MCO members and understand OMHSAS Deputy Secretary Jen Smith will be meeting with that group and the county contractors on the processes moving forward.

We are hopeful for an expedited legislative solution that will aid OMHSAS in making any resulting policy, practice, or program changes that will support the initiative. We are extremely encouraged by the system’s efforts and focus this week and will continue to provide key updates to members and stakeholders.

If you have any questions, please contact RCP Policy Director Jim Sharp.

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The Department of Human Services (DHS) just announced that, due to reaching capacity in the February 9 meeting, they are adding a second session at 1:30 pm on the same day. If you are already registered for the morning session, do not register for the afternoon session so that they can keep enough space for all who are interested. Both sessions will be recorded and posted publicly to YouTube, and content will be roughly similar within the two sessions. DHS will share Question and Answer (Q&A) sessions from both, and a follow-up Q&A document will be shared next week.

Visit here to register for the afternoon session.

(If the registration link above does not work, please try copying this link directly into your browser: https://events.gcc.teams.microsoft.com/event/9f3d9e64-6d38-45a7-84eb-b0ae2b1aafd9@418e2841-0128-4dd5-9b6c-47fc5a9a1bde)

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The Pennsylvania Commission on Crime and Delinquency (PCCD) announces the opening of registration for the 2024 Criminal Justice Advisory Board (CJAB) Conference, themed “An Evolving Justice System: Adapting and Navigating New Directions.” The conference is scheduled for April 9 – 10, 2024, at the Penn Stater Hotel and Conference Center in State College. The event will convene criminal justice, behavioral health, and treatment partners for a dynamic one and a half-day gathering. Featuring a lineup of national and local experts, discussions will center on emerging issues impacting criminal justice and behavioral health systems, offering innovative strategies and collaborative solutions.

Registration and conference details are available on the 2024 CJAB Conference page on PCCD’s website. Additionally, notable sessions include a plenary by Jason Snyder, RCPA SUD Policy Director, on April 9, and a workshop on SUD confidentiality facilitated by RCPA, which will include representatives from the SUD treatment and criminal justice systems on April 10. Attendees should be aware that the discounted room rate deadline is Friday, March 8, 2024.

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The Pennsylvania Department of Human Services (DHS) is hosting a post-award forum regarding the federal Section 1115 Demonstration, which includes Medicaid coverage for out-of-state former foster care youth and substance use disorder (SUD) services. It will take place at 1:00 pm – 2:30 pm on Friday, March 8, 2024, via WebEx. The forum aims to gather public feedback on the progress of these initiatives, both of which were approved by the Centers for Medicare & Medicaid Services (CMS). The Former Foster Care Youth (FFCY) component allows Medicaid coverage for individuals under 26 who were in foster care in another state upon turning 18. The SUD component provides funding for essential SUD services, including residential care.

Register for the forum here. Written comments are also acceptable until the same date. For inquiries, contact Shivani Patel. Further details and the announcement can be found here. Please contact RCPA Policy Director Jim Sharp for any further questions.

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During this week’s budget presentation by Governor Shapiro, funding for mental health services was addressed as a priority for vulnerable Pennsylvanians. RCPA is working to review the preliminary funding recommendations listed below, and we hope to have greater line-item insight from DHS Secretary Arkoosh’s address this Friday.

Please note that registration is now open for the DHS 2024/25 Budget Briefing. You can register to view the briefing here. Additionally, the DHS House and Senate Budget Hearings will be March 5 and 6, 2024, respectively, and RCPA has been asked to provide questions for the testimony. The DHS budget book is available here.

Lastly, as part of our RCPA Mental Health Steering Committees and Work Groups, we will review recommendations as we develop our strategic budget advocacy campaign over the next several months in our meetings with stakeholders and legislators.

We offer the following as the initial review of yesterday’s budget presentation:

2024/25 Budget: Mental Health Program Recommendations:
This budget recommends the following changes: (Dollar Amounts in Thousands) for Mental Health Services

  • $20,000 — To replace nonrecurring prior-year carryover funding.
  • $5,750 — Initiative to expand diversion and discharge for individuals with mental illness currently in the criminal justice system.
  • $18,259 — To continue current programs.
  • $20,000 — To restore one-third of base funding to counties.
  • $3,443 — To replace federal funding received in 2023/24.
  • $5,000 — Initiative to maintain walk-in mental health crisis for COVID-19 response stabilization centers serving multiple counties.
  • $1,250 — To annualize prior-year expansion of home and community-based services.
  • $1,600 — Initiative to provide home and community-based services for 20 individuals currently residing in state hospitals.
  • $305 — To annualize prior-year expansion of diversion state hospitals and discharge programs.
  • $10,000 — Initiative to provide support to the 988 network for mental health services.
  • $85,607 — To increase appropriations.

School-Based Mental Health
This year, the Shapiro Administration looks once more to address the needs of student mental health with a $100 million investment. This new set of funds comes on the heels of $90 million recently allocated to schools, with monies originally set aside for adult mental health services targeted through the now defunct 2022 Behavioral Health Commission.

The funding mechanism for the distribution of these funds has yet to be determined if it is approved by the General Assembly. The last two rounds of school-based mental health funding have been allocated to individual districts through noncompetitive grants. The concerns have been that the funds, if not earmarked for the development of service delivery pathways, will go to building staff infrastructure in the form of social workers. While there are advantages to having these professionals in the buildings, they alone cannot address the student needs for assessment and treatment services

RCPA supports the funding being designated through the schools but will work with legislators to encourage developing a coordinated system of care coupled with a longer-term financial strategy with the schools, community-based providers, Student Assistant Programs (SAP), and county involvement in SAP coordination.

Early Intervention Services
As part of our initial budget discussions with OCDEL, we were concerned that there would not be an interim rate increase for 2024/25 as we work through the new Early Intervention rate methodology. We see in the budget that there is an increase of $16 million, nearly 9% over last year’s number. It is also projected that more children and families will be served in this coming year, and we will work with the administration to, at a minimum, continue to fund the ARPA-supported 3% increase from over the last three years.

County Child Welfare
It is projected that the County Child Welfare budget will essentially be flat, with less than a 1% increase. As the child welfare systems await the DHS Blueprint recommendations on addressing the extensive number of services for youth with complex care, especially those in congregate care, it was surprising there was not a designated funding allocation to support this initiative. This remains a priority to fund these programs.

County-Based Mental Health Funding
It was disappointing that the Shapiro Administration failed to deliver on last year’s “down payment” of the 2022/23 allocation of $20 million towards the county base. Up until last year, the county-based mental health system has gone more than a decade without a base rate increase. Last year’s $20 million represented only a 3% increase over the 2022/23 base funding. This year’s $20 million will equate to less.

We will continue, as part of our advocacy strategy, to support an allocation that is projected to be in the neighborhood of $1.2 billion to create a sustainable platform for county-based mental health service delivery.

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Today, Governor Josh Shapiro gave his second budget address to members of the General Assembly.  The Governor outlined an agenda that included new spending for direct service providers, minimum wage, education, health care, law enforcement, and a number of other initiatives. The below budget initiatives come from information from the Governor and his team, which has been made available to stakeholders. The budget proposals include:

Investing in Competitive Pay and Reimbursement of Services for Home & Community-Based Care

  • Increase in minimum wage to $15/hr.
  • $34.2 million in Community Waiver and $1.85 million in the Community Base Program, which will allow DHS to expand the number of individuals participating in home and community-based services programs.
  • Reimbursement Rates: The 2024/25 executive budget invests $213 million toward Community Waiver Program, $2.1 million in the Autism Intervention Program, and $1.1 million in the Community Base program. It also leverages $266 million in total federal funding to increase resources for providers of home and community-based services.
  • Equality in Communication Services: Inclusivity and equality require appropriate communication for Pennsylvanians with intellectual disabilities and/or autism who need it. This budget invests $934,000 to add American Sign Language and English interpreter services to program serving this population.
  • For more in-depth information regarding funding for ID/A services, visit here.

Making Pennsylvania a Leader in Economic Development, Job Creation, and Innovation

  • $500 million in PA SITES funding to bring more commercial and industrial sites online and ensure companies have options for attractive business environments where they can move quickly and thrive in Pennsylvania.
  • $25 million for the Main Street Matters program, to support small businesses and commercial corridors that are the backbone of communities across our Commonwealth.
  • $20 million to support large-scale innovation and leverage Pennsylvania’s best-in-class research and development assets.
  • $3.5 million to create and launch the Pennsylvania Regional Economic Competitiveness Challenge, which will incentivize regional growth, build vibrant and resilient regions, and support communities by investing in the development of comprehensive strategies to propel entire regions forward.

Building on Historic Education Investments & Making Progress to Support Every Pennsylvania Child

  • A historic nearly $1.1 billion increase in basic education funding — the largest increase in Pennsylvania history, recognizing the work of the BEFC and the need to direct these investments to the schools that need them the most. Of this significant increase, nearly $900 million is proposed as a first-year adequacy investment as recommended by the BEFC. The remaining $200 million will be distributed through the Basic Education Funding Formula.
  • A $50 million increase for special education funding to ensure school districts have the basic resources necessary to provide special education services to students with disabilities and special needs.
  • A $50 million annual investment in school safety and security improvements and $300 million in sustainable funding for environmental repair projects in school buildings.
  • $10 million for the Educator Talent Recruitment Account and $450,000 to support the Talent Recruitment Office at the Pennsylvania Department of Education.
  • A $5 million increase — coming to a total of $15 million — in funding for student teacher stipends to support Pennsylvanians training to become certified and committed educators.

Delivering a New Blueprint for Higher Education Grounded in Access & Affordability

  • $975 million in this new governance system that combines our community colleges and PASSHE schools — a 15 percent increase from $850 million last year in state investment in state-owned universities, community colleges, and the students they serve.
  • A 5 percent increase in institutional support for the Commonwealth’s state-related universities — Penn State, Temple, Lincoln, and Pitt — and a 15 percent increase to Thaddeus Stevens College of Technology.
  • An increase in financial aid for students who attend the schools under the new governance system, so that Pennsylvanians making up to the median income will pay no more than $1,000 in tuition and fees per semester.
  • An increase in financial aid for students who attend the schools under the new governance system, so that Pennsylvanians making up to the median income will pay no more than $1,000 in tuition and fees per semester beginning in FY 2025/26.
  • Increasing Pennsylvania Higher Education Assistance Agency (PHEAA) state grants by $1,000, bringing the maximum award up from $5,750 to $6,750 beginning in FY 2025/26.
  • Investing $279 million annually starting in FY 2025/26 so Pennsylvania students can attend college in-state with a limited debt load after they graduate and can enter the workforce ready to start their careers and build a future in our Commonwealth.

The above are highlights of the Governor’s proposed budget. RCPA will be examining the budget spreadsheets over the next few days, will be attending the DHS Budget Overview this Friday afternoon, and will update members with any new information as it becomes available during the budget season.

If you have any questions, please contact Jack Phillips.

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Secretary Val Arkoosh and leadership from the Department of Human Services (DHS) will host a webinar to discuss the proposed 2024/25 budget for the department. The briefing will take place at 10:00 am on Friday, February 9. If you are unable to attend, the briefing will be recorded and available for viewing afterwards.

Visit here to register for the briefing. DHS encourages individuals to submit questions ahead of the briefing so they can prepare as much information as possible. The Departments will follow up on any questions that they are unable to answer during the webinar.

(If the registration link above does not work, please try copying this link directly into your browser: https://events.gcc.teams.microsoft.com/event/3049c317-17f6-46ab-8396-1e5f3a370422@418e2841-0128-4dd5-9b6c-47fc5a9a1bde)

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