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Substance Use Disorder

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On June 14, 2021, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) resubmitted to the Independent Regulatory Review Commission (IRRC) its Final-Omitted Regulations on Standards for Drug and Alcohol Recovery House Licensure. As of yesterday afternoon, they are publicly available on IRRC’s website.

The submitted regulatory package includes:

  • the updated regulations (p. 49–78);
  • a regulatory analysis (p. 1–11);
  • a preamble that includes public comments and DDAP response to comments (p. 13–48);
  • a sample recovery house licensing application (p. 79–80);
  • a sample recovery house licensing checklist (p. 81–88);
  • additional DDAP forms (p. 89–101); and
  • a description of forms that must be provided by the recovery house (p. 102–112).

DDAP expects that the new regulations will be in effect by July 2021 and will require compliance with the new regulations by January 2022. More information on drug and alcohol recovery house licensing is available on DDAP’s website.

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Message from the Department of Human Services:

As you may know, the American Rescue Plan of 2021 (ARP) provides a temporary 10% increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS). The funding must be used to enhance, expand, or strengthen HCBS beyond what is available under the Medicaid program as of April 1, 2021.

On Monday, June 14, the Department of Human Services (DHS) submitted a preliminary spending plan to the Centers for Medicare & Medicaid Services (CMS) that serves as a foundation for Pennsylvania’s planning efforts by outlining our principles and overarching priorities. The preliminary plan encompasses many of the stakeholder recommendations that have been made to date. The overarching priorities include:

  1. Increasing access to HCBS;
  2. Enhancing HCBS provider payment rates and benefits;
  3. Protecting the health and well-being of direct care workers and direct support professionals through the provision of supplies and equipment;
  4. Recruitment and retention efforts to support the workforce;
  5. Supporting caregivers;
  6. Assistive technology and other supports to improve functional capabilities of persons with disabilities;
  7. Supporting the transition of individuals to community-based living arrangements;
  8. Investing in activities to address Mental Health and Substance Use Disorder treatment and recovery needs of Medicaid beneficiaries; and
  9. Building HCBS capacity and rebalancing Long-term Services and Supports.

With these priorities in mind, we hope to hear more from stakeholders about Pennsylvania’s efforts as we continue to flesh out the details of our plan to strengthen, enhance, and expand HCBS. Comments must be submitted by close of business on July 6.

Please visit the public comment overview as well as Pennsylvania’s preliminary spending plan for further information. Your comments can be submitted via email. Additionally, a live virtual public comment session will take place on Wednesday, June 30 at 10 am for those who are unable or prefer not to submit written feedback. More information about how to RSVP for this session will be available soon.

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On June 11, 2021, the Department of Health and Human Services issued a document titled “Provider Relief Fund General and Targeted Distribution: Post-Payment Notice of Reporting Requirements” to notify Provider Relief Fund (PRF) recipients of the data elements and deadlines that constitute the post payment reporting process. The June 11 PRF requirements establish:

  1. the deadlines by which recipients are required to use or return funds, and
  2. the deadlines by which recipients must submit a report on use of funds.

The previous PRF guidance, titled “General and Targeted Distribution: Post-Payment Notice of Reporting Requirements,” was released on January 15, 2021 and is superseded by the June 11 guidance. Principle differences between the guidance are:

  1. Updated Reporting Times
  2. Updated Payment Use Periods
  3. Reporting Requirement Changes

Please see the document provided to us by ANCOR for the information.

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As you may know, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) has issued three temporary regulatory suspensions under authority granted by the Governor’s declaration of a disaster emergency due to the coronavirus pandemic. Based on flexibilities granted by the Substance Abuse and Mental Health Services Administration (SAMHSA), DDAP’s goal with these suspensions was to respond to the extraordinary circumstances of the last year by allowing entities regulated by DDAP to continue operating throughout the uncertainty of the pandemic.

On June 10, 2021, the General Assembly passed House Resolution 106, which terminated the Disaster Declaration in whole, effective immediately. However, Governor Wolf signed Act 21 of 2021 on June 11, 2021 to ensure regulatory and statutory suspensions enacted under the Disaster Declaration would continue. Act 21 extends all of the regulatory and statutory suspensions authorized under the Disaster Declaration until September 30, 2021. More information on Act 21 is outlined in this press release from the Governor.

In the table below, you will find the three regulations in which DDAP suspended utilizing the Disaster Declaration. DDAP would like to reiterate that these suspended regulations will continue to be in place until September 30, 2021.

 

Statute/Regulation Statute/Regulation Purpose Waiver benefit/explanation
28 Pa. Code § 715.16(e)

 

 Prohibits narcotic treatment programs (NTPs — methadone clinics) from permitting a patient to receive more than a 2-week take-home supply of medication. In response to COVID-19, SAMHSA is allowing up to 28 days of take-home medications for patients on stable dosages, if the physician deems appropriate.

 
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 buprenorphine treatment. In response to COVID-19, SAMHSA is allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth.
28 Pa. Code § 715.6(d) Requires NTPs to have narcotic treatment physician services onsite. In response to COVID-19, SAMHSA is allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth.

 

In the coming weeks, DDAP will continue to work with SAMHSA and solicit feedback on the best way to move forward with these suspended regulations to ensure that the drug and alcohol treatment field is able to provide necessary services to patients in the safest, most effective way possible.

Thank you all for your continued work to help better the lives of Pennsylvanians with substance use disorder. If you have any further questions, please do not hesitate to reach out to the Bureau of Program Licensure, Division of Licensing Inspection at (717) 783-8675 or via email.

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