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Substance Use Disorder

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By Robert Swift
Staff Writer

HARRISBURG (July 28) – The COVID-19 pandemic will present mental health challenges for years to come even after the immediate health dangers have passed, a deputy secretary for the state Department of Human Services told a House committee Tuesday.

“Our office is among thousands of behavioral health entities across the country that believe behavioral health needs created by this pandemic will be much longer lasting than the health crisis,” said Kristen Houser overseeing the Office of Mental Health and Substance Abuse. “We fully anticipate to feel and treat the impact of COVID-19 for the years to come.”

Houser’s assessment came during a hearing by the Human Services Committee on the pandemic’s impact on mental health. The committee also heard testimony from academics, county mental and behavioral health officials and service providers.

She said the pandemic has led to isolation and created feelings of helplessness, hopelessness, anxiety, fear of the unknown and unresolved grief that can have a negative impact on behavioral health in the form of depression, substance abuse and even suicide.

Pennsylvania could see a jump in Medicaid enrollment ranging from 1.2 million to 1.34 million depending on different scenarios involving unemployment and the recovery, according to a preliminary report in April from the Medicaid Research Center at the University of Pittsburgh that Houser cited.

“These new enrollees may pose a significant influx of people seeking Medicaid-supported behavioral healthcare in the coming year,” said Houser.

The pandemic has led providers to use “telehealth” with the help of relaxed rules to address mental health issues instead of personal visits to an office.

“We are both faced and facing exacerbations of the problems that plague our mental health system before COVID, including lack of care due to closure of clinics, closure of crisis services, lack of access to hospital beds,” said Dr. Erika Saunders, chair of Penn State Health’s Department of Psychiatry and Behavioral Health. “The telehealth waiver has been enormously helpful, however we still struggle because many patients do not have access to the technology or internet/cellular service to use technology for telehealth.”

Telehealth has been convenient for elderly patients, but hasn’t worked well for sessions with young children and children with autism under age six, said Paul Denault, president of Northern Tier Counseling Inc. The lack of broadband and cell phone service in rural areas has been a major problem, he added.

“I think we are going to be bombarded,” said Denault referring to demand for services after the crisis is over.

Several of those testifying spoke of the challenges facing workers in the mental health field worried about providing care while also worried about the risk of getting infected themselves or infecting their families.

“Our essential workers wake up every day knowing that not going to work could pose a serious risk to their health and yet staying home could mean forgoing a paycheck,” said Cherie Brummans, CEO of The Alliance of Community Service Providers. “We say that we support and admire essential workers, and yet providers are not reimbursed enough to substantially increase the amount of money that we pay these employees.”

Several testifiers urged that mental health workers receive priority in getting COVID-19 tests and prompt test results and personal protective equipment.

Houser said that Act 24 of 2020 — a state law distributing federal CARES Act money to counties — didn’t specifically allocate funding for behavioral health care providers.

Rep. Tarah Toohil, R-Luzerne, said Act 24 distributes millions of dollars to counties. She urged care providers to contact county officials to secure a share of that money.

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If you have any questions, please contact RCPA Mental Health Division Director Sarah Eyster or Children’s Division Director Jim Sharp.

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Pennsylvania’s DRAFT Workforce Innovation and Opportunity Act Performance Reporting Policy is posted on the Pennsylvania Department of Labor & Industry website for public review and comment. Public comment is open through Friday, August 14, 2020 at 12:00 pm. Please submit comments via email.

This policy identifies the Workforce Innovation and Opportunity Act, or WIOA, primary indicators of performance, and how they apply to the programs delivered under WIOA titles I and III. This policy establishes procedures for local workforce development boards to negotiate and reach agreement with the commonwealth on LWDA levels of performance for the primary indicators of performance for Title I and Title III. This is a new Pennsylvania workforce system policy.

Should you have any questions or concerns regarding this correspondence, please contact the Bureau of Workforce Development Administration Policy Coordination Unit. Comments received during this period will be addressed before the policy is finalized, published, and placed into effect.

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As part of RPCA’s ongoing effort with members and stakeholders regarding the Alternative Pay Arrangements/Agreements (APA), we are asking members to complete this APA Survey.

We understand that these may look different across our membership, so we have requested input and feedback from the BH-MCOs in the development of the survey questions.

We respectfully request that one survey be completed for each of those program areas if the APAs differ across your service continuum. The data we collect will be instrumental in our collective efforts with DHS, and managed care organizations, regarding strategic fiscal considerations in the coming months.

We request the surveys be completed by August 7, 2020. Thank you, and if you have questions, please contact RCPA Children’s Division Director Jim Sharp or your RCPA Policy Director.

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On July 24, 2020, Senator Casey hosted a Virtual Disability Employment Summit. The Summit included conversation with APSE, OVR, and employment support providers to examine the impact of the novel coronavirus (COVID-19) health crisis on disability employment, as well as discussing strategies to improve the disability employment rate and ensure people with disabilities are able to return to work.

The full recording of the Summit with ASL or Closed Captioning is available on the Senator’s web page. If you have trouble loading the video on the website, you may need to clear your browser’s cache or restart it. Alternatively, you can view the Summit on Senator Casey’s Facebook page. You can find additional resources about the topics discussed on the Senator’s web page as well.

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The Department of Community and Economic Development has posted Frequently Asked Questions for the COVID-19 Hazard Pay Grant Program.

Additional details about the program, including eligible applicants, eligible industries, and instructions on how to apply can be found in the program guidelines, which can be accessed on the COVID-19 PA Hazard Pay Grant web page.

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On March 6, 2020, Governor Tom Wolf issued a Proclamation of Disaster Emergency (“the Disaster Proclamation”) to enable agencies to respond promptly to address the 2019 Novel Coronavirus (COVID-19) pandemic. With the Governor’s authorization as conferred in the Disaster Proclamation, on March 30, 2020, DHS announced that it “will not be conducting any annual licensing inspections until Governor Wolf lifts the current Proclamation of Disaster Emergency for COVID-19 or until such other time set by DHS” to support the Commonwealth’s efforts to prevent transmission and spread of COVID-19. In doing so, DHS suspended 62 P.S. §§ 911(a)(2) and 1016, to the extent those statutory provisions may be interpreted to require annual on-site visits, and the regulation at 55 Pa. Code Ş 20.31 (relating to annual inspection), which explicitly requires that DHS conduct an “on-site inspection of a facility or agency at least once every 12 months.”

DHS is responsible for enforcing licensing regulations intended to protect the health and safety of people who are served in licensed settings. Enforcement is primarily achieved by conducting annual on-site inspections of each setting to ensure that the licensee is in full compliance with all applicable regulatory) requirements. Regulatory requirements are applied and enforced by the following DHS program offices:

  • Office of Child Development and Early Learning (OCDEL)
  • Office of Children, Youth and Families (OCYF)
  • Office of Developmental Programs (ODP)
  • Office of Long-Term Living (OLTL)
  • Office of Mental Health and Substance Abuse Services (OMHSAS)

DHS remains committed to preventing and containing the spread of COVID-19. As the Commonwealth reopens in accordance with the Governor’s Process to Reopen Pennsylvania, DHS has resumed annual on-site inspections of licensed settings.

To balance the need to contain the COVID-19 virus with the responsibility for regulatory oversight and enforcement of licensed settings, DHS may apply alternative techniques for annual inspections that do not require an on-site presence in the licensed setting and when an in-person presence in the facility may contribute to the spread of COVID-19, e.g., a participant, consumer, or staff person has tested positive or is suspected to have COVID-19 in the past 21 days.

Alternative techniques include, but are not limited to, the use of videotelephony and file-sharing applications that will allow for real-time observations of conditions at the licensed setting. Use of these techniques will ensure that regulatory compliance is maintained in a manner that does not contribute to the spread of COVID-19.

Additional information regarding the application of these techniques for annual inspections will be communicated to the field by DHS program office before the inspections takes place.

This suspension will remain in place only while the Disaster Proclamation remains in effect or such other time as DHS directs. DHS will continue to conduct complaint, incident, and protective services investigations on-site.

Please contact your regional licensing office for any questions.

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