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Substance Use Disorder

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Message from Rep. Dan Williams’s Office:

HARRISBURG, June 24 – Bipartisan legislation introduced by state Rep. Dan Williams, D-Chester, that would help Pennsylvanians take advantage of new federal Medicaid rules that give patients and clinicians more telehealth options for behavioral health services passed the PA House today with overwhelming support.

“The longstanding and outdated ‘four walls’ requirement has limited Medicaid reimbursement to services within the physical walls of a clinic,” said Williams. “This only creates barriers to care, particularly in rural areas and regions experiencing mental health workforce shortages.”

The Centers for Medicare and Medicaid Services gave states the option to waive the requirement on Jan. 1. In response, the Pennsylvania Department of Human Services has submitted a State Plan Amendment to adopt this flexibility, which is currently awaiting federal approval.

House Bill 1590 would repeal state regulations that conflict with the new federal flexibility. Importantly, the bill would not change existing rules requiring in-person treatment hours for outpatient behavioral health clinics.

“Under this bill, Pennsylvania can fully implement the change, expanding access to behavioral health services and reducing care gaps for our vulnerable populations across the Commonwealth,” Williams said.

The bill now moves to the state Senate for consideration.

It is important to note that, at this time, OMHSAS is awaiting approval from CMS. To address the Federal Medicaid payment conditions in the Pennsylvania statute, there was a need for this legislation to permit services be covered under Medicaid, and HB 1590 would achieve this. It is also important to reiterate that this bill will not change outpatient behavioral health clinic rules requiring in-person treatment hours. The passage of this bill will address these conditions for outpatient clinics as well as the delivery of SUD services.

Both the CMS SPA approval and the legislation would be retroactive to January 1, 2025.

Until then, the completion of both the SPA and the legislation on 4 walls flexibilities will remain in place. RCPA is grateful to have partnered with OMHSAS, House legislators, and other stakeholder associations on the development of this bill. We will continue our efforts in getting the legislation to the Governor’s desk.

If you have any questions, please contact RCPA COO and Director of Mental Health Services Jim Sharp.

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African Woman Filling Survey Poll Or Form On Laptop Computer

The Pennsylvania Insurance Department, in partnership with the Department of Health (DOH), the Department of Human Services (DHS), and the Department of Drug and Alcohol Programs (DDAP), is conducting a Women’s Health Survey to better understand the health experiences and coverage needs of women across the commonwealth.

The survey is open through July 7, 2025, and takes 10 minutes or less to complete. It is designed to capture voices from all backgrounds — including women impacted by substance use disorder — so the administration can better identify and address gaps in care, coverage, and support.

Providers are asked for their help in sharing the survey by posting the flyer in their facilities and promoting the survey link on their social media or publishing the link in newsletters. All responses are anonymous and will help inform future outreach, programming, and policy decisions.

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Drexel University’s Division of Behavioral Healthcare Education will virtually host its 33rd Annual Forensic Conference, “Contemporary Issues Impacting Forensic Services,” which will be held December 10 – 11, 2025.

Proposals for workshops are now being accepted. The conference committee is also accepting nominations for the Forensic Rights and Treatment Conference Award.

Applications are due by August 29, 2025.

Contact Yolanda Ramirez with questions.

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Cooling centers are designated locations with air conditioning where people can go to escape the heat during extreme temperatures. They are typically open during the hottest parts of the day and offer a cool environment, water, and sometimes other support services.

Types of locations that typically serve as cooling centers during a heatwave include:

  • Senior centers;
  • Libraries; and
  • Other community spaces.

Please call PA 211 or visit the Search Pennsylvania 211 website for more current and up-to-date information.

Additional resources about cooling centers:

Please note:

This is not an all-inclusive list. There are more cooling centers than those listed on the PA211 map link.

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A new Center for American Progress (CAP) analysis estimates that if H.R. 1 were to become law, more than 1.6 million Medicaid-expansion enrollees receiving SUD treatment would become uninsured. Although these estimates reflect the House-passed bill, the Senate’s more extreme Medicaid cuts could cause even greater coverage losses and disruptions to care.

KFF developed a table that provides a summary comparison of Medicaid provisions, including details on work requirements, in the House and Senate budget reconciliation bills.

The reconciliation legislation still needs to pass the Senate, and the House and Senate will need to reconcile any outstanding differences. President Trump expects to have the reconciliation bill on his desk for signing by July 4.

The bulk of those coverage losses would come from the bill’s proposed burdensome work-reporting requirements on adults enrolled in Medicaid through the Affordable Care Act’s expansion option. Specifically, the bill would require nonpregnant, nondisabled, non-caregiver adults ages 19 to 64 to document at least 80 hours of work per month or other qualifying activities (such as job training or volunteering) in order to maintain their Medicaid coverage. Individuals unable to meet the requirement would risk losing coverage. The Senate Finance Committee text goes even further, eliminating the exemption and requiring compliance from parents with children older than age 14.

Though the bill includes an exemption for individuals with SUD from work-reporting requirements, it remains unclear how states would implement or enforce that exemption.

CAP estimates that the states with the largest coverage losses among Medicaid enrollees being treated for SUD include California (nearly 170,000), New York (nearly 166,500), Ohio (134,500), and Pennsylvania (nearly 118,000). These coverage losses reflect the size of each state’s Medicaid expansion population as well as each state’s rate of SUD treatment take-up among people with Medicaid.

Medicaid is the largest payer of behavioral health services in the United States, including for SUD treatment. According to the latest available data, Medicaid covered nearly 60 percent of all national spending on SUD treatment in 2019 — accounting for $17 billion out of the $30 billion spent across all payers.

ACA improved SUD treatment access by making SUD services one of ten essential health benefits that nearly all insurers are required to cover. The ACA also allowed states to expand Medicaid eligibility to adults with incomes up to 138 percent of the federal-poverty level, providing millions of previously uninsured low-income adults with access to life-saving SUD treatment.

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SUD Workforce Trends in Pennsylvania: Strengths and Opportunities for Improvement
Free RCPA Members-Only Webinar

Tuesday, July 22, 2025
11:00 am – 12:00 pm
Register Here

The U.S. faces critical behavioral health workforce shortages, with HRSA projecting a 49% increase in demand for care alongside an 11% decrease in available clinical professionals. These shortages are particularly pronounced in the SUD workforce regarding access to essential treatments. Inevitability, workforce challenges impact patients, who may encounter restricted access in underserved areas and compromised care quality.

Shatterproof Treatment Atlas has collected data on SUD treatment delivery from over 4,500 facilities. This data offers insights into staff composition, clinical focus, and training, aiding efforts to strengthen the SUD workforce and ensure positive patient outcomes.

This workshop also analyzes SUD workforce trends in Pennsylvania and other states. Participants will engage in discussions on workforce challenges, existing models, and innovative solutions to support staff in delivering high-quality SUD care.

Presenter:
Lisa Kugler, PsyD, Senior Vice President, Shatterproof Treatment Atlas

Objectives: Following this course, the learner will:

  • Explore staffing trends across Pennsylvania SUD treatment sites to understand areas of strength and opportunities for improvement;
  • Analyze and compare Pennsylvania SUD treatment staffing against other states to understand progress at the local and multi-state levels; and
  • Evaluate potential solutions to support and enhance SUD treatment staffing in Pennsylvania based on available data and their own experiences in the field.

Certificates of attendance are available to RCPA members who attend this webinar; anyone interested in a certificate should contact Cathy Barrick. To apply for CEs, you will need to register for the RCPA Annual Conference Strive to Thrive and indicate you attended the webinar in your CE packet, which will be made available on the mobile app.

Contact Carol Ferenz, Conference Coordinator, for details, or visit the RCPA Conference website for information on workshops, sponsors, exhibitors, and more!

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The Mental Health Safety Net (MHSN) Coalition is a group of stakeholders participating in a joint advocacy effort to protect and preserve our mental health service delivery system. The Coalition’s third advocacy letter addresses the need for funding for county mental health services for adults in Pennsylvania. The full letter can be read here.

RCPA invites all members, non-members, and systems-wide behavioral health stakeholders to participate in the Mental Health Safety Net Coalition meeting on Monday, June 23, 2025, from 2:30 pm – 3:00 pm. This meeting will serve to update the group on strategy, activities, and engagement opportunities.

Please contact Emma Sharp with any questions or if you would like to join the Coalition.

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The House Energy & Commerce Committee will hold a hearing on June 24, 2025, regarding the Department of Health and Human Services’ (HHS) fiscal year (FY) 2026 budget. The hearing will begin at 10:00 am, and Secretary of HHS Robert F. Kennedy, Jr. is expected to serve as witness and provide testimony on the President’s proposed budget.

The hearing is open to the public and will be livestreamed online using the link above.

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OMHSAS is announcing the publication of OMHSAS-25-03 Administration of Psychotropic Medication to Individuals Over Objection in State Mental Hospitals, updating the procedures for determining when to administer psychotropic medications over objection in the State Mental Hospitals through the establishment of an additional appeals process.

OMHSAS-25-03 supersedes 99-85-10 Administration of Psychotropic Medication to Protesting Patients, meaning that 99-85-10 remains in effect, but OMHSAS-25-03 takes precedence over it.

**Importantly, 99-85-10 applies to both state mental hospitals and community providers, but OMHSAS-25-03 applies only to state mental hospitals.**

OMHSAS-25-03 and forms may be found at the links provided below:

 

Please submit any questions regarding this bulletin via email.

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