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Substance Use Disorder

In recent years, the Office of Mental Health and Substance Abuse Services (OMHSAS) had received concerns regarding the Bureau of Children’s Behavioral Health Services (Children’s Bureau). Four major themes emerged from this feedback relating to communication, regulations and policy, operational consistency, and system partner engagement. Last spring, OMHSAS engaged Mercer Consulting to conduct a study of the Children’s Bureau that included three two-hour focus groups with OMHSAS system partners, including representatives from RCPA. The primary goal of the review was to identify ways in which OMHSAS can improve internal operations as well as communication and collaboration.

On Tuesday, Deputy Secretary Dennis Marion shared both an executive summary of the Mercer Independent Study as well as his description of the steps forward that OMHSAS has initiated in response to the concerns and findings. The action items outlined by Deputy Secretary Marion are:

  • Review and consolidation of regulations related to Behavioral Health Rehabilitation Services (BHRS). OMHSAS will engage with stakeholders to draft regulatory changes with the expectation that proposed BHRS regulations will be released for public comment in mid-2017.
  • Strategic reorganization of OMHSAS leadership. On March 7, Shannon Fagan joined OMHSAS as Children’s Bureau director, and Sherry Peters became director of the Bureau of Policy, Planning, and Program Development.
  • Organization-wide effort to improve consistency and quality. Moving forward, OMHSAS senior staff will focus on identifying areas of potential improvement, developing strategies to strengthen internal and external processes, promoting an organizational culture of collaboration, coordination, communication, and cohesiveness, and monitoring progress towards addressing the concerns voiced by OMHSAS stakeholders.
  • Emphasis on family and stakeholder engagement. The involvement of PACA, RCPA, BH-MCOs, and their contractors, played an integral role in working to identify issues of concern.
  • A redefining of “customer service.” To address concerns relating to responsiveness and professionalism, internal meetings have been held to stress the importance of holding OMHSAS staff to high standards of customer service.
  • Renewed focus on communications. In response to concerns regarding effectiveness of internal and external communications, Shanna Klucar was appointed as executive assistant to the deputy secretary on January 30.

OMHSAS invites RCPA members and other stakeholders to share comments and concerns regarding Children’s Behavioral Health Services to Shannon Fagan, bureau director, as well as the RCPA Children’s Division. In addition, members may contact OMHSAS leadership Sherry Peters and Shanna Klucar with more general comments and concerns.

The Department of Human Services (DHS) Medical Assistance Online Provider Enrollment Application information is now electronic, online, and available to provider organizations. The improvements and modernization of the PROMISe system have been strongly encouraged by RCPA and a significant goal of DHS. Some of the benefits of online enrollment application submissions are:

  • Allowing documents that previously had to be mailed or faxed to be uploaded directly to the portal;
  • Permitting providers see the status of their submissions; and
  • Decreasing wait time to review applications.

The information you will need to submit an application for enrollment:

  • Access the online enrollment application
  • Review the training guide
  • Review the frequently asked questions document for important clarifications
  • A “Help” feature is available at any time during the completion of an application
  • Supplemental Services require the Behavioral Health Managed Care Organization to attest that a provider is credentialed

RCPA has been advocating for years for significant changes to the Mental Health Outpatient regulations to help to protect and strengthen mental health outpatient services in Pennsylvania. In 2010, RCPA developed a position paper outlining the major problems in this area. In response to this crisis, the Office of Mental Health and Substance Abuse Services (OMHSAS) developed a task force to work on regulation changes. The task force was a broad range of stakeholders which included consumers, counties, providers, and behavioral health managed care organizations. The task force worked for several years to develop a new set of regulations intended to protect and strengthen mental health outpatient services. The job of the task force was complete in 2014 and OMHSAS submitted the revised regulations to internal sources for approval. From beginning to now, it has been six years since we requested help. OMHSAS responded with strong support but the regulations have been held up in various areas of the department and the administration.

We received the following email today from Jean Rush, who has been the lead at OMHSAS since the beginning of the project:

“I wanted to share the current status of the OP regulation package since we drafted the revisions. With the expansion of Medicaid, the department has made changes to our State Plan Amendments for compliance with ACA which have been approved by CMS. This will require some minimal changes to the OP regulation package which were not an issue during our work.

OMHSAS will be making the minimal changes to the regulation package in conjunction with the Office of Medical Assistance Programs (OMAP) as the Medicaid Authority for the Commonwealth, as well as our Office of Legal Counsel.

The changes will not impact your recommendations but are necessary for compliance and the ability to complete the IRRC review. We will share the changes with you via email and if there are any areas where input is needed, I will be contacting you to schedule a call to discuss.

We appreciate all of the time and dedication to this project and will continue to work on making the changes to move this regulation package to completion. It is still a priority for the department.”

RCPA is hopeful that a resolution is forthcoming and will keep you all posted.

Time is running out; the deadline for revalidating is Thursday, March 24, 2016. Numerous RCPA members have already gone through this process, but it appears that large numbers of providers have not yet done so. A special provider revalidation webinar will be held by RCPA on Wednesday, January 6 at 10:00 am. Jamie Buchenauer, from the Department of Human Services, will be presenting the webcast.

This article from Capitolwire is a good and extensive overview of what is going on with the budget here in Harrisburg. Health and Human service budget line items are still fluid until the House and Senate negotiate a final budget deal. RCPA will provide updates on any budget deal, and RCPA encourages members to continue to contact the governor and state legislators to inform them why it’s necessary for them to pass a state budget sooner rather than later. Questions, contact Jack Phillips.

The Department of Drug and Alcohol Programs (DDAP) is concerned about the rise in hepatitis C cases in Pennsylvania (PA), particularly among persons who inject drugs (IDU).  The Centers for Disease Control and Prevention recommends hepatitis C virus (HCV) testing for those who currently inject any type of drug (Opioids, Methamphetamine, Cocaine, etc.) or have injected drugs in the past, including those who injected once or a few times many years ago.  PA has experienced a dramatic increase in hepatitis C infections in individuals with injection opioid and/or heroin addiction who are 18 to 35 years of age.  DDAP recommends that all licensed drug and alcohol addiction treatment facilities perform a risk assessment for HCV and refer to medical or community based providers for necessary screening/testing as appropriate.

 

Because many individuals you serve are at high risk for hepatitis C, you play an important role in combating this public health issue.  If you have current practices that you believe are effective in combating this disease, we would appreciate you sharing these with us so we can promote them across the field.  Please send this information to DDAP Treatment, Prevention & Intervention Bureau Director, Angela Episale, at [email protected].   

 

Through improved identification and treatment of individuals with hepatitis C, we can begin to reduce the spread of this disease.  Please remember to obtain consumer consent and maintain confidentiality when sharing test results with the consumers’ primary care physicians or other physical health specialists involved in hepatitis treatment.  In some cases, you may be able to utilize a Qualified Service Organization Agreement (QSOA) to permit the exchange of patient identifying information.  If you have questions about when this is possible, please contact our Division of Licensing Acting Director, Gary Stauffer, at [email protected].

 

For more information regarding hepatitis C testing of IDU clientele, please contact:

 

Charles Howsare, MD, MPH

Viral Hepatitis Prevention Coordinator

PA Department of Health

717-787-3350

[email protected]

 

Thank you for your critical assistance in controlling hepatitis C in PA.

 

Contact Person: Angela Episale, 717-736-7438

The Office of Children, Youth and Families (OCYF) has compiled the responses from the survey conducted on the Child Protective Services Law (CPSL). Many of the questions that were posed in response to the survey are answered through the following handouts, as well as on the state’s CPSL website. Members are strongly encouraged to review the website and handouts.

The OCYF is coordinating with Bureau of Human Services Licensing to host a webinar for providers in November, in order to address questions on CPSL and provide further clarification. Additional details for this webinar will be available in the near future. After your organization has reviewed the materials provided, please send any additional, unanswered questions you may have to Nicole Good at OCYF by Friday, October 9, 2015. These questions can then be addressed during the webinar.